What to Know About Voyeuristic Disorder

A person with voyeuristic disorder gets sexually aroused by observing someone in a sexual act who does not realize they are being watched. A person with this mental health condition acts on their voyeuristic urges and is unable to function in their daily life because their voyeuristic fantasies are so consuming.

This article will explain what voyeuristic fantasies are and when voyeurism is classified as a psychological disorder.

What Is Voyeurism?

By itself, voyeurism is not a mental health disorder. People may get aroused by watching another person perform a sexual act but will not engage in sexual activity with the person they are observing.

Voyeurism becomes a disorder if a person is so consumed by their voyeuristic thoughts that they are distressed and unable to function, or if they act on the urges with a person who has not given consent.

Voyeuristic fantasies usually start in adolescence or early adulthood and are more common in men than in women. Around 12% of men and 4% of women have voyeuristic disorder.

Voyeuristic Disorder Symptoms

The most common symptoms of voyeuristic disorder are:

• Persistent, intense sexual arousal from observing people perform sexual activities
• Becoming distressed or unable to function because of voyeurism urges and fantasies
• Engaging in voyeurism with a person who does not give their consent

People with voyeuristic disorder may perform sexual acts on themselves while watching others engage in sexual activities or have the urge to harm themselves or others during sex.

People with voyeuristic disorder may also have other mental health conditions like depression, anxiety, and substance use disorder. Some people with voyeuristic disorder develop another paraphilic disorder, like exhibitionist disorder.

Causes of Voyeuristic Disorder

There is no single cause of voyeuristic disorder, but certain risk factors seem to increase a person’s chances of developing the condition.

• Sexual abuse 
• Substance misuse 
• Hypersexuality 
• Sexual preoccupation

How Voyeuristic Disorder Is Diagnosed

A healthcare provider or licensed therapist can make a diagnosis of voyeuristic disorder. They will talk to you about your medical history (including your mental health) and ask you questions about your current thoughts and feelings. Symptoms of the disorder should have also persisted for 6 months or more before a conclusive diagnosis can be given. 

Voyeuristic disorder is diagnosed when someone’s voyeuristic urges and behaviors are so severe that they cause harm or distress to the person having them or others.

According to the DSM-5, a few other criteria must be met before a provider can make a conclusive diagnosis of voyeuristic disorder: 

• The person must be at least 18 years old.
• The symptoms must have lasted over six months.
• The person has acted on sexual urges with a non-consenting individual.

People with voyeuristic disorder may or may not believe that there is anything wrong with their behavior. They usually won’t talk about their thoughts and urges with healthcare providers or loved ones. As a result, people with voyeuristic disorder often do not get diagnosed until after they’ve been caught committing sexual offenses.

However, early treatment can help prevent a person with voyeuristic disorder from harming themselves or others. 

Voyeuristic Disorder Treatment 

Voyeuristic disorder can be treated with psychotherapy, medication, or both. The best treatment or combination of treatments for each person with voyeuristic disorder will depend on different factors, such as whether they have insight into their behavior or have any other mental health conditions.

Medication 

Selective serotonin reuptake inhibitors (SSRIs) like Prozac (fluoxetine) and Lexapro (escitalopram) are commonly prescribed to treat voyeuristic disorders. SSRIs are most often used to treat depression, but research has shown that they can be effective at suppressing impulses in people with voyeuristic disorder.

Zoladex (goserelin), Lupron (leuprolide acetate), and drugs that reduce testosterone are also used to help people with voyeuristic disorder. Reducing testosterone levels reduces sex drive, which can help suppress voyeuristic urges.

Psychotherapy 

Different types of therapy may help a person with voyeuristic disorder, as well as be beneficial for their loved ones.

Cognitive behavior therapy can help people with voyeuristic disorder understand why their behavior is not socially acceptable and gain insight into what might be causing their voyeuristic thoughts.

Therapy can also teach people coping mechanisms to help them overcome voyeuristic thoughts and urges.

Going to couples and family therapy can also be important for the loved ones of someone with voyeuristic disorder. In therapy, they can learn about the condition and get the support they need, particularly if they are healing from the harm the disorder has caused in their relationships

Coping 

If you are having voyeuristic thoughts and urges, the most important step is recognizing that you need help and reaching out for support. Start by confiding in someone that you trust who can help you get treatment.

If your loved one is showing signs of voyeuristic disorder, keep in mind that they may not think they need to change. They may not consider asking for help until after they have hurt someone or even gotten in trouble with the law.

Encourage your loved one to reach out to a healthcare or mental health provider. Let your loved one know that the condition is treatable and that you will support them in getting the help they need.

Summary

Voyeurism on its own is not a disorder. However, if a person is so consumed and distressed by voyeuristic thoughts and urges that they cannot function, they need to reach out for help.

Voyeuristic disorder can often be treated with therapy and medication, but a person must get the support they need before their behaviors cause harm in their relationships or lead to sexual crimes.