Depression and Sex Addictionby Anne Windermere Patient Advocate
We have all heard the term "sex addiction" before. The gossip magazines love to feature celebrities who are famous for their sexual addiction. Famous sexual addicts include Tiger Woods who made the news for months, not for golfing, but for his many sexual exploits and David Duchovny, whose real life mirrors his sex obsessed character on the television show, "Californication." There is even a reality show called, "Sex Rehab with Dr. Drew" in which celebrities show their struggle to overcome their sexual addiction.
As popular as the term, "sexual addiction" is, what do we really know about it? Can this truly be considered an addiction much like an addiction to alcohol or heroin? And if this is a true addiction then why is sexual addiction not included as a diagnostic category of the Diagnostic and Statistical Manual of Mental Disorders? How does depression play a part in sexual addiction? If one is considered to have a sexual addiction what can be done about it? This post will try to provide answers to these questions and more.
What is sexual addiction?
The Society for the Advancement of Sexual Health gives a conservative estimate that as many as 3 to 5 percent of Americans may fall into the category of having a sexual addiction. The true percentage may be higher because many individuals with sexual addiction do not admit that they have a problem. There is no single consensus of what constitutes a sexual addiction in the literature. One definition is that a sexual addiction is any sexually related compulsive behavior which interferes with normal living and causes severe stress on family, loved ones, and one's occupation. Like any addiction sexual addiction means that the individual will sometimes risk everything they cherish in order to get their "fix."
There are a wide variety of compulsive behaviors which may fall under the broad category of sexual addiction which may include compulsive masturbation, unsafe sex with a variety of partners, or extensive use of pornography or sexual services. Despite efforts to stop, the individual with a sex addiction may find themselves continuing to engage in self destructive behaviors. As Dr. Drew Pinsky, addiction expert and host of VH1's "Celebrity Rehab" reports, sexual addiction isn't simply about promiscuity. He and other experts agree that sexual addiction is not about sex but is a problem with intimacy. The sex addict may be afraid of intimacy so they use sex as a substitute for human connection.
How is sexual addiction related to depression?
Depression and anxiety may be the underlying disorders which fuel a sexual addiction. Some experts say that sexual addiction is really a coping mechanism to numb painful feelings and memories. This theory seems to be confirmed in interviews with persons having a sexual addiction. In a 2004 Dateline NBC article entitled, "Battling Sexual Addiction,"one female interviewee talked about "feeling rotten" as the precipitating factor before she acted out sexually. Afterwards she would feel horrible and the cycle would begin again. Other people having a sexual addiction agree that it isn't about the sex but more about escaping pain or reducing anxiety. The guilt and shame over their actions causes some sexual addicts to contemplate suicide just to stop the endless cycle.
Some studies have demonstrated the link between depression and sexual addiction. In a 2004 study, researchers at the Kinsey Institute for Research in Gender and Reproduction at Indiana University, concluded that their sample of individuals identified as having a sexual addiction had an increased interest in sex when they were either depressed or feeling anxious.
Other experts such as Maureen Canning, author of "Lust, Anger, Love: Understanding Sexual Addiction and the Road to Healthy Intimacy" theorize that trauma in childhood such as sexual abuse can also drive sexual addiction or hypersexuality in adulthood. There are estimates that about a third of sex addicts are female and that early sexual abuse may be one precipitating factor.
What is the controversy behind using "sexual addiction" as a diagnostic label?
Not everyone agrees that sexual addiction should be included in the upcoming edition of the Diagnostic and Statistical Manual of Mental Disorders. In a CNN Health article, "Is Sex Addiction Real?" some therapists doubt the validity of calling this an addiction. Some see the behaviors classified as sexual addiction to be more a part of an obsessive compulsive disorder. Others see these behaviors as symptoms of other psychiatric illnesses including depression. More research may need to be done before any consensus is reached in the psychiatric community as to the appropriate diagnostic label for what the general public is calling sexual addiction.
Political commentators, such as Raymond J. Lawrence, believe that the term "sexual addiction" is an ominous sign of cultural and religious influences. In a Counterpunch post entitled, "The Brave New World of Sexual Addiction," Lawrence worries about the implications of treating sexual addictions: "Following the substance abuse mode implies that the only cure for an addiction to sexual pleasure would be a celibate or monastic life, a complete renunciation of the alleged addictive sexual pleasure."
Lawrence also wonders aloud about the power of psychiatry to determine if our sex lives are healthy or not: "So now according to the working version of the new DSM-5, psychiatrists will be able to assess whether one is having too much sex, or even whether one simply wants too much sex. Or too little. They will presumably have some kind of measuring rod to determine what is too much or too little."
Others who are against the inclusion of sex addiction as a diagnostic label fear that sexual addiction will be the new "excuse" for bad behavior. Despite the controversy over the label, many therapists and self identified sexual addicts believe that this is a true disorder in need of a proper diagnosis and treatment.
How does one know if they are a sexual addict?
We hear about the extremes in the news all the time but is sexual addiction also a term which is too broadly used? What about the wife who finds porn on her husband's computer and comes to the conclusion that he is a sex addict? What about the husband who can't keep up with his spouse's demand for sexual intimacy and declares his wife to be a sex addict because she wants sex more than twice a week? Are there actual criteria for determining a sexual addiction?
There do seem to be many on-line resources to help draw these lines of distinction between whether your sexual behavior is veering towards addictive behavior. PsychCentral, for example, provides a list of sexual addiction symptoms for you to read.
There are also many on-line screening tests such as the ones offered by The Sexual Recovery Institute which include screening tests such as: Cybersex Addiction Screening Test and Partner's Sexual Co-Addiction Screening Test.
The most valid way to know if sexual addiction is a psychological issue for you is to seek the help of a qualified mental health professional.
Are there resources to help overcome sexual addiction?
The Internet is filled with many resources to assist the individual with a sexual addiction as well as family members and loved ones. Here are some links to find help:
Codependents of Sex Addicts (COSA)
Do you feel that you or your loved one may have a sexual addiction? Could you share some of your story with us? Remember that you can choose to be anonymous in your comments. We would love to hear from you.