What Is “Sex Addiction” And Is It Real?
“Sex addiction” is a phrase often used to describe a compulsive disorder that’s characterized by an intense need and urge to engage in sexual activities, often despite negative consequences — but it isn’t a recognized diagnosis in and of itself.
Here’s what you need to understand about “sex addiction”:
- “Sex addiction” is a phrase that’s commonly used to refer to compulsive sexual behavior disorder or hypersexuality, which is characterized by persistent and escalating engagement in sexual activities.
- It’s important to note that “sex addiction” is not considered to be a diagnosable condition by the American Psychological Association (APA), the American Association of Sexual Educators, Counselors, and Therapists (AASECT), or the World Health Organization (WHO).
- Symptoms of “sex addiction” include compulsive sexual thoughts, activities and behaviors, difficulty controlling sexual impulses, and a preoccupation with sex, which can be caused by a range of biological, psychological, or social factors.
- Treatment for “sex addiction” usually includes counseling and therapy but it’s difficult to diagnose because there are no established diagnostic criteria in place.
Although one’s symptoms may be considered signs of “sex addiction” in certain circles and there are treatment programs designed for it, specifically, the condition is not recognized by major psychological or sexual education associations — and we’ll explain why.
Editor’s note: In this article, the term “sex addiction” is used to describe what many equate to compulsive sexual behavior disorder— although only the latter is considered a diagnosable condition by the World Health Organization, the American Psychological Association, and the American Association of Sexual Educators, Counselors, and Therapists. Currently, there is no evidence that finds symptoms of compulsive sexual behavior are an addiction.
This statement does not imply that the symptoms are not real or valid; it refers to formal terminology only. The terminology used may impact everything from diagnosis to treatment.
What “Sex Addiction” Means
Sex addiction is a term commonly used to characterize an obsession or compulsive behavior involving sex (related to hypersexuality) that leads to impairments in daily functioning.
It can include frequent, uncontrollable sexual thoughts or risky behaviors, such as having unprotected sex, cheating on a partner, frequenting sex workers, and exchanging sex for money or other favors.
“Sex addiction” can also involve obsessive sexual fantasies, spending excessive amounts of time looking at pornographic material, and engaging in risky behaviors.
Is Sex Addiction Real?
That’s the million-dollar question and while “sex addiction” is considered to be a real problem by those who suffer from it, it is not a diagnosable condition in and of itself.
As we mentioned earlier, “sex addiction” is a term often used to describe compulsive sexual behavior disorder (CSBD), a condition for which diagnostic criteria have been published in the International Classification of Diseases (ICD-11), provided by the World Health Organization (WHO).
But even CSBD is not considered an addiction.
On the topic of CSBD as it relates to “sex addiction,” the ICD-11 states:
“Individuals who make religious or moral judgments about their own sexual behaviour or view it with disapproval, or who are concerned about the judgments and disapproval of others or about other potential consequences of their sexual behaviour, may describe themselves as ‘sex addicts’ or describe their sexual behaviour as ‘compulsive’ or using similar terms.”
The term “sex addict” is self-described and may refer to CSBD — but only if “other diagnostic requirements of Compulsive Sexual Behaviour Disorder are actually present.”
Some mental health practitioners may turn to a portion of the diagnostic criteria published on addiction in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), which is provided by the American Psychiatric Association (APA).
Those with a “sex addiction” have an unhealthy and compulsive preoccupation with sexual thoughts and behaviors, typically to the point where it may interfere with a person’s work, relationships, and other areas of their life.
Additionally, those affected by “sex addiction” often struggle with feelings of guilt, isolation, and shame, and medical professionals may diagnose them with a condition similar to substance abuse disorder.
But there are a couple of major differences between substance abuse disorder and “sex addiction” — the first of which is the lack of physical dependence.
A person who is addicted to a substance, whether it is alcohol or a drug, will experience physical changes in their brain and body that require them to have that substance in order to function.
That simply doesn’t happen with “sex addiction.”
And because those physical changes to the brain and body don’t occur, we also don’t see similar issues surrounding withdrawal, which is another classic sign of addiction.
When a drug addict or alcoholic stops using the substance they’re addicted to, they go through physical and mental withdrawal.
That same type of withdrawal doesn’t occur in a person who has a “sex addiction.”
They might desire sex, or continue thinking about it, but the lack of engagement in sexual activities doesn’t manifest in the same manner as withdrawal from drugs or alcohol.
As we talk about here, therapists and mental health care professionals may borrow the diagnostic criteria from the DSM-5 or the ICD-11, as they might apply to a person’s situation, but neither manual actually contains clear diagnostic criteria for “sex addiction” as a condition.
Causes Of Compulsive Sexual Behavior (“Sex Addiction”)
The term, “sex addiction,” is most often used to refer to compulsive sexual behavior disorder.
Compulsive sexual behavior disorder (CSBD) is often a result of underlying issues such as stress, anxiety, depression, trauma, or a history of abuse.
It can also be a form of self-medication to cope with past experiences or a way to manage difficult emotions.
Additionally, biological factors, such as the effects of certain hormones or changes in brain chemistry (such as a dopamine imbalance), may help contribute to this behavior.
Symptoms And Signs Of “Sex Addiction”
Signs and symptoms of “sex addiction” may include:
- Compulsive sexual behaviors that interfere with a person’s daily life
- Difficulty forming and maintaining intimate relationships
- Preoccupation with pornography
- Satisfying impulses and fantasies by engaging in repetitive sexual activities
- Increased risk of contracting sexually transmitted infections (STIs)
- Financial or legal issues associated with sexual activities
- Being unable to stop or decrease sexual behaviors, impulses, thoughts, or fantasies
Other signs of “sex addiction” may include neglecting other areas of life, such as family, work, or school, due to obsessive thoughts and behaviors.
How “Sex Addiction” Is Diagnosed
A “sex addiction” diagnosis typically involves an evaluation by a mental health specialist who uses this terminology and may include participating in a structured addiction recovery program.
The specialist will also look for a pattern of compulsive behaviors and symptoms, such as lying, engaging in high-risk sexual activities, or having difficulty establishing or maintaining relationships.
The individual struggling with “sex addiction” might also experience a sense of shame or guilt related to their behaviors and feel a strong urge to participate in specific sexual activities.
But it’s important to remember that there are no diagnostic criteria for “sex addiction” — and that makes diagnosis extremely difficult.
Another part of the problem is that for someone to be considered a “sex addict,” there needs to be a deviation from the norm.
But whose norm?
There is no real “normal” when it comes to sexual activity or the frequency of human sexual behaviors and fantasies.
How “Sex Addiction” Is Treated
Treatment for compulsive sexual behavior (“sex addiction”) typically involves psychotherapy, medications, and lifestyle changes in order to address the underlying issues causing the compulsive behavior.
Other approaches may include family therapy, 12-step recovery programs, and even spiritual counseling.
In some cases, the individual may undergo inpatient hospitalization for evaluation or undergo a residential stay in a treatment program to gain structure and support.
But it’s difficult to measure a treatment’s level of success, especially since there are no formal diagnostic criteria in place for “sex addiction” as a condition.
Although “sex addiction” isn’t an official mental health condition that’s recognized by major psychological, health, or sexual education associations, it doesn’t mean a person’s symptoms are not real — or valid.
It’s important to seek out the treatment you need if you’re struggling with compulsive sexual behavior — regardless of the terminology being used to describe it.