Hypersexual Disorder (Sex Addiction)

Sex addiction can involve pornography, sexting, compulsively engaging in sex acts with multiple partners, excessive masturbation, exhibition/voyeurism, and sometimes involves pedophilia. Much to the dismay of many sex addiction experts, the American Psychiatric Association (APA) did not include this in its Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), published in 2013. Despite the omission, diagnostic codes for this disorder were incorporated into the International Classification of Diseases (ICD-10), the primary diagnostic codes used in the U.S., in October 2015. This enables clinicians to make an official diagnosis and also impacts mental health coverage. Although ICD-11 is not scheduled to be published until 2018, a diagnosis of Compulsive Sexual Behavior Disorder is being considered, with the following suggested definition.1

Compulsive sexual behavior disorder is characterized by persistent and repetitive sexual impulses or urges that are experienced as irresistible or uncontrollable, leading to repetitive sexual behaviors, along with additional indicators such as sexual activities becoming the central focus of the person’s life to the point of neglecting health and personal care or other activities, unsuccessful efforts to control or reduce sexual behaviors, or continuing to engage in repetitive sexual behavior despite adverse consequences (e.g., relationship disruption, occupational consequences or negative impact on health). The individual experiences increased tension or affective arousal immediately before the sexual activity, and relief or dissipation of tension afterward. The pattern of sexual impulses and behavior causes marked distress or significant impairment in personal, family, social, educational, occupational or other important areas of functioning.1

Every so often a scandalous sex addiction story about a celebrity or politician is reported by the mainstream and tabloid media. Former N.Y. Congressman Anthony Weiner is a case in point of somebody who denied he had a sex addiction for many years, but whose compulsive behaviors proved otherwise. In 2011, he was forced to resign his congressional seat after being caught exchanging sexual messages on Twitter. Two years later during his run for mayor of NYC, his wife Huma Abedin still by his side, another sex scandal came to light involving sexting, once again ruining his political aspirations. On May 19, 2017, the former congressman tearfully acknowledged a “sickness” and “destructive impulses,” pleading guilty to federal charges of transmitting sexual material to a minor. He could face prison and his long-estranged wife finally filed for divorce. Despite all the repercussions to his career and personal life, Weiner seemingly could not stop – that certainly meets the criteria for an addiction, even if experts still cannot agree if sexual addiction is a clinically diagnosable disorder.2

Sex Addiction Withdrawal Symptoms

The mental and emotional components of sex addiction withdrawal can be intense, in particular in the beginning, and like substance use, cause cravings. Withdrawal is different for everyone, but in general, a person can experience bouts of depression or anxiety, mental and physical exhaustion, mood swings, irrational thoughts, unexplainable physical pain, irritability, sleepiness or sleeplessness.3 The following represent porn withdrawal symptoms experienced by a male over a period of time, with onset starting within 48 hours of quitting.4

  • Grumpiness
  • Mood swings
  • Headaches
  • Anxiety
  • Craving (a strong temptation to look at porn, called the seven-day craving)

One to Three Weeks Post Porn

  • Zombie-like state
  • Low energy levels (up to two months)
  • Inability to focus
  • Social awkwardness
  • Low sex drive
  • Loneliness

Days 30 to 60

  • Random temptations
  • Outbursts of overwhelming emotion
  • Insomnia
  • Depression

Love Addiction

Like sex addiction, love addiction is not included in the DSM-5, but scientific studies provide evidence that this is a real disorder. Widely used expressions such as “I need you” and “I’m addicted to you” reflect the fact that when humans are in love, they feel an overwhelmingly strong attraction to another person – best described as persistent, urgent and hard to ignore. People with a love addiction are often in love with the feeling of being in love, which triggers compulsive behaviors. It is not uncommon for individuals with love addiction to never get past the initial stages of falling in love. This stage produces the euphoric feelings they desperately crave, whereas a long-term relationship, albeit a loving one, can become fraught with the everyday challenges all humans face, which can lead to diminished happiness.5

In the last decade, an increasing number of studies have suggested that “being in love” is associated with characteristic biochemical reactions in the brain involving dopamine, oxytocin, vasopressin, and serotonin. These neurochemicals impact brain regions known to play a role in the development of trust, feelings of pleasure and reward signaling. A seminal article on this subject, published by Burkett and Young in 2012, includes the following insightful vignette, which could easily be interpreted as a description of substance addiction.3

At first, each encounter was accompanied by a rush of euphoria – new experiences, new pleasures, each more exciting than the last. Every detail became associated with those intense feelings: places, times, objects, faces. Other interests suddenly became less important as more time was spent pursuing the next joyful encounter. Gradually, the euphoria during these encounters waned, replaced imperceptibly by feelings of contentment, calm and happiness. The moments between encounters seemed to grow longer, even as they stayed the same, and separation came to be filled with painful longing and desire. When everything was brought to an abrupt end, desperation and grief followed, leading slowly into depression.3

Love Addiction Withdrawal Symptoms

When addictive relationships come to an unwanted end, typically one person fares worse than the other, experiencing pain, grief, loss, clinically diagnosable depression and sometimes vengeful behavior. The alternating cycles of ecstasy and despair, desperate longing and extreme, sometimes damaging behaviors bear a resemblance to drug, alcohol or gambling addictions. In worst-case scenarios, this can end in tragedy, with more than 10% of murders in the U.S. committed by a victim’s lover in 2011.3

Although these disorders are not yet officially recognized by the APA, the good news is they are highly treatable, with a variety of available therapeutic approaches including psychotherapy, 12-step programs such as love addiction anonymous and pornography addicts anonymous and couples therapy. With proper treatment, people who suffer from these addictions can achieve happiness in long-term, loving relationships, if that is their desire.

  1. Krueger RB. Diagnosis of hypersexual or compulsive sexual behavior can be made using ICD-10 and DSM-5 despite rejection of this diagnosis by the American Psychiatric Association. Addiction. 2016 Dec;111(12):2110-2111. doi: 10.1111/add.13366.
  2. Anthony Weiner pleads guilty to sexting with minor; Huma Abedin files for divorce. USA Today website. https://www.usatoday.com/story/news/2017/05/19/reports-anthony-weiner-plead-guilty-sexting-minor/101870332/ Published May 19, 2017. Accessed May 19, 2017.
  3. Earp BD, Wudarczyk OA, Foddy B, Savulescu J. Addicted to love: What is love addiction and when should it be treated? Philos Psychiatr Psychol. 2017;24(1):77-92.
  4. 12-Week Porn Addiction Withdrawal Walkthrough. Husband Help Haven website. http://husbandhelphaven.com/porn-addiction-withdrawal-walkthrough/ Accessed May 19, 2017.
  5. What is Love Addiction? Project Know website. http://www.projectknow.com/research/love-addiction/ Accessed May 19, 2017.

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