Sex addiction is not considered a mental health disorder.
However, sex addiction is a compulsive behavior that can disrupt daily life and relationships.
An estimated 90% of people being treated for sex addiction have an underlying mental health disorder.
"Sex addiction" is more of a media buzz word than a medical term. This behavior is not technically an addiction in the same way as drug or alcohol addiction.
In the news: The suspect for the Atlanta massage parlor shootings told authorities that he has a sex addiction. This is the latest example of a high-profile suspect claiming sex addiction as the reason for their crimes. Others who have made this claim include Harvey Weinstein and Charlie Sheen.
It's important to note that sexual addiction is not a mental disorder but can be an indicator of a more serious underlying condition.
However, the compulsive sexual urges that come with self-proclaimed sex addicts are a subject of scientific research and can be medically treated when necessary.
Compulsive sexual behavior isn't the same as an addiction
Engaging in sexual behaviors triggers dopamine, a hormone that activates the brain's "neurocircuit of reward," says Gail Saltz, an associate professor of psychiatry at the New York Presbyterian Hospital Weill-Cornell School of Medicine. Meaning, when the person stops having sex, they want more, because it's gratifying.
But, according to Saltz, that feeling is normal. Similarly, self-identifying sex addicts may yearn for certain consensual sexual behaviors when they stop engaging in them, but those feelings are not the same as a physiological addiction to substances like drugs and alcohol.
Addiction to drugs and alcohol happens because these substances alter brain function to the point where the brain goes from wanting the substance to needing it. Therefore, drug and alcohol addiction is classified as mental health disorders by the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-5).
However, the DSM-5 does not classify sex addiction as a mental health disorder. Because unlike drug addicts, those engaging in compulsive sex behaviors don't physically need sex, and won't experience withdrawal symptoms like jitters, elevated blood pressure, and malaise if they don't have it, says David Ley, PhD, a clinical psychologist in Albuquerque, New Mexico.
Many sex addicts don't have abnormal amounts of sex
It's important to note that many self-labeled sex addicts do not have abnormal levels of consensual sexual activity, says Ley. Instead, these are often people coming from religious or culturally-conservative backgrounds who struggle with their sexuality.
A 2020 study published in the Journal of Abnormal Psychology, surveyed 3,500 people and found that religious and moral factors often increase a person's worry over porn addiction. This holds true even if they watch it at the same rate as non-religious people. Porn addiction isn't the same as sex addiction, but the guilt and shame likely stem from a similar source.
"The higher levels of internal shame and conflict you have over your sexual desires, the more likely you are to report struggles with controlling your sexual behavior," says Ley. "Even though these people don't actually have more sex or engage in more masturbation than anyone else."
When compulsive sexual behavior is problematic
The World Health Organization's International Classification of Diseases (ICD) recognizes multiple sexual behavior disorders including excessive sexual drive and compulsive sexual behavior disorder. However, there is a fine line between being highly sexually active and having a sexual disorder.
For example, if a person is having a lot of consensual sex and it isn't affecting their job or relationship, then their behavior isn't considered a dysfunction, says Saltz. Compulsive sexual behavior becomes a disorder when it impairs a person's functioning and keeps them from living the life they want.
Saltz says that symptoms of compulsive sexual behavior disorder include:
Thinking about sex nonstop.
Engaging in risky sexual behaviors, leaving them at risk of pregnancy and STIs.
Engaging in sexual behaviors at work.
Repeatedly violating expressed relationship agreements like monogamy.
Loss of interest in other hobbies.
Spending money in excess to have sex.
A scientific review, published in 2014 in Current Pharmaceutical Design, estimated that roughly 3% to 6% of the population may struggle with hypersexual behaviors like watching porn for hours on end to satisfy intense sexual urges.
Treatment for sexual behavior disorders
While a person may identify as a sex addict, their behaviors are often part of a larger group of issues. A 2013 study, published in Sexual Addiction & Compulsivity, indicated more than 90% of those being treated for "sex addiction" had an underlying mental health disorder.
Common mental health conditions associated with compulsive sex behaviors include borderline personality disorder, depression, anxiety disorders, and obsessive-compulsive disorder, says both Saltz and Ley. A possible explanation could be that these mental health conditions all share a common trait: issues with regulating the nervous system, from which sexual gratification might provide temporary relief.
"A lot of clinicians, who are poorly trained around sexuality, perceive these sexual behavior problems as the problem," Ley explains. "They are treating the symptom rather than the cause."
It's also possible that there is no mental health issue occurring and, instead, a person is grappling with desires and behaviors that are outside of their values, community norms, or religious ideals.
Dealing with the underlying issue, whether it's a mental health disorder or otherwise, can help treat compulsive sexual behaviors, says Ley. Treatments that have proven effective include:
Mindfulness practices such as meditation
For more treatment advice and options visit The Harvey Institute for modern sex therapy.
The bottom line
Ultimately, treatment for compulsive sexual behaviors will vary from person to person depending on underlying cultural norms, values, relationship dynamics, and mental health conditions, says Saltz. That's why it's best to speak to a psychiatrist or therapist to determine an individualized treatment plan.
And don't forget that sex, masturbation, and viewing pornography are often part of a completely healthy sexuality. The majority of people who enjoy sex, masturbation, and pornography do so without any harm to themselves or others.
Plus, sex and masturbation come with many additional health benefits besides sexual gratification. For example, masturbation can improve sex with your partner. For more information check out our articles on the health benefits of sex and the benefits of masturbation.
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