Sexual compulsive behavior is an excessive obsession with sexual fantasies, impulses, and behaviors that are difficult to control and manage. It causes distress or adversely affects physical health, self-esteem, relationships, career, and other areas of one’s life. Some may think sexual compulsive behavior is sexual addiction, hypersexuality, lack of impulse control, or just a love for sex. But is it a confirmed diagnosis? What actually classifies sexual compulsive disorder as a problem, a real diagnosis, or even unhealthy behavior? Can excessive sexual activities indeed be harmful? Keep reading this blog to unfold the truth about sexually compulsive behavior.
The American Psychiatric Association (APA) and the American Association of Sexuality Educators, Counselors, and Therapists (AASECT), do not classify compulsive sexual behavior or hypersexuality as a diagnosable mental health disorder from the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). However, it is an ongoing debate and strongly suggests it is a subcategory of a mental health illness such as behavioral addiction or impulse control disorder. The debate continues as the International Classification of Diseased (ICD-11) defines it as an impulse disorder, “Compulsive sexual behavior disorder is characterized by a persistent pattern of failure to control intense, repetitive sexual impulses or urges resulting in repetitive sexual behavior.” Ongoing studies show there are medical, psychological, and social consequences because of the behavior. Although very little empirical data exists to consider it a tangible classified disorder, there is a significant increase in individuals needing help understanding and controlling the urges. Through the lens of mental health, sexual behaviors serve a purpose to escape emotional or physical anguish or a way to cope with life stressors.
Sex has become part of our mainstream culture as opposed to decades ago, when it was taboo or “what goes on behind closed doors stays behind closed doors.” Sexual expression and explicit coverage are now acceptable in movies, digital media, magazines, and entertainment. Sexual content is easily accessible through all digital platforms, advertisements, in-person and online retail stores, venues like strip clubs, cabaret shows, and even video games! Our cultural changes increase sexual presence and intensify in the United States, exposing the failure to control impulses – sexual addiction, also known as hypersexuality.
Compulsive sexual behavior can appear in various forms and severity comparable to substance abuse, impulse control, and mood disorders. Consequences mimic those much like those from substance use and impulse control disorders. However, identifying the behavior is challenging because it is a sensitive subject to discuss and accept by nature. According to National Center for Biotechnology Information (NCBI), signs are often subtle or irrelevant, and some apparent indications don’t justify compulsive behavior.
Characteristics and Symptoms
- It is recurring sexual activities that become the predominant focus of one’s life, neglecting and disrupting self-care, health, non-sexual activities, daily routine, and responsibilities.
- A powerful urge to engage in sexual activities thinking it’s for pleasure, but often it releases tension, anxiety, depression, loneliness, or stress afterward.
- Numerous unsuccessful attempts to drastically reduce repetitive sexual behaviors over a period of extended time.
- Continuously engaging in compulsive sexual behaviors, after experiencing and rightfully knowing the adverse consequences like sexually transmitted diseases, impairment in personal, family, social, academic, and occupational functions, financial strain, and legal issues.
- Detachment, continuing sexual behaviors despite receiving little to no emotional satisfaction or pleasure.
- Trouble establishing or maintaining stable and healthy relationships.
- Feelings of guilt or shame after
What activities are sometimes linked with compulsive sexual behavior?
- Uncontrollable masturbation
- Numerous affairs, sexual partners and one-night stands
- Engaging in unprotected sex
- Persistently using pornography
- Cybersex
- Sex with prostitutes and escorts
Although there is no official mental health diagnosis according to the DSM-5, compulsive sexual behavior presents and is associated with differential diagnoses and appears to be a subcategory. It is seen in individuals who suffer from:
- Bipolar or related mood disorders increase sexual urges and behaviors with evident persistent failure to control during a manic, hypomanic, or mixed episode. It must coincide with the presence of diagnostic requirements outside the episode.
- Personality disorders heighten sexual behaviors as a maladaptive regulation technique to prevent or reduce emotional distress or regulate oneself. If emotional dysregulation and other key components of personality disorders are married to compulsive sexual behavior, then an additional diagnosis is not warranted.
- Substance abuse/addiction: disinhibited and impulsive sexual activities occur during intoxication. They are primarily used for the intention to engage in sexual behaviors and enhance pleasure.
Compulsive sexual behavior can appear in anyone, but statistics show there is a heightened risk in people who have:
- Childhood trauma, including physical and sexual abuse, has higher rates in women and higher severity of abuse.
- Adults and adolescents who experience co-occurrent mental, behavioral, and neurodevelopmental disorders (ADHD, Autism, and others), including those due to substance use.
- Mental health conditions include mood disorders, depression, anxiety, substance abuse addiction, and gambling addiction.
- Family members who suffer from addiction
Unlike addictions to substances, the goal is NOT to completely refrain from sex. The goal is often to identify, understand and lessen triggers that lead to sexually compulsive behavior and perhaps reframe sex in one’s life where it doesn’t present functional impairments. As the controversy is ongoing if compulsive sexual behavior will be an official diagnosis in the DSM-5, mental health treatments, clinical assessment measures, and/or psychotropic medication can help control the impulses and provide a better understanding of what stems from this behavior. It suggests the use of various forms of psychotherapy modalities and medications to treat compulsive sexual behaviors once the differential diagnosis is relevant:
- Cognitive behavioral therapy (CBT): It helps find new ways through cognition (perception, thinking, reasoning, attention, and judgment) to change their thought patterns positively.
- Acceptance and commitment therapy (ACT): An acceptance and mindfulness-based technique that encourages commitment and change processes to create psychological flexibility.
- Psychodynamic psychotherapy: It increases awareness of unconscious thoughts and behaviors, producing new perceptions of the individual’s motivations and resolving conflicts.
- Antidepressants: SSRIs used to treat depression, anxiety, or obsessive-compulsive disorder
- Mood stabilizers: They are used to treat bipolar and other personality/mood disorders and can reduce sexual urges due to the episodes one cycles through.
- Naltrexone: It treats alcohol and opiate addictions and prevents the part of the brain that feels pleasure from addictive behaviors.
- Anti-androgens: It reduces the biological effect of sex hormones known as androgens in men. It is often prescribed with compulsive sexual behaviors when the behaviors are dangerous to others.
- Self-help groups: Sex Addicts Anonymous (SAA). It mimics the AAA program but is specific to sex addicts in a group setting.
Although most mental health treatments and psychotropic medications are used to lessen or reduce symptoms, the controversy still remains about whether compulsive sexual behavior is indeed an official mental health disorder. If you feel concerned you are exhibiting these behaviors, seeking professional help from a mental health clinician for a full clinical assessment is essential. You may uncover what truly stems from these behaviors and develop a healthier you.
The American Psychiatric Association (APA) and the American Association of Sexuality Educators, Counselors, and Therapists (AASECT), do not classify compulsive sexual behavior or hypersexuality as a diagnosable mental health disorder from the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). However, it is an ongoing debate and strongly suggests it is a subcategory of a mental health illness such as behavioral addiction or impulse control disorder. The debate continues as the International Classification of Diseased (ICD-11) defines it as an impulse disorder, “Compulsive sexual behavior disorder is characterized by a persistent pattern of failure to control intense, repetitive sexual impulses or urges resulting in repetitive sexual behavior.” Ongoing studies show there are medical, psychological, and social consequences because of the behavior. Although very little empirical data exists to consider it a tangible classified disorder, there is a significant increase in individuals needing help understanding and controlling the urges. Through the lens of mental health, sexual behaviors serve a purpose to escape emotional or physical anguish or a way to cope with life stressors.
Sex has become part of our mainstream culture as opposed to decades ago, when it was taboo or “what goes on behind closed doors stays behind closed doors.” Sexual expression and explicit coverage are now acceptable in movies, digital media, magazines, and entertainment. Sexual content is easily accessible through all digital platforms, advertisements, in-person and online retail stores, venues like strip clubs, cabaret shows, and even video games! Our cultural changes increase sexual presence and intensify in the United States, exposing the failure to control impulses – sexual addiction, also known as hypersexuality.
Compulsive sexual behavior can appear in various forms and severity comparable to substance abuse, impulse control, and mood disorders. Consequences mimic those much like those from substance use and impulse control disorders. However, identifying the behavior is challenging because it is a sensitive subject to discuss and accept by nature. According to National Center for Biotechnology Information (NCBI), signs are often subtle or irrelevant, and some apparent indications don’t justify compulsive behavior.
Characteristics and Symptoms
- It is recurring sexual activities that become the predominant focus of one’s life, neglecting and disrupting self-care, health, non-sexual activities, daily routine, and responsibilities.
- A powerful urge to engage in sexual activities, thinking it’s for pleasure, but often it releases tension, anxiety, depression, loneliness, or stress afterward.
- Numerous unsuccessful attempts to drastically reduce repetitive sexual behaviors over a period of extended time.
- Continuously engaging in compulsive sexual behaviors after experiencing and rightfully knowing the adverse consequences like sexually transmitted diseases, impairment in personal, family, social, academic, and occupational functions, financial strain, and legal issues.
- Detachment, continuing sexual behaviors despite receiving little to no emotional satisfaction or pleasure.
- Trouble establishing or maintaining stable and healthy relationships.
- Feelings of guilt or shame after
What activities are sometimes linked with compulsive sexual behavior?
- Uncontrollable masturbation
- Numerous affairs, sexual partners, and one-night stands
- Engaging in unprotected sex
- Persistently using pornography
- Cybersex
- Sex with prostitutes and escorts
Although there is no official mental health diagnosis according to the DSM-5, compulsive sexual behavior presents and is associated with differential diagnoses and appears to be a subcategory. It is seen in individuals who suffer from:
- Bipolar or related mood disorders increase sexual urges and behaviors with evident persistent failure to control during a manic, hypomanic, or mixed episode. It must coincide with the presence of diagnostic requirements outside the episode.
- Personality disorders heighten sexual behaviors as a maladaptive regulation technique to prevent or reduce emotional distress or regulate oneself. If emotional dysregulation and other key components of personality disorders are married to compulsive sexual behavior, then an additional diagnosis is not warranted.
- Substance abuse/addiction: disinhibited and impulsive sexual activities occur during intoxication. They are primarily used for the intention to engage in sexual behaviors and enhance pleasure.
Compulsive sexual behavior can appear in anyone, but statistics show there is a heightened risk in people who have:
- Childhood trauma, including physical and sexual abuse, has higher rates in women and higher severity of abuse.
- Adults and adolescents who experience co-occurrent mental, behavioral, and neurodevelopmental disorders (ADHD, Autism, and others), including those due to substance use.
- Mental health conditions include mood disorders, depression, anxiety, substance abuse addiction, and gambling addiction.
- Family members who suffer from addiction
Unlike addictions to substances, the goal is NOT to completely refrain from sex. The goal is often to identify, understand and lessen triggers that lead to sexually compulsive behavior and perhaps reframe sex in ones’ life where it doesn’t present functional impairments. As the controversy is ongoing if compulsive sexual behavior will be an official diagnosis in the DSM-5, mental health treatments, clinical assessment measures, and/or psychotropic medication can help control the impulses and provide a better understanding of what stems from this behavior. It suggests the use of various forms of psychotherapy modalities and medications to treat compulsive sexual behaviors once the differential diagnosis is relevant:
- Cognitive behavioral therapy (CBT): It helps find new ways through cognition (perception, thinking, reasoning, attention, and judgment) to change their thought patterns positively.
- Acceptance and commitment therapy (ACT): An acceptance and mindfulness-based technique that encourages commitment and change processes to create psychological flexibility.
- Psychodynamic psychotherapy: It increases awareness of unconscious thoughts and behaviors, producing new perceptions of the individual’s motivations and resolving conflicts.
- Antidepressants: SSRIs used to treat depression, anxiety, or obsessive-compulsive disorder
- Mood stabilizers: They are used to treat bipolar and other personality/mood disorders and can reduce sexual urges due to the episodes one cycles through.
- Naltrexone: It treats alcohol and opiate addictions and prevents the part of the brain that feels pleasure from addictive behaviors.
- Anti-androgens: It reduces the biological effect of sex hormones known as androgens in men. It is often prescribed with compulsive sexual behaviors when the behaviors are dangerous to others.
- Self-help groups: Sex Addicts Anonymous (SAA). It mimics the AAA program but is specific to sex addicts in a group setting.
Although most mental health treatments and psychotropic medications are used to lessen or reduce symptoms, the controversy still remains about whether compulsive sexual behavior is indeed an official mental health disorder. If you feel concerned you are exhibiting these behaviors, seeking professional help from a mental health clinician for a full clinical assessment is essential. You may uncover what truly stems from these behaviors and develop a healthier you.
