Is Sex Addiction Real?

Jada Pinkett-Smith is the latest in a string of celebrities who've come out as sex addicts. "When I was younger, I definitely think I had a sex addiction of some kind, yes, that everything could be fixed by sex," the actress revealed in the latest episode of her Facebook Watch series, Red Table Talk. But it's not just the rich and famous who are being treated for this disorder.

The signs of sex addiction

Sex therapist Alexandra Katehakis says that people who identify as sex addicts usually have a “constellation” of symptoms:

Repeatedly fail to resist impulses for certain sexual behaviours (like going to a strip club or masturbating at work)
Have urges that interfere with their day-to-day life
Continue to engage in sexual activity despite its negative consequences
Spend an inordinate amount of time thinking about sex
Feel an intense need to have more frequent or intense sex
Feel distressed about the symptoms above

Problem: Some experts say sex addiction isn't a thing

Clinicians, therapists, and doctors are split on whether sex addiction is even a real condition. Sex addiction isn't part of the Diagnostic Statistical Manual for Psychiatric Disorders (DSM-5)-or the “bible” of mental health conditions-which means it's not a diagnosable mental health condition. And though the World Health Organization will classify "compulsive sexual behaviour" in the International Classification of Diseases (ICD-11), the group has stopped short of calling it "sex addiction." But at the same time, rehab clinics catered toward sex addicts have been popping up for years, and various certifications exists for therapists who want to specialise in sexual addiction.

Is sex addictive?

Sex is a behaviour-not a substance that can manipulate your brain-so that's why many experts do not consider it a true addiction. Sex researcher Dr Justin Lehmiller is one of them. “I see the ‘sex addiction’ label as problematic because there just isn’t evidence that sex is addictive in the same way that, say, alcohol and drugs are,” he says.

When you’re addicted to something, the reward part of your brain is activated and levels of feel-good chemicals like dopamine spike. While the brain’s reward system is responsive to sex, many non-addictive behaviours-like, for instance, looking at cute puppies-also involve your brain’s reward system, explains sex researcher Dr Nicole Prause.

She notes many scientists don’t advocate for an addiction model of sexual behaviours, since sex fails to meet important addiction criteria. For example, with an addiction, someone might struggle to control their behaviour because physically, they can’t, but Prause notes that research finds this is not the case with sexual urges.

Why some people believe they're addicted to sex

“Some people who feel like their sexual behaviours are out of control aren’t truly out of control,” explains Lehmiller. “In fact, there’s some research finding that people who have moral qualms with their desires often label those desires as ‘compulsive’ or ‘out of control,’ perhaps because that’s easier than trying to accept and come to terms with one’s desires.”

Culture, upbringing, and religious views can all impact our views of sex. So it’s possible that an identifying sex addict may not be “addicted” at all, but rather was conditioned to feel shame toward otherwise common sexual behaviours.

Plus, many people who seek treatment for sex addiction are impacted by more than sex. In fact, they are often struggling with underlying mental health conditions such as depression, anxiety, bipolar disorder, and OCD, says sex therapist Michael Aaron.

One study of men seeking treatment for sex addiction actually found that 72 percent had at least one other psychiatric diagnosis. Many people who identify as sex addicts were also sexually abused as children, Katehakis notes.

“When you start looking at their sexual behaviours, they aren’t necessarily out of the ordinary in terms of their frequency,” Aaron explains. “These people just feel like they’re masturbating, looking at porn, or having sex ‘too much’ in relation to their moral standards.”

Even though most experts reject the term sex addiction, that’s not to say they reject the idea that people truly feel that their sexual behaviours are out of control or interfere with their day-to-day lives. This simply means that a person thinks that their sexual urges, thoughts, and behaviours have gone beyond what they see as normal, and are ultimately bothered by it, explains psychotherapist Douglas Braun-Harvey.

How out-of-control sex is treated

Because sex addiction isn’t a universally accepted term or idea, treatment can get tricky, and where you go can dictate what kind of treatment you get.

Those looking for help will be met with a couple of options. The most common course of action involves, at least at first, abstinence. So if you masturbate twice a day at work, then you’ll be told not to. The end point, Katehakis says, is to “restore sexuality to something that is exciting for someone.”

But others strongly oppose this method. “To create an abstinence-only approach is, to me, kind of akin to conversion therapy,” says Aaron, ultimately creating an umbrella of shame. After all, he says that research shows that many kinky desires and fetishes can be hard-wired.

Therapists also use the sexual health model, which views out-of-control sexual behaviour on a spectrum, and aims to understand how a man’s (the model has only been used on men so far) sex life might be “out of control.” The ultimate goal is to have someone’s life be more aligned with his values of sexual health.

Aaron notes that sex addiction therapy often leaves the root issues unaddressed. Almost universally, he says people report being bored, anxious, or depressed, so he works to give them the skills to tolerate those feelings-mindfulness exercises, for example. Medication for underlying mental health conditions (like antidepressants or anxiety meds) is also a treatment option.

While men are, in large part, the ones who seek out treatment for sex addiction issues, anyone who feels seriously distressed about sex (to the point where it is negatively affecting your everyday life), should consider counselling, says Lehmiller. He encourages looking for a provider who is a trained sex therapist.