By Dr. Jackline Ochieng' Specialist Psychiatrist
Sex is a healthy human activity and enjoying it within the right context and boundaries is very normal. It is important to note that there may be differences in level of sexual interest between partners, with some enjoying sexual activity more than others. This should not be misinterpreted as sex addiction.
Addiction is a primary, chronic disease of brain reward, motivation, memory and related circuitry. Dysfunction in these circuits leads to characteristic biological, psychological, social and spiritual manifestations. It is characterized by inability to consistently abstain, impairment in behavioral control, craving, diminished recognition of significant problems with one’s behaviors and interpersonal relationships, and a dysfunctional emotional response. Addiction can be reflected in an individual pathologically pursuing reward and/or relief by substance use and other behaviors or experiences such as sex, food, gambling, exercise, internet, television, shopping, among others.
Sex addiction is referred to as the compulsive need to perform sexual acts in order to achieve the kind of fix that one with a drug addiction would get from using a particular drug/substance. This may range from having sexual activities with multiple sex partners, compulsive need to be in sexually stimulating situations, to masturbate or view pornography.
Causes may be physical/biological (genetic or hormonal), psychological or even social:
Physical/biological causes may include genetic predisposition to behavior that results from emotional dysregulation, impulsivity or sensation seeking. Or even predisposition to anxiety or depression, that may be associated with sex addiction. Hormonal influences like higher levels of sex hormones ( estrogen /testosterone) can affect libido, making one more likely to engage in impulsive behavior and excess sexual activities.
Psychological causes may include underlying mental disorders such as depression, personality disorders, poor impulse control, anxiety or even bipolar mood disorder where there is tendency towards excessive or risky sexual behavior in the manic phase. Early life/ childhood events like child abuse or exposure to sexual content may contribute to hypersexual behavior.
Social factors may include: social learning/modeling a behavior by observing others engaging in excessive sexual activities physically or through pornography; social isolation which may increase one’s likelihood of seeking inappropriate ways of sexual gratification, and may predispose to depression; rejection in relationships and social circles that may lead to unhealthy ways of finding sexual gratification.
Some signs and symptoms to look out for may include:
Chronic, obsessive sexual thoughts and fantasies
Preoccupation with having sex even if it interferes with daily life, productivity and work performance
Compulsive relations with multiple partners, including strangers
Inability to stop or control the behaviors
Putting oneself in danger due to sexual behavior
Lying to cover behaviors
Feeling remorse or guilt after sex
One may be secretive in their behavior, hiding their habit from spouse/partner and family members. They may lie about their activities or engage in them at times and places where they will not be discovered. These behaviors can be dangerous, causing strain and infidelity in relationships.
The effects of sex addiction can be physical, psychological, social and even spiritual. One may get sexually transmitted infections/diseases, sexual dysfunction and unwanted pregnancies. They may experience feelings of shame, inadequacy and emotional distress as well as anxiety, depression, substance use disorders and obsessive-compulsive disorders.
Treatment can be done in an in-patient setting, to remove one from their normal daily lives and help them regain control of their impulses. One is not expected to give up sex completely but is encouraged to refrain from compulsive and destructive sexual behavior.
This may include some medication to reduce urges and/or psychotherapy;
Individual Therapy and/or Cognitive Behavioral Therapy (CBT), whereby one is systematically helped to identify triggers for sexual impulses and taught how to alter behaviors.
Group Therapy and/or Sex Addicts Anonymous (SAA) which uses the 12-step program like Alcoholics Anonymous (AA). This provides a good support system and accountability platform.
It would also be important addressing co-occurring problems such as depression, social anxiety, or social isolation, as well as managing the physical conditions that may be present.