Is Sex Addiction a Mental Illness?

August 7, 2020

Compulsive sexual behavior, teen sex addiction, or hypersexuality are terms often used interchangeably to describe the actions of a person who either with or without intention engages in sexual behavior. Someone with sexual addiction will experience excessive preoccupations with sexual fantasies, urges, or behaviors that are difficult to control. These behaviors and fantasies eventually cause distress, negatively affect health, jobs, relationships, and other parts of the individual’s life. Unfortunately, sex addiction is often used as the groundwork for comedic routines and funny punchlines on television shows and movies. The painful reality is that sex addiction is a condition that destroys relationships, lives, and extended families. Over the years, psychiatrists have been hesitant to apply a mental health diagnosis to the presence of “out-of-control sexual behavior.”

What is Compulsive Sexual Behavior?

Sex and sexual behavior are a normal part of human existence. So, at what point does normal sexual behavior cross the line to compulsive sexual behavior? Compulsive sexual behavior or sexual addiction may involve a variety of everyday sexual experiences. Some examples may include the use of pornography, paying for sex, masturbation, or engaging in sex with multiple partners. When these activities or behaviors become a primary focus of life, become difficult to control, or are disruptive and harmful to the other people in your teen’s life, they may be considered sexual addiction or compulsive sexual behavior.

Is Sex Addiction a Mental Disorder?

For many years, mental health providers and the medical community have been hesitant to attribute the mental health diagnosis to compulsive sexual disorders. In 2010 researchers at UCLA set out to determine whether sex addiction was, in fact, a mental health disorder or, conversely, a willful engagement in sexual acts and behaviors. The findings of this study were published in the Journal of Sexual Medicine. They were intended to help play a role in determining whether hypersexual disorder would be listed as a mental health diagnosis in the up-and-coming edition of the Diagnostic and Statistical Manual of Mental Health Disorders (fifth edition) or the DSM-5.

Those in charge of this study believe the research was significant because it would help to declare hypersexual disorder a “real” mental illness and, therefore, a condition that could be treated through therapeutic means. The UCLA study laid out criteria required for hypersexual disorder or sex addiction to be deemed an actual mental health disorder. Within the DSM-5, diagnosable mental health conditions contain a detailed list of criteria that one must experience for specific windows of time or in repeated iterations for their condition to be considered diagnosable. In the case of sex addiction, it was deemed that an individual must experience repeated sexual fantasies, behaviors, and urges lasting upwards of six months. These behaviors could not be due to factors such as medication, another medical condition, substance abuse, or manic episodes linked to previously diagnosed bipolar disorder. As with other mental health disorders, the individual must also display evidence of personal distress arising from the sexual behaviors that interfere with their relationships and other aspects of life.

Diagnosable Mental Health Disorder

The 2010 UCLA sexual addiction study, along with other research in the field, helped pave the way for sexual addiction or hypersexual disorder to receive more attention as a diagnosable mental health disorder. The study itself showed that increased sexualized behavior was related to more significant emotional disturbances, inability to manage stress, and impulsive behavior in the study participants. It also showed that individuals who met the standards for hypersexual disorder experienced significantly more adverse consequences due to their behaviors when compared with those who were suffering from substance abuse disorders or a different medical condition. A few other noteworthy findings include that among the 207 participants in the study, an overwhelming 54% of the participants believe their sexual activity problems began during their teen years and well before turning eighteen. Consequently, sexual addiction appears to be a disorder that emerges during adolescence. This finding is of critical importance because it indicates that early intervention and treatment at a residential facility like Hillcrest in Agoura Hills could help to limit the long-term adverse impact on a teen’s life.

Symptoms of Sexual Addiction

Sexual addiction, as with many addiction-related mental health conditions, does not pick and choose who it impacts. There have been many stories over the years showing how sexual addiction affects everyone, from celebrities to the kind person who owns the corner store in your hometown. While the exact causes of sexual addiction in teens remain unknown, there are a variety of symptoms or indicators that may indicate sexual addiction in your teen.

Behavioral Indications

If your teen is experiencing recurrent or intense sexual fantasies, urges and behaviors that take up a lot of their time or it seems as though these behaviors are out of their control it may be time to consider treatment with the team of treatment professionals at Hillcrest where we specialize in creating treatment programs for each individual that we work with. Also, if your teen is experiencing a drive to engage in certain sexual behaviors but feels guilt or remorse after this could be indicative of sexual addiction or a hypersexual disorder.

Sexual Behavior as a Substitute

The inability to reduce or control fantasy behavior and the use of sexual behavior as an escape from other problems such as anxiety and stress or depression are also of concern. Similarly, suppose your teen chooses to continue to engage in sexual behaviors with severe adverse consequences such as legal problems, loss of relationships, or loss of a job. In that case, it may be time to have a conversation with your mental health provider.

Causes and Risk Factors

Despite research and studies, the exact causes of compulsive sexual behavior in teens remain unclear; however, it is thought to arise from various brain changes.

Brain Chemicals

Neurotransmitters are chemicals within the brain responsible for regulating mood. An imbalance of these chemicals such as serotonin, dopamine, and norepinephrine may contribute to dysregulation and, therefore, alterations in behavior. High levels of these chemicals may be related to compulsive sexual behavior.

Changes in Brain Pathways

Over time, certain addictions cause changes in the circuitry of the brain. Compulsive sexual behavior may cause changes in the reinforcement centers of the brain. Like other addictions, eventually, the individual requires more intense sexual content and stimulation to meet their perceived needs or game satisfaction and relief.

Conditions that Affect the Brain

Certain diagnosed medical conditions such as epilepsy and dementia may damage parts of the brain that affect or control sexual behavior. Also, some medications used to treat certain diseases or health problems may cause compulsive sexual behavior.

Compulsive sexual behavior can occur in both men and women, though it may be more common in men. It can also affect anyone, regardless of sexual orientation. Factors that may increase the risk of compulsive sexual behavior include things such as the ease of which sexual content is accessed and coexisting mental health or other addiction-related problems. For example, in today’s technologically heavy age, advances in technology and social media allow easy access to increasingly vivid sexual imagery and information online. Content that was once considered taboo or only available in the back corner of a local video rental store is now often available on free websites without any form of access restriction.

Adolescents and teens already diagnosed with another mental health condition such as depression or anxiety or an addictive disorder such as alcohol or drug abuse problems may be at higher risk of sex addiction or compulsive sexual behavior than teens without a coexisting disorder.

Down - Sex Addiction - Hillcrest

Seeking Treatment

Shame and embarrassment often inhibit people from seeking treatment for sex addictions. Your teen (and family) need to remember they are not alone, and many people from all walks of life struggle with compulsive sexual behavior. If your teen has lost the ability to control their sexual behavior and their actions have begun to impact others, it is time to seek professional treatment. While seeking a treatment provider, it is essential to remember that not all medical providers are trained to treat sexual addiction. It is imperative to find a provider with the skills necessary to adequately diagnose and treat the symptoms and negative impacts of this condition. The symptoms and consequences associated with sex addiction tend to increase over time, and therefore, it is essential to seek treatment as soon as you realize there was a problem.

As with many addiction disorders, early intervention and treatment are often the keys to a successful recovery. Because the causes of compulsive sexual behavior are not clear, there remains a question as to whether this mental health condition is “preventable.”

Identifying and treating the early symptoms of compulsive sexual behavior may help prevent it from worsening or escalating to a point where the behavior harms your teen, family, or loved ones. Compulsive sexual behavior and sex addiction may also be further exacerbated by coexisting mental health conditions such as depression and anxiety, alcohol or drug abuse problems, or trauma-related disorders. It is important to seek treatment for these coexisting conditions as the therapeutic process may also help to minimize the symptoms and effects of sex addiction. Regardless of title, untreated sex addiction can lead to damage and self-esteem, irreversible relationship damage, career difficulties, legal problems, and other health conditions such as sexually transmitted diseases. With early treatment, your teen can learn to manage compulsive sexual behavior and its associated symptoms.

If you believe your teen is struggling with behaviors that could be related to sex addiction, don’t wait to seek treatment. As previously noted, the symptoms associated with this mental health condition typically escalate overtime, only leading to further detriment. Our trained team of Southern California mental health providers understands the challenges and difficulties related to your teen admitting they need help for sex addiction. For many, facing sex addiction may be more complicated than any other form of addiction due to stigma and embarrassment. Despite these concerns, early treatment is essential.