We talk about compulsive sexual behaviour when a person has, in an excessive way, recurrent sexual fantasies and anxiety about behaviors related to sex. This results in a state of impulsivity that is difficult for the patient to stop. It has its diagnostic criteria and treatment protocols.
Although there is some reluctance on the part of certain mental health professionals to accept the disorder, most include it as just another addiction. It receives, among other names, those of hypersexuality and sex addiction.
Identifying the Boundary Between Normal Sexual Desire and Compulsive Sexual Behaviour
How can we identify between good sexual health and desire and compulsive behavior? Because the compulsion, the deep need to satisfy the desire for sex, begins to take away the principles of personal lives.
When a person constantly violates covenants with his partner, he assumes impossible financial expenses and performs reckless behaviors that risk important things such as his health, his family, and his job. So we can talk about something that becomes pathological, that is stronger than the person himself.
In general, these irrational impulses are developed with a state of internal tension that does not allow one to fully enjoy sex either. As if it were an excess, hypersexual people rush towards anything that can calm them; This implies people who do not like extreme sexual practices and homosexual or heterosexual encounters would not choose if it were not for the urgency. For hypersexuals, the other person takes on the role of object, and the encounter is a discharge function. They feel that in this way, they release their anguish, anxiety, and any complex emotions. The problem is that the release is momentary, and added to it is the feeling of loss of control.
A Rare Addiction
It is not known for certain just how many people in the world suffer from compulsive sexual behaviour. Some vague estimates made in developed countries consider that up to 5% of the general population suffers from it.
The problem with measuring and quantifying this disorder is that the data is collected from subjective information. That is, there is no lab test or diagnostic imaging to confirm the presence of this problem.
The Criteria for Hypersexual
A series of criteria have been established to guide the diagnosis and establish the presence of compulsive sexual behavior. In the first instance, the patient must be over 18 years of age.
Second, the symptoms must be present for at least 6 months, configured by the recurrence of intense sexual fantasies and an excessive sexual desire. This would imply that the person spends much of their daily time involved in these fantasies, in addition to planning and executing them.
Now, this is not just any sexual fantasy someone might have. The addiction criterion implies that this person ceases to attend to other vital matters by dedicating hours and hours to sexual behavior. Social and family relationships are lost, and work is put at risk due to hypersexuality.
Other diagnostic criteria are that the behavior is not motivated by the consumption of any drug that explains the fantasies. Also, there may be attempts and failures on the part of the person to control that impulse without being successful.
Ultimately, the diagnosis will be established by a mental health professional. It is not just about fitting the criteria, but a rigorous scientific evaluation must be made to determine the degree of severity.
The origin of compulsive sexual behavior is unclear. Everything indicates that the disorder is based on the brain and its neurotransmitters. A change in the amount of these substances or an alteration in the conduction pathways could be behind hypersexuality.
The first hypothesis postulates that there is an imbalance between dopamine, serotonin, and norepinephrine in the brain. All three substances powerfully regulate mood at all times, and minimal changes at this level affect anxiety.
Another theory is that the brain’s reward circuits are stimulated by sexual fantasies to an extreme extent. The daily reinforcement of this satisfaction would be channeled in the same way as other addictions develop, even generating tolerance – more and more stimulus is needed to achieve the same effect.
Among the secondary causes, we have diseases that alter brain architecture. Epileptic patients can suffer from compulsive sexual behavior, as well as patients with vascular dementia or Parkinson’s disease.
Psychotherapy is a treatment of choice in the case of hypersexuality. Some medications can also be used. The approach to this disorder is not easy and involves a combination of drugs and psychotherapy. Mental health professionals are in charge of guiding the action protocols.
Depending on the specific case, patients can opt for cognitive-behavioral therapies or psychodynamic forms. An attempt is made to equip the person with tools to handle recurring fantasies and not to neglect other aspects of their daily life.
Under the cognitive-behavioral form, emphasis is placed on limiting access to sexual content and developing strategies to avoid risky situations. It is helpful to attend support groups with other people who suffer from the same. Regarding the pharmacology for compulsive sexual behavior, the battery of therapeutic options is based on antidepressants and two other drugs:
- Naltrexone: This substance is used, above all, in the addiction to alcohol and morphine. However, due to its ability to act on reward circuits, it is also an adjunct in other addictions
- Anti-androgens: For men, drugs have prescribed that block the action of androgens, which are natural male sex hormones
Although it is still a subject under discussion, we are facing addictive behavior. Compulsive sexual behavior disrupts the daily lives of patients and puts their social fabric at risk, including family, friends, and work. These people must receive the corresponding professional help so as not to become more and more isolated in their behavior.