Sex Addiction (Hypersexuality Disorder)

What is sex addiction and hypersexuality disorder?

Sexual addiction, compulsive sexual behavior, hypersexuality disorder, or simply hypersexuality are all terms used to describe someone who has a compulsive need to engage in sexual activities. 

Though sexual addiction by any name is not recognized as a diagnosable condition according to the DSM-5^[1], many clinicians and psychological experts agree certain individuals can and do display the same behaviors toward sex as with diagnosable behavioral addictions.

For example, those with sexual addiction may be incapable of controlling their actions toward sex despite the negative consequences that may occur in their life as a result. This can include ruining relationships, missing important events to pursue sex, contracting diseases from not practicing safe sex with multiple partners, and using sex as a way of ignoring mental health issues such as depression or anxiety. 

This has led to many practicing counselors and therapists treating clients with undiagnosable hypersexuality using evidence-based treatment approaches for addiction. 

Types of hypersexuality disorder

Hypersexuality disorder is not confined to behavior just relating to sexual intercourse. The definition, as it stands, incorporates all sexual activity that can lead to problematic or compulsive behavior. This may include:

• Sexual intercourse with multiple partners
• Uncontrollable need for masturbation
• Watching excessive amounts of pornography
• Recurrent and intense sexual fantasies

Diagnosing hypersexuality

As previously mentioned, sex addiction or hypersexuality disorder is still only seen as a hypothetical condition according to diagnostic materials such as the DSM-5 and ICD-10.^[2][3] However, many psychologists, therapists, and medical professionals are calling for this to be amended in the next edition of the Diagnostic and Statistical Manual of Mental Disorders. The World Health Organisation (WHO) has also recognized compulsive sexual behavior disorder as a condition since 2018.

This is due to those experiencing issues controlling their behavior towards sex displaying the same criteria for other addictions, such as substance or alcohol use disorders.^[4]

This can include:

• Continued engaging in sexual activity despite adverse effects on social or interpersonal problems
• Neglecting work, social or educational responsibilities in favor of sex
• Experiencing withdrawal symptoms when not having sex
• Repeated failed attempts to control sexual behavior
• Social and recreational activities replaced by sex

For now, those presenting recognizable behavioral patterns towards sex that are in line with addiction criteria can and will find help and treatment from a range of therapists and rehab centers across the country, as well as support groups and 12-step programs. 

Signs and symptoms of compulsive sexual behavior

As there are no set criteria for diagnosis, deciding what is healthy and unhealthy sexual behavior is not wholly objective, meaning it can be difficult to know if you should seek help or not. 

However, recognizing the negative impacts your sexual behavior is having on your life can serve as an indicator of an issue being present. 

If you have experienced any of the below negative consequences of sex, it is possible you may have a hypersexuality disorder:^[5]

• Sexual fantasies, urges, and behaviors that are recurrent and intense and that distract from daily tasks
• Failure to control or subdue sexual fantasies, urges, and behaviors
• Feeling a constant drive to perform sexual acts to seek a release of pressure, despite feelings of guilt and shame
• You use sex or sexual activity as a release from mental health issues such as anxiety, loneliness, depression, and stress
• You have difficulty starting and/or maintaining relationships that are not solely focused on sex
• You continue to engage in troubling sexual behavior despite negative consequences to yourself and others (such as cheating on a partner, having unprotected sex with strangers, or having risky sex with strangers)
• Need to watch pornography even when it’s not appropriate

It is important to note that someone with hypersexuality disorder may not display a need for sexual gratification in all areas, nor does enjoying sex mean that a person has a sex addiction. The signs of porn addiction can also serve as an indicator of hypersexuality.

What causes sex addiction?

The exact causes of sexual behavior disorder are not entirely clear, though many have theorized that it may be an extension of other behavior disorders such as obsessive-compulsive, relationship, or impulse control disorder. 

As with other forms of behavioral disorders, hypersexuality has also been linked to past trauma, especially in those who have experienced sexual abuse or trauma.^[5] 

Other typical indicators of addiction may also be present such as the early life and environment of the individual and family history of hypersexuality. In some cases, people with mental illnesses such as bipolar disorder may display hypersexuality as a symptom, as do those with certain neurological disorders like epilepsy.

Is porn addiction the same as sex addiction?

Though the two are often treated as the same disorder, and indeed share a lot of similarities, sex addiction and porn addiction are not strictly the same thing. Key differences to note between sex and porn addiction include:

1. Hypersexuality often involves real-life interaction, porn does not
2. Porn addicts often struggle with real-life sexual scenarios
3. Porn addiction is also closely linked with internet addiction and stimulates the brain in different ways to sex addiction

Those with hypersexuality disorder will sometimes engage with porn in an unhealthy way. Similarly, those with porn addictions may develop unhealthy attitudes toward sex, including unrealistic expectations of appearance and wanting to perform extreme sexual acts with partners.

Is nymphomania the same as hypersexuality?

Nymphomania is an archaic term that dates back to the eighteen hundreds and was a diagnosable medical condition used to describe women who were deemed to have high sex drives. These women were seen as delinquents and heightened sexual appetite was deemed in females was seen as a disease worthy of treatment.^[6]

Nymphomania was also occasionally referred to as satyromania, though this term was mainly used in rare instances to describe men who were seen to have insatiable sexual appetites. 

Nymphomania and satyromania are no longer used as medical diagnoses and are rarely used in modern language when talking about sexual behavior. Hypersexuality disorder, compulsive sexual behavior, and sex addiction have become preferred terms for both male and female hypersexual behavior. 

Is hypersexuality the same as erotomania?

Despite its name sounding sexual in nature, erotomania has little to do with sexual behavior. Erotomania is in fact a specific delusional mental disorder. A person with erotomania believes that another person, often of higher social status and/or out of their social circle, is in love with them.^[7] 

Someone with erotomania may believe that the person who is in love with them is passing them secret messages to declare their love, often through hidden symbols or meaning. 

Erotomania has often been linked to delusions towards people on television (e.g. believing a talk show host is secretly communicating and in love with you) but in recent years has seen growing prevalence among social media obsessions. The condition is still rarely recorded and can often be overlooked as part of a larger delusional disorder.

What treatment options are available for sex addiction?

Compulsive sexual behavior is treated in much the same way as other forms of behavioral disorders such as shopping or gambling. Treatment solutions will often be focused on therapy, inpatient treatment, or support groups.

Get help for sex addiction today

Hypersexuality disorder is increasingly recognized as a condition that can dramatically affect a person's life and requires treatment and support to overcome. Visit our rehab directory today to see what treatment for sex addiction is available near you.