(HYPERSEXUALITY)

Addiction can cross many borders and manifest through many avenues. More commonly, it’s thought to mean an abuse of drugs or alcohol, or even an addiction to gambling. A lesser discussed and researched topic, however, is that of an addiction to sex and/or pornography. Like with substances, those who deal with an unhealthy, compulsive need to engage in sexual stimulation or imagery, do so in an attempt to meet a need by escaping, avoiding or altering a distressing or uncomfortable mood or emotion, the actions of which result in negative consequences, and yet the continued desire remains. While the most recent version of the Diagnostic and Statistical Manual of Mental Disorders, the DSM- 5, omitted the condition of hypersexuality, the issue continues to present with serious implications.

According to the National Institutes of Health (NIH), sexual addiction is characterized by the inability to control sexual impulses with continued engagement in the identified behaviors despite experienced negative consequences. This has become part of a larger conversation, including the mainstreaming of the adult entertainment industry and accessibility of pornography. While the clinical diagnosis of hypersexuality evades the DSM- 5, the concept of compulsive sexual behaviors and excessive sexual desire can be examined through the lenses of addiction, impulse-related disorders or obsessive-compulsive disorders. The research and empirically-based evidence on the topic remains limited, but there continues to be the existence of treatment centers and Sex Addicts Anonymous support groups throughout the country. A factor in the ambiguity of diagnosing sex addiction is identifying the problematic behaviors in exclusion from primary disorders such as substance use, mania, medication or medical conditions.

The NIH explains the difficulty in defining sex addiction is due in part to the various types of symptom presentation. Addiction symptoms include the loss of control and a continued engagement in the destructive behavior despite physical or psychological consequences, while those that are similar to impulse control include irresistible urges to behave in a sexual manner without consideration to the implications. In relation to obsessive-compulsive disorders, the experience of sexually obsessive thoughts and the need to act them out in a compulsive manner is in connection with the need to manage feelings of fear and anxiety.

For those who struggle with the compulsive need to engage in sexual behaviors or stimulation through imagery and pornography, the effects wreak similar havoc like that of substance abuse and other related addictions. The impact of these negative behaviors can affect relationships, work and home life, and bring intense feelings of shame, guilt and blame. Additionally, there could be the presence of sexually transmitted infections or physical injuries due to continued and excessive sexual behaviors.

A common symptom of this nature is the time spent and lost on viewing pornography, or seeking out sexual engagements through many means, including prostitution. These activities can lead to more serious implications as well, such as financial consequences or legal trouble due to an arrest for solicitation or engaging in illegal sexual acts. The impact on family and relationship can be sordid and complex. The NIH states that often the issues around compulsive sexual behaviors leads to an unrealistic and distorted view of a healthy sexual relationship, as well as issues involving infidelity, secrecy and violation of trust – leading to unstable or broken marriages and relationships. In addition, the psychological implications can be even more extensive.

With consultation from a mental health professional and medical doctor, the best treatment approach can vary depending on the individual and symptom presentation. As with other obsessivecompulsive related disorders, the NIH states that a cognitive behavioral therapy (CBT) and/or psychodynamic approach may be effective. CBT centers around identifying and reframing distorted thinking patterns, as well as becoming aware of triggers and patterns of maladaptive behavior. Psychodynamic therapy has a focus on exploring the core conflicts that may be causing the dysfunctional sexual behaviors.

While there is no identified FDA-approved medication to treat compulsive sexual behaviors, medications can be provided to treat co-occurring related disorders such as depression, bipolar disorder, obsessive-compulsive disorder or anxiety. Finally, there are identified, anonymous support groups such as Sex Addicts Anonymous that can provide a safe environment for those dealing with compulsive sexual behaviors to share their experience and find support in their recovery.