Sex Addiction

Sex addiction is a condition characterised by a compulsive engagement in sexual activity, regardless of any negative consequences that this may have for an individual’s physical and mental health and life circumstances. People suffering from sex addiction are obsessed with sex and related matters; thinking about, planning, seeking out and actually having sexual intercourse take up most of their time, often to the exclusion of important and/or previously valued activities, responsibilities and relationships.

Other names for sex addiction

Some people who advocate a diagnostic model for sex addiction view it as being one sex-related disorder among several within a broader disorder known as hypersexual disorder, a pattern of behaviour featuring an obsession with sex, sexual fantasies and sexual impulses which causes “clinically significant distress or impairment”.

Sex addiction (or sexual addiction; the terms are used interchangeably) when it manifests in an individual’s being unable to control their sexual urges is sometimes called “sexual dependence”. Other terms used to describe pathological sexual behaviour, or similar or related conditions, include hypersexuality (previously known as nymphomania and satyriasis in women and men respectively), extremely high libido often causing very frequent engagement in sex; hyperphilia; problematic hypersexuality; sex compulsivity; sexual impulsivity; compulsive sexual behaviour; and hyperlibido/hyperlibidinism. Colloquially, a sex addict may be referred to as a “sexaholic”.

Erotomania (delusions on the part of an affected individual that someone else is infatuated with or in love with them), Don Juanism (the desire felt by a man to have sex with many different women; the equivalent term for a woman is Don Juanitaism), compulsive masturbation, porn addiction, and paraphilia-related disorder are all terms for conditions or disorders which may be considered related to hypersexuality.

There are many terms used in common parlance to describe a person with a very high sex drive and/or who has a high number of sexual partners; some of these may be highly offensive (and may constitute “slut-shaming”). These terms typically have no relation to any clinical diagnosis (and in many cases date back several centuries, long before the birth of modern psychiatry).

• An obsession with sex: sexual thoughts, memories and/or fantasies are a constant preoccupation, and you find it difficult to go even a few minutes without them intruding into your mind. Seeking out sex takes up a good proportion of your mental energy, limiting your ability to concentrate on matters such as work or academic endeavours.
• Constant or near-constant arousal: you find yourself in a state of arousal for much of the day, perhaps even after engaging in sex or masturbation – nevertheless ,you may masturbate much more frequently than the average person.
• Impact upon your interaction with others: the extent to which sex figures in your conversation, and your suggestive behaviour (and even outright propositions), negatively affects the way in which you interact with other people, including in a work environment.
• A disregard for consequences: you engage in activity which you know is likely to have negative consequences for you in future (for example, infidelity which is likely to become common knowledge; spending unaffordable sums pursuing sex; missing work in order to have sex, etc).
• Intensification of kinks/thrillseeking: if you have certain kinks or fetishes, you may find yourself going to ever greater lengths to satisfy them, potentially breaking the law and/or the bounds of social acceptability, and possibly engaging in increasingly dangerous activities.
• Deceit: you lie a great deal about your activities to those close to you (especially your partner, if you’re in a relationship).
• An inability to sustain relationships: either because of your constant infidelity, your deceit, your obsession with sex which is not shared by a partner or for many other reasons, long-term relationships prove impossible for you.
• You are unhappy, maybe worse: your obsession with, and constant pursuit of, sex takes a significant toll on your well-being. You feel a range of negative emotions very frequently, including guilt, shame and loneliness; you may even develop any of various mental health disorders including depression.
• You can’t stop: you’ve tried moderating your behaviour, concentrating on other things and restricting your pursuit of, and engagement in, sex – but your obsession overwhelms you and you return again and again to destructive patterns of behaviour.

Types of Sex Addiction

If you are a sex addict you may be motivated by the quest for, and/or obsessed by, any of the following types of sexual activity:

• Voyeurism: observing others engaging in sex, usually from a concealed position, and possibly masturbating whilst you watch.
• Exhibitionism: having sex in places where you can be, or run the risk of being, seen by others. You may also find sexual pleasure in exposing your genitals to others.
• Paying for sex: paying someone else, such as a prostitute, to have sex with you; or paying someone to perform sexually before you, either in person or online (ie, via a webcam).
• Trading sex: being paid – usually in money, but also potentially in other forms including drugs – to have sex with somebody else.
• Anonymous sex: having sex with strangers, possibly at established locations for such encounters or via arrangements online.
• S&M/pain exchange sex: having sexual encounters in which inflicting and receiving pain is a key component.
• Humiliating sex: participating in sex in which the humiliation and degradation of one of the parties is the objective.
• Rough/violent sex: having sex in which social norms regarding aggression and violence are ignored, and in which one party may behave savagely towards the other, potentially causing physical harm. This may also comprise acting out consensual rape and/or other sexual assault.
• Non-consensual/intrusive sex: engaging in sexual activity without the consent of the other party. This can constitute rape and/or sexual assault, which are serious criminal offences typically punishable by long prison sentences.

Stages of a Sex Addiction

While every case of sex addiction is unique, the condition often follows a relatively predictable course (which may be cyclical – i.e., the stages repeat themselves over and over).

• Preoccupation/fantasy: the individual is constantly thinking about sex, and fantasising about specific sexual situations and/or partners.
• Ritualisation: the individual develops specific routines which increase arousal and intensify the preoccupation with sex: dressing up, purchasing sex-related items, “cruising” for partners, substance abuse and many other activities can all form part of these rituals.
• Compulsion/acting out: actually participating in sexual activity – of whatever type (see above) – is typically the shortest phase of the cycle. Although orgasm may result, even when it does so it is frequently not accompanied by feelings of sexual satisfaction and fulfilment.
• Remorse/despair: the addict is overwhelmed by negative emotions such as guilt, shame, self-loathing and anxiety – which can result regardless of how extreme, “kinky”, degrading etc the sex itself has been.

Biological causes

Behavioural addictions are disorders of the brain’s reward system, in particular affecting those areas of the brain known as the ventral tegmental area and the amygdala. Engaging in repeated behaviour can create fluctuations in levels of chemicals including dopamine, which affect receptors in the brain’s reward centre in a way which drives further engagement in that behaviour and can lead to the manifestation of withdrawal symptoms if that behaviour ceases. Individuals with pre-existing abnormalities in any part of this mechanism (for example, abnormal dopamine production) may be more likely to develop addictions (behavioural addictions as well as substance abuse disorders).

Hormonal imbalances are also known to affect libido; testosterone in particular is closely linked with sexual drive, although by itself an excessive testosterone is not believed to be sufficient to cause hypersexuality.

The temporal/frontal lobe has been identified as the part of the brain most responsible for regulating libido, and individuals who have suffered from injuries to this part of the brain, or from illnesses affecting it, are at a heightened risk of developing behavioural disorders including hypersexuality.

Indeed, some observers have seen Western society as being obsessed with sex; from this perspective it is unsurprising that some of the individuals comprising that society may also develop such an obsession. With the advent of internet pornography, even extremely hard-core and niche sexual behaviour which may previously have been inaccessible to (and even unimaginable by) many people is now only a few clicks away on devices the vast majority of us carry in our pockets.

The constant exposure to sex which may for most people be unproblematic can cause the development of preoccupations and obsessions in particularly susceptible individuals, which can in turn contribute to the establishment of negative patterns of repeated behaviour culminating in addiction.

Psychological causes

A great many psychological factors can contribute to the development of sex addiction – and just as every individual’s psychology is unique, so too is every combination of such factors.
Many people use sex as a form of escapism – from loneliness, sadness and other negative emotions – and this can drive repeated behaviour of the sort likely to develop into an addiction. Low self-esteem is also seen as a critical contributor.
People suffering from depression, anxiety, obsessive-compulsive disorders, learning disabilities and substance abuse disorders are all more likely than the average to develop sex addiction, as are individuals with personality traits including low self-esteem, difficulties sustaining intimacy and relationship stability, insecurity, and a low tolerance for frustration, and people with paraphilia-related disorders.

Sex addicts may find it hard to view other people as anything other than potential partners and/or participants in sexual activity, creating huge problems for even run-of-the-mill interpersonal interactions. Social isolation and loneliness are often side-effects of sex addiction.

Depending on the specific manner in which the sex addiction manifests, and the nature of the sexual desires the individual experiences, various extremely risky behaviours may be engaged in which can result in physical harm (including illness) and criminal activity. The condition can also lead to the manifestation of a range of other mental health disorders, including depression and substance abuse.

Long-Term Impacts of Sex Addiction

Sex addiction can have permanent consequences for those suffering from it. It can contribute to the breakdown of marriages and other long-term relationships, and alienation from other loved ones, friends and associates. If it has had a negative impact on work, career prospects can be permanently damaged, while financial prospects can be similarly affected if the addiction has led to excessive spending and debt.

Even in recovery, sex addicts’ perception of themselves can be seriously negatively affected, with feelings of guilt and shame taking a long time to overcome if indeed they ever are. Future relationships can be made much more difficult to find and sustain as a result of the impact of sex addiction on the way an addict views sex and other people, and due to concerns potential partners may have regarding a former addict’s sexual history.

Various sexual health conditions can develop as a result of risky and/or promiscuous sex, including potentially fatal illnesses such as HIV/AIDS, while especially rough and/or kinky sex can result in permanent injury.

Depending on the nature of an individual’s sexual desires and proclivities, there is a risk that they may experience difficulties of a legal nature, including criminal penalties and a criminal record which may have profound ramifications for future employment prospects, ability to travel etc.

Meanwhile, people with substance abuse disorders are much more likely to engage in promiscuous sex – again, possibly as a result of the aphrodisiac effects of the drug/s in question, though also possibly as a means to fund the substance abuse (i.e., through trading sex/sex work). Long-term substance abuse can also cause neurological damage which has the potential to alter sexual behaviour (see above).

Sex Addiction and Mental Health Disorders

As noted above, sex addiction is associated with a number of mental health disorders both as cause and symptom.
Individuals suffering from mental health disorders including depression, obsessive-compulsive disorders, anxiety disorder, borderline personality disorder, paraphilia-related disorders and more are all much more likely than the average to develop a sex addiction. Cognitive impairments that impact upon emotional understanding – such as autism and ADHD – can also contribute to the development of sex addiction.
Meanwhile, sex addicts themselves are similarly more likely to develop mental health disorders as a result of the impact of addiction upon their lives, and the emotional toll of engaging in repeated negative sexual behaviour.

Because of the disagreement regarding the classification of sex addiction as a distinct diagnosis mentioned above, most treatment for sex addiction is provided by addiction professionals rather than psychosexual specialists.

As with all addiction treatment, psychotherapy is the foundation of treatment for sex addiction. Therapy models commonly deployed include cognitive behavioural therapy (CBT), dialectical behaviour therapy (DBT), motivational therapy (MT), and motivational interviewing (MI), though various other approaches to therapy have also been found to yield positive results.
A number of support groups exist to provide help to sex addicts looking to overcome their addictions, including Sex Addicts Anonymous and Sex & Love Addicts Anonymous which provide 12-step programmes for addicts in recovery. Other groups include Sexaholics Anonymous and Sexual Compulsives Anonymous.

While no medication exists which can provide a “cure” for sex addiction, various drugs can be prescribed to treat certain aspects, symptoms or side effects of the condition, including antidepressants to treat depression (which in many cases can also have a suppressing effect on libido) and antianxiety medication. Anti-viral drugs are used in the treatment of certain diseases which may result from risky sexual behaviour, such as HIV/AIDS.

Difficulties with diagnosing sex addiction

Again, there is no universal consensus within the medical and psychiatric communities worldwide regarding what specifically comprises sex addiction. As a result, there is no single agreed diagnostic framework against which symptoms can be compared, and one medical professional’s diagnosis of sex addiction may not be endorsed by another.

Moreover, some of the symptoms of sex addiction may in fact be caused by other disorders, especially including borderline personality disorder and ADHD, and substance abuse disorders. It is unfortunately not uncommon for sex addiction to be misdiagnosed initially.

Anyone beginning to exhibit any of the symptoms discussed above, or even who simply feels that their attitudes towards sex and the amount of time they spent thinking about, seeking or having it are becoming increasingly unhealthy, should contact their GP and/or an addiction specialist to discuss their situation and get a third-party assessment.

Sex Addiction Facts/Statistics

Research suggests that sex addiction or compulsive sexual behaviour affects up to 6% of adults.

Although different studies give different results, it is thought that up to 80% of those suffering from sex addiction are men – but many more women than men suffering from porn addiction specifically act out their behaviours in real life.

Over 40% of people using the internet view online pornography.

80% of all sex addicts also suffer from other types of addiction including substances abuse disorders.

Individuals who experienced childhood sexual abuse are many times more likely than the average to develop sex addiction as adults.

One study states that the average male sex addict has had 32 different partners before entering treatment; the equivalent figure for women is 22. However, in many cases that number is far higher: for example famous US basketball star Wilt Chamberlain is thought to have had up to 20,000 sexual partners in his lifetime.

If you are suffering from sex addiction, leaving it untreated is likely to have catastrophic impacts on your life which may be permanent. Your relationships with others, your professional and academic prospects, and your financial viability may all be irreparably damaged. However, only you can make the decision to seek treatment: if you are not ready to do so, any treatment provided to you is unlikely to be successful. In order to get the help you need, you first need to be able to ask for it, and in order to do that you first need to be able to acknowledge your condition.