One major problem with sex addiction is that many people don't understand how destructive, painful and damaging the addiction really is. While humans are naturally programmed to crave sex, people with sex addiction are unable to control these cravings. They may exhibit bizarre and exhibitionist behavior in public related to sex. They may also be unable to stop themselves from engaging in a sex act in an inappropriate place, such as work. A sex addict may be burdened with relentless and uncontrollable thoughts about sex. These thoughts and symptoms can be present to such a degree that hopelessness and depression are often mentioned by people living with sex addiction. The pleasure component of sex is often lost during sex addiction. Over time, the brain begins to crave the release or escape factor of sex - and the sex addict can literally numb out during sex. Many people with the addiction also have trouble becoming interested or performing in "regular" real-life sex situations, such as with a spouse or committed partner. Many come to view sex as more of an opportunity to escape negative emotions than a pleasurable activity. People with sex addiction may also use pornography excessively, and can have both a sex addiction and a pornography addiction simultaneously. While the symptoms of sex addiction can vary in severity from person to person, the addiction is progressive - like addictions to drugs or alcohol. It requires professional help to reach symptom management and recovery. Researchers are learning more about the complex factors related to sex addiction, including long-held problems with emotional intimacy and in some cases, a history of low self-esteem or abuse.