Is Sex Addiction Real?

Sex addiction is the compulsive engagement in sexual acts despite negative consequences. Moreover, it is emotionally distressing rather than fulfilling.

The concept of sex addiction has been thought of in a variety of ways. Thus, it is often referred to by several different names. Hypersexuality, hypersexual disorder, sexual compulsivity, sexual impulsivity, and sexual addiction disorder are all names used when referring to sexual addiction.

While not always recognized as a legitimate diagnosis, sex addiction does have real consequences. This addiction can have a negative impact on a person's relationships, occupation, mental well-being, and more.

Symptoms of Sex Addiction

How do you know if you or someone you care about may have an addiction to sex? Some of the signs of sexual addiction include:

• Sex dominates the person's life to the exclusion of other activities.
• Sexual activities may be inappropriate and/or risky and may include exhibitionism, public sex, sex with prostitutes, or regular attendance at sex clubs.
• The constant urge for sex is typically interspersed with feelings of regret, anxiety, depression, or shame.
• The person engages in other forms of sex when alone, including phone sex, pornography, or computer sex. 
• The person engages in sex with multiple partners and/or has extramarital affairs.
• The person masturbates habitually when alone.

It's important to note that a person does not have to engage in extreme or "strange" sex to have an addiction. They are simply unable to stop themselves, despite the harm that they know may result from their behavior.

Diagnosis of Sex Addiction

Not everyone in the medical community is convinced that sex addiction is a true mental health condition. Because of this, it is not listed as a clinical diagnosis in the Diagnostic and Statistical Manual of Mental Disorders (DSM) published by the American Psychiatric Association (APA).

Although the DSM once allowed for sexual disorders "not otherwise specified"—which is where a sexual addiction diagnosis could fall—the DSM-5, which is the fifth edition of this manual, deleted this category. That has eliminated this diagnostic option.

That said, it is possible for practitioners to diagnose compulsive sexual behaviors using the International Classification of Diseases (ICD). The ICD-11 allows for a diagnosis of compulsive sexual behavior disorder, which is defined as "a persistent pattern of failure to control intense, repetitive sexual impulses or urges resulting in repetitive sexual behaviour."

In the end, a lack of consensus has left the diagnostic criteria for sex addiction both vague and subjective. Though, there are some tools that practitioners can use to determine if this addiction might exist. One is the Sexual Addiction Screening Test, which helps differentiate between addictive and non-addictive sexual behaviors.

Causes of Sex Addiction 

There are a number of theories as to why sex addiction occurs. Some of these involve conceptualizing a sex addiction as a form of impulse control, obsessive-compulsive disorder, or relationship disorder. Another theory is that, in some individuals, sexual addiction emerges as a consequence and way of coping with early trauma, including sexual trauma.

People with a sex addiction often use sex as a form of escape from other emotional and psychological problems. This includes escaping from stress, anxiety, depression, and social isolation.

Hypersexuality can also be a symptom of some mental illnesses, such as bipolar disorder. Neurological disorders such as epilepsy, head injury, and dementia have also been known to cause hypersexual behaviors. In rare cases, some drugs that impact dopamine may do the same.

Impact of Sex Addiction

People with sex addiction are unable to stop their behaviors unless there is some sort of intervening event. As a result, personal and professional relationships may suffer. There may even be an increased risk of sexually transmitted infection, including HIV, if a person is unable to rein in their sexual impulses.

There has also been concern over a new type of sex addiction: online sex addiction. This involves engaging in sexually addictive behavior while on the internet and research has connected this with negative impacts on one's interpersonal relationships, their productivity at work, and even their academic success.

Sexual addiction is most often characterized by a vicious circle of hypersexuality and low self-esteem. Although sex can bring short-term relief, the harm to the person's psychological well-being will often increase and worsen over time.

Treatment for Sex Addiction

Sexual addiction requires treatment from a medical professional experienced in the field, such as a psychologist, psychiatrist, or sex therapist. The first point of contact can be a family doctor or local psychiatric association, both of which can make a referral to the appropriate specialist.

Sex addiction therapy options can vary based on the underlying cause but are typically conducted on an outpatient basis with counseling and behavioral approaches. Marital therapy may also be helpful in treating sex addiction.

If sex addiction is associated with an anxiety disorder or mood disorder, medications may be prescribed as part of the treatment plan. There are currently no established recommendations on the appropriate use of medications to treat sex addiction outside of the realm of these clinically classified disorders.

In addition, there are a growing number of support groups that can assist with sex addiction recovery. Some deal with co-addictions such as sex and substance abuse and others are built on a 12-step recovery model.