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When the term addiction is used, most people initially think of drugs or alcohol addiction. There are, however, many other types of addiction that can damage lives, and whilst a variety of addictions often exist in different societies around the world, created by levels of what is acceptable and what is not, there is a universal “league table” of addictions based on prevalence.
These are, in rank order:
- Coffee – It is widely used in society so it is generally acceptable, which can open the door to overuse.
- Tobacco and nicotine – The World Health Organisation (WHO) reported that smoking causes 90% of lung cancers in men and 70% of lung cancer in women and contributes to almost 80% of the cases of respiratory diseases and 22% of cardiovascular disease.
- Alcohol – It is as addictive and as deadly as most illicit drugs.
- Sex addiction – It is estimated that 8% of men and 3% of women are affected by sex or relationship addiction.
- Illegal and prescription drugs – Around 269 million people used drugs worldwide in 2018 according to the United Nations (UN).
- Gambling – Whilst only 1% to 2% of adults develop problems with gambling, it still continues to be a significant number of the population.
- Modern technology – According to research, internet addiction particularly affects young people and symptoms include feelings of desperation and anxiety when separated from their phones.
- Gaming – It is similar to gambling in that it elevates dopamine and creates a strong psychological component to the addiction.
- Food – Appropriately 2% of populations have food issues, eating disorders or food addictions.
- Work – Overworking or “workaholism” can be a mental health condition and often a serious one.
It may be surprising to many that sex addiction is probably the fourth most prevalent addiction worldwide. 80% of all sex addicts also suffer from other types of addiction including substance abuse disorders.
Is sex addiction real?
So, what is sex addiction and is sex addiction real? Sexual compulsivity, addiction and hypersexuality are all ways to define an unhealthy relationship with an aspect(s) of sex.
Sex addiction is currently not a clinical diagnosis, which means there are no official figures on how many people have sought help for related concerns through the NHS. Some experts still disagree over whether addiction is real or a myth.
Sex and Porn Addiction Help, a self-help website for people who feel they are struggling with sex or porn addiction, surveyed 21,000 people in the UK who have visited the site for help since 2013. Of these, 91% were male and only 10% had sought help from a GP.
Sex addiction was considered for inclusion in the Diagnostic and Statistical Manual of Mental Disorders (DSM), a key diagnostic tool used in both the US and the UK, but was rejected because of lack of evidence.
However, “compulsive sexual behaviour” is now an entry in the International Classification of Disease (ICD) manual produced by the World Health Organization. They describe compulsive sexual behaviour as “a disorder that is characterised by a persistent pattern of failure to control intense, repetitive sexual impulses or urges resulting in repetitive sexual behaviour”.
What is a sex addict?
Sexual desires and urges are a normal and healthy part of life. But in the case of sex addiction, these urges become overwhelming and the resultant decisions and actions can be extremely destructive.
When sexual behaviours become a major focus in someone’s life, are difficult to control, and are disruptive or harmful to the individual or to others, the behaviours may be considered compulsive sexual behaviour and the person may be considered a sex addict.
A sex addict feels compelled to seek out and engage in sexual behaviour, despite the problems it may cause to their personal, social and work lives. It may encompass any single or multiple types of sexual behaviour.
What causes sex addiction?
The causes of compulsive sexual behaviour or sex addiction are unclear and under-researched.
However, some professionals working in the field of addictions draw comparisons with other addictive behaviours and cite:
- An imbalance of natural brain chemicals – High levels of certain chemicals in the brain, that is neurotransmitters such as serotonin, dopamine and norepinephrine which help regulate mood, may be related to compulsive sexual behaviour.
- Changes in brain pathways – Compulsive sexual behaviour may be an addiction that, over time, might cause changes in the brain’s neural circuits, especially in the reinforcement centres of the brain. Like other addictions, more-intensive sexual content and stimulation are typically required over time in order to gain satisfaction or relief.
- Conditions that affect the brain – Certain diseases or health issues, such as epilepsy and dementia, may cause damage to parts of the brain that affect sexual behaviours. Some dopamine agonist medications such as those used in the treatment of Parkinson’s disease may cause compulsive sexual behaviours.
- Hormonal imbalances – These are also known to affect libido. Testosterone in particular is closely linked with sexual drive, although by itself excessive testosterone is not believed to be sufficient to cause hypersexuality.
- Ease of access to sexual content – Advances in technology and social media allow access to increasingly intensive sexual imagery and information. 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.
- Privacy – Secrecy and privacy of compulsive sexual activities tend to allow these issues to worsen over time.
Other possible causes and or risk factors can include:
- A history of physical or sexual abuse.
- Alcohol or drug abuse problems. Sex addiction is recognised as potentially both a driver of, and a consequence of, substance abuse.
- Other addictive behaviours.
- A high sex drive.
- Exposure to porn in childhood.
What are the signs of sex addiction?
The World Health Organization (WHO) International Classification of Disease (ICD) describe the symptoms as follows:
- May include repetitive sexual activities becoming a central focus of the person’s life to the point of neglecting health and personal care or other interests, activities and responsibilities.
- Numerous unsuccessful efforts to significantly reduce repetitive sexual behaviour.
- Continued repetitive sexual behaviour despite adverse consequences or deriving little or no satisfaction from it.
“The pattern of failure to control intense, sexual impulses or urges and resulting repetitive sexual behaviour is manifested over an extended period of time (e.g., 6 months or more), and causes marked distress or significant impairment in personal, family, social, educational, occupational, or other important areas of functioning. Distress that is entirely related to moral judgments and disapproval about sexual impulses, urges, or behaviours is not sufficient to meet this requirement.”
There is no definitive list of specific behaviours because people can sexualise many things.
Many practitioners working in the area of sex addiction look for dysfunction in the following key areas:
- Preoccupation – Obsessive thoughts, fantasy, loss of interest in other pursuits.
- Loss of control – Attempts to reduce or stop the acting out behaviour(s) fail.
- Persistence – Continued acting out despite negative consequences.
Someone suffering from sex addiction can find themselves isolated, depressed, anxious or shameful. They may be experiencing overwhelming, persistent sexual thoughts and urges, acting on these thoughts and urges, not in order to experience joy or pleasure, but because they feel compelled to do so.
These symptoms can also appear in spouses or loved ones, perhaps more so than other addictions. Many sex addicts have a fear of abandonment and therefore can remain in destructive and unhealthy relationships.
Some common signs of sex addiction can include but may not be limited to:
- Being incapable of refraining from having sex with others, even when involved in a relationship.
- Spending significant amounts of time viewing pornography.
- Having unprotected sex, anonymous sex, sex in public places or otherwise engaging in sexual behaviours that can obviously endanger health or social wellbeing.
- Typically feeling guilty, ashamed or self-disgusted after acting on sexual compulsions.
- Having persistent and unavoidable sex-related thoughts, urges and fantasies.
- Seeking the euphoric rush of a new sexual relationship or encounter.
- Mistaking sexual experiences or romantic intensity for genuine intimacy.
How to overcome sex addiction
The exact cause of compulsive sexual behaviours and sex addiction is not known, so it is not clear how it might be prevented or overcome. Sex addiction can be classified as an impulse control disorder. Impulse control disorders are characterised by the repeated failure to resist an impulse, drive, or urge to perform an act that is rewarding to the person, at least in the short term, despite the consequences.
There are some actions that people with an impulse control disorder, including sex addiction, can take to help to overcome the compulsion, including:
- Know your triggers – Knowing what your triggers are is the first step to avoiding them and being able to better control your behaviours.
- Practise meditation – Meditation is one of the most effective ways to keep track of your internal dialogue. Meditation also increases your awareness of your thoughts and feelings. It helps you to recognise what might be an unproductive state of mind, so you can pause before you act.
- Avoidance – Avoid any risky situations where you might be tempted to engage in risky sexual practices.
- Be patient with yourself – This is the most important tool you could employ. It takes time to overcome impulse control issues; it won’t happen overnight.
Identifying and seeking treatment for the early symptoms may help prevent sex addiction and compulsive sexual behaviour from getting worse over time or escalating into a downward spiral of shame, relationship problems and harmful acts. Talk to your GP about how you are feeling.
How is sex addiction diagnosed?
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.
Some of the symptoms of sex addiction may in fact be caused by other disorders, especially borderline personality disorder, ADHD, and substance abuse disorders.
There are a range of facilities across the UK that provide high-quality treatment to addicts of all kinds, including those suffering from sex addiction, while various support groups can give you help and support through your recovery. In the first instance contact your GP to discuss your symptoms and concerns. You can also contact an addiction specialist; there are links to organisations that provide help, support and therapy recommendations at the end of this article.
How is sex addiction treated?
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.
Unlike alcohol and drug addictions where the individual is expected to stop using the drug of choice and abstain forever, not surprisingly, those suffering from sex addiction are likely to want to engage in sexual relations especially if they are in an intimate relationship.
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).
- Motivational interviewing (MI).
Working through a programme of understanding sex addiction, accepting one’s own addiction and learning control and avoidance techniques with a trained therapist will help those with this addiction take back control over their lives. However, similar to taking control of other addictions, it is difficult and it will take a focused and determined person to succeed.
Support and help available
There are a number of organisations in the UK that can provide help and support if you are worried that you or someone that you know might be suffering from sex addiction.
Many treatment centres offer support to partners, in group or private sessions.