Addiction may start out as a choice but soon it becomes a matter of physiological dependence and evolves into a brain disease that alters your brain chemistry. Therefore, addiction cannot have a one-dimensional definition. And when it comes to sex addiction, unlike substance addiction, there is no organic cause to alter brain chemicals like drugs or alcohol. Yet, the rewarding mechanism and responding to environmental stimuli are similar to substance addiction. For example, a study carried out by the University of Cambridge showed that pornography could trigger brain activity in people with sex addiction similar to how drugs triggered the brain activity of drug addicts. 

Definition of Sex Addiction

The Diagnostic and Statistical Manual of Psychiatric Disorders, Fourth Edition (DSM-IV) describes sex addiction, under the category “Sexual Disorders Not Otherwise Specified,” as “distress about a pattern of repeated sexual relationships involving a succession of lovers who are experienced by the individual only as things to be used.” According to the manual, sex addiction also involves “compulsive searching for multiple partners, compulsive fixation on an unattainable partner, compulsive masturbation, compulsive love relationships and compulsive sexuality in a relationship.”

Four Core Beliefs Maintaining Sex Addiction

Dr. Patrick Carnes, who popularized the term “sex addiction” attributes a person’s belief system as the source of the sex addiction. He identified four core beliefs that provide “a fundamental momentum for the addiction”.  

1. I am unlovable, I am not worthwhile. 
2. Other people would not care for me if they know about me and my addiction. 
3. Sex is my most important need. 
4. Sex is what makes isolation bearable. 

Related Article: WHAT IS THE CONNECTION BETWEEN MENTAL HEALTH AND ADDICTION RECOVERY?

Symptoms of Sex Addiction 

Although there is still no official diagnostic criteria for Sex Addiction or Hypersexuality disorder (as was known earlier) in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), following is a set of criteria formulated by clinicians and researchers based on their studies:

• Frequently engaging in more sex and with more partners than intended.
• Being preoccupied with or persistently craving sex; wanting to cut down and unsuccessfully attempting to limit sexual activity.
• Thinking of sex to the detriment of other activities or continually engaging in excessive sexual practices despite a desire to stop.
• Spending considerable time in activities related to sex, such as cruising for partners or spending hours online visiting pornographic websites.
• Neglecting obligations such as work, school, or family in pursuit of sex.
• Continually engaging in sexual behavior despite negative consequences, such as broken relationships or potential health risks.
• Escalating scope or frequency of sexual activity to achieve the desired effect, such as more frequent visits to prostitutes or more sex partners.
• Feeling irritable when unable to engage in the desired behavior.

You may have a sex addiction problem if you identify with three or more of the above criteria.

(Adapted from Symptoms of Sex Addiction, Michael Herkov, Ph.D.)

Compare this with the 2010 draft released by the American Psychiatric Association on preliminary criteria defining “sex addiction,” (formally called Hypersexual Disorder). 

The symptoms of Hypersexual Disorder are:

• Over a period of at least six months, a person experiences recurrent and intense sexual fantasies, sexual urges, and sexual behavior in association with four or more of the following five criteria:

1. Excessive time is consumed by sexual fantasies and urges, and by planning for and engaging in sexual behavior.
2. Repetitively engaging in these sexual fantasies, urges, and behavior in response to dysphoric mood states (e.g., anxiety, depression, boredom, irritability).
3. Repetitively engaging in sexual fantasies, urges, and behavior in response to stressful life events.
4. Repetitive but unsuccessful efforts to control or significantly reduce these sexual fantasies, urges, and behavior.
5. Repetitively engaging in sexual behavior while disregarding the risk for physical or emotional harm to self or others.

• The person experiences clinically significant personal distress or impairment in social, occupational or other important areas of functioning associated with the frequency and intensity of these sexual fantasies, urges, and behavior.

• These sexual fantasies, urges, and behavior are not due to direct physiological effects of drugs or medications, or to Manic Episodes.

(Adapted from Symptoms of Hypersexuality disorder, John M Grohol, Psy.D) 

Despite the fact that sex addiction does not yet have a defined set of clinical diagnosis, we cannot deny that people are going through severe physical and mental health issues because of their uncontrollable sexual behaviors/ urges. There is also no denying that people with sex addiction do show addictive behavior, in terms of rewarding and reinforcing, along with physical as well as psychological dependence. Based on the behavioral patterns displayed by people with sex addiction, there are treatment options available like behavioral therapies and medications. 

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