Sex is often a delicate topic, whether that be between two adults or a parent and a child. This is especially true when the issue of “sex addiction” comes up.
Sex addiction, also known as compulsive sexual behavior, has been defined as an excessive focus on and participation in sexual activities despite negative consequences. It can have extreme consequences on one’s emotional, psychological and social well-being.
When the American Psychiatric Association made the bold decision not to include sex addiction in the DSM-5 (the Diagnostic and Statistical Manual of Mental Disorders, fifth edition), many felt the choice was controversial. Those against its inclusion argue that it does not meet sufficient diagnostic criteria and that pathologizing sexual behavior can have dangerous ramifications. After all, how do you draw the line between a healthy relationship with sex and compulsive sexual behaviors?
Proponents of its inclusion, however, argue that without a formal categorization system people may not receive the help they need. For example, will insurance cover health care treatment for sex addiction if it is not considered a mental health disorder?
While both sides make fair arguments, we cannot deny the connections between mental health and sex addiction. For 88% of those with a sex addiction, mental illnesses play a key role.
In this article, KeyStone Center ECU dives into exactly what those connections are. We explore how mental health problems can become both a cause or a symptom of sex addiction and how it can be similar to other behavioral health issues.
Mental Health and Sex Addiction
Understanding how mental health and sex addiction are connected is crucial for developing empathy for those affected by it. KeyStone Center ECU has compiled a list of examples of how mental health and sex addiction are connected.
The Effects of Trauma
One instance in which mental health can lead to sex addiction involves trauma. Trauma is a common thread among people affected by a variety of addiction issues.
According to a study conducted by sex addiction researcher Patrick Carnes, Ph.D., a significant amount of people with sex addiction experienced emotional abuse (97%), sexual abuse (81%) or physical abuse (72%) in childhood.
Furthermore, people who came from rigid, uninvolved and emotionally absent families were also more likely to experience sex addiction (77%). In other words, sex addicts often come from childhood environments in which they never learned how to create and maintain emotional bonds. Once they reach independence in adulthood, now free of their former rigid environment, they may struggle to self-regulate their behavior.
People with traumatic backgrounds may develop trauma responses that manifest as compulsive sexual behaviors. This can include developing a sense of unworthiness (which can cause guilt and shame in sexual experiences), extreme risk-taking with the goal of achieving fleeting pleasure and re-creation of the traumatic experience, also called trauma reenactment.
For example, someone with a traumatic background may develop extreme anxiety as an adult. When this anxiety is triggered, the affected person may resort to sexual behavior to decrease the discomfort they are experiencing. When anxiety and trauma are severe enough, the sexual behavior can become all-consuming.
Eye Movement Desensitization and Reprocessing (EMDR) is a common treatment for those with a sex addiction rooted in trauma. EMDR is a trauma-focused therapy that helps patients identify and process their trauma.
Often, trauma gets stored in the right side of the brain (the emotional side). By stimulating both sides of the brain, EMDR shifts the traumatic memory from the right side of the brain to the left side (the logical side). Doing this can reduce the negative feelings associated with trauma. EMDR can provide a faster and more effective results than other traditional forms of therapy.
By exploring the root cause of their trauma and mental health, those affected by sex addictions may understand why they use sexual behavior as a coping mechanism and work through their issues to develop healthier responses.
Self-Worth and Depression
Sexual behavior may provide a temporary ‘relief’ to a person’s depressive symptoms. They achieve a dopamine high by engaging in sexual behaviors repetitively. Ultimately this may do more harm than good.
Addiction affects dopamine levels in the brain making it difficult to maintain that same intense high. Consequently, an addict needs more and more of the behavior to achieve the same high.
Sex addicts often report feelings of guilt, shame and remorse associated with their sexual experiences. Addicts may feel hopeless and powerless in their situation, believing they have no control over their sexual thoughts and actions. Therefore, they get stuck in a loop of negative behaviors. Patrick Carnes calls this “The Offending Cycle”.
As a result, antidepressants and cognitive behavioral therapy are a common treatment option for sex addiction.
Bipolar Disorders as Symptom and Cause
Bipolar disorder can be both a cause and a symptom of compulsive sexual behavior, as, untreated bipolar disorder may lead to behaviors consistent with sex addiction. For example, the individual may slip into a manic state and feel increased sexual urges. This, in turn, may manifest as reckless or out-of-control sexual behaviors.
Once the manic state is over, however, the individual may feel shame or remorse for their actions, exacerbating symptoms of depression. This, in turn, may lead to subsequent acting out behavior.
For some people, there are specific ‘triggers’ which cause the onset of manic episodes. For example, there may be certain places, times of the day, or thoughts that lead to manic episodes involving sexual acting out behavior.
For others, manic states may appear randomly. In this case, the manic state is often caused by irregular brain chemistry. This is why mood stabilizers, antipsychotics and therapy are often an effective treatment option for those experiencing compulsive sexual behavior.
By understanding how to recognize the occurrence manic episodes, the person is better armed to stabilize their sexual addiction as well.
Substance Abuse and Sex Addiction
The connections between substance abuse and sex addiction, often referred to as ‘pairing’ go back to the roots of the term ‘sex addiction’ itself.
‘Sex Addiction’ as a term first appeared in the mid-1970s when a group of people in Alcoholics Anonymous got together to apply the principles of 12-step programs to issues of compulsive sexual behaviors.
Research has shown that sexual addiction and substance abuse are often correlated. An estimated 40-64% of sex addicts also suffer from substance abuse disorders. Common addictions include alcohol abuse (30-40%) and marijuana abuse (18-21.7%). However, sex addiction has also been observed in cocaine and amphetamine users.
Though sex, gambling and food are process addictions, sex addiction can feel just like any other addiction, including substance abuse. The symptoms are similar to those who have an alcohol or drug addiction, as sex addicts often believe that their cravings are out of their control.
They may return to sex, over and over again, to experience the ‘high’ of it despite negative consequences. Just like with other addictions, they may escalate their behavior over time. They may begin to engage in sexual behaviors more frequently or with more recklessness.
Someone suffering from both substance abuse and mental health issues, including sex addiction, is defined as having a co-occurring disorder.
KeyStone Center ECU understands the importance of treating individuals with co-occurring disorders and takes this into consideration when developing an individualized treatment plan.
Recovery Is Possible
Understanding the connections between mental health and sex addiction is crucial to developing a holistic and empathetic approach to treatment.
While sex addiction can feel isolating, you are not alone. Some estimates show that up to 10% of the U.S. population suffers from some type of sex addiction.
Recovery is possible with the help of mental health professionals, support groups, and, as needed, medication.