Sex Addiction or High Sex Drive – How to Distinguish?

Sex Addiction is a topic that became renowned after Michael Fassbender’s acting in the movie ‘Shame’. Later on, many other movies like ‘Nymphomaniac’ and ‘Fatal Attraction’ also depicted the problem of sex addiction. So now we all know at least the basics of the hypersexual disorder commonly known as sex addiction. But the million dollar question is how to distinguish between sex addiction and high sex drive? Whether the urge to have sex again and again just means that someone has a healthy body with a high sexual urge or is it something else, a problem that they should be concerned about, namely sex addiction?

Everyone enjoys a good sexual marathon every now and then as the euphoric feeling people get from a good orgasm is like nothing else but the problem arises when it is not enough, never enough! That is when high sex drive turns into sex addiction.

We know some very high profile people suffering from sex addiction from actors to entrepreneurs as anyone can get addicted to sex though some are more vulnerable to it than others. Some of these people have actually publicly admitted to suffering from the problem such as actor David Duchovny and golfer Tiger Woods. Michael Douglas actually went to rehab for sex addiction in early 1990s.

But whether it is sex addiction or high sex drive, it is not an excuse for bad behavior though some people surely take it that way. If a person genuinely has this problem, he/she should get help and treatment, not use it as an excuse to get out of scrapes.

Criteria for Distinguishing Between Sex Addiction and High Sex Drive

Sex addiction is when one is obsessed with sex to the point that it starts causing problems in their everyday life. They start fantasizing about sex and show a marked change in their behavior.

While sex drive also known as libido is the arousal or desire for sexual activity or desire to have sex that one feels. Some people have naturally high sex drive that does not interfere with their normal everyday life. They still lead a healthy and happy life. In fact, researchers believe that a high sex drive is actually responsible for a lot of cases of sex addiction.

When the American Psychiatric Association was deliberating on including hypersexual disorders in its diagnostic guidelines for doctors, their main problem was how to consistently differentiate damaging consequences that originate from sex addiction from the healthy expressions that are a result of naturally high sex drive.

This is because some people with high sex drive sometimes live a life that may seem extreme, aggressive or objectionable to other but actually cause no harm to them or to their sexual partners and therefore cannot be included in sex addiction category, no matter how much the cases may seem similar to sex addiction. This conundrum is behind many a problem related to the matter of distinguishing sex addiction from high sex drive.

High Sex Drive or Sex Addiction

High Sex Drive or Sex Addiction- According to Science

According to American Association for Marriage and Family Therapy, more than 12 million people suffer from sex addiction or compulsive sexual behavior but there is still no strict definition or guideline for it. In fact, DSM-V (Diagnostic and Statistical Manual of Mental Disorders) very briefly and lightly touches on the topic on a section on sexual disorders as it says:

“Research suggests that sexual response is not always a linear, uniform process and that the distinction between certain phases (e.g., desire and arousal) may be artificial.”
Sex addiction was included in the DSM-III in 1980 but was later on removed due to insufficient research from 1994 edition. This lack of classification actually makes life more difficult for sex addicts as it is perceived as infidelity and cheating by their partners and peers when in actuality their behavior is an actual disorder that has the potential of destroying their lives and carriers as well as causing trauma to their partners.

Scientific researchers are divided on the topic of qualifying sex addiction as a real disorder and not just a high sex drive. Some believe that there are no distinct margins for the disorder and therefore should not be qualified but others believe that it is an actual problem and at the very least some research should be done on the matter before dismissing it out of hand.

The latter view is actually supported by a 2012 research published in ‘The Journal of Sexual Medicine’ that says that sex addiction is a diagnosis-worthy disorder. According to this research the patients on whom the research was done, told about doing excessive masturbation, using pornography, indulging in cybersex and sex with prostitutes as well as having affairs with an average of 15 anonymous partners in the previous 12 months.

Brain Scan to Distinguish Between Sex Addiction and High Sex Drive

In 2014, a study was published in the journal ‘Neural Correlates of Sexual Cue Reactivity in Individuals with and without Compulsive Sexual Behaviors’ in which brain scans were used to distinguish between people suffering from sex addiction and those with a high sex drive. This was to prove that sex addiction is an actual disorder. This brain scanning technique could actually prove very useful in distinguishing between sex addiction and high sex drive.

In this research, it was found that the brain activity of drug addicts as well as sex addicts were same when shown drug related and sexual imagery respectively while the brain scans of normal adults were different. Three significant brain regions namely the ventral striatum which processes rewards, the dorsal anterior cingulate which anticipates rewards and the amygdala which processes the significance of events and emotions were simultaneously activated in sex as well as drug addicts when given their particular stimuli.

This disorder is most probably because the brain of an addict is deficient in dopamine receptor while the drugs as well as sex act as quick dopamine enhancers which the addict use as a tool to generate a kind of high. But the more they engage in the activity to achieve that high, the more tolerant they become to that particular stimulus and thus it makes it even more difficult to achieve that high and the cycle goes on and on.

Back to the Original Question- High Sex Drive or Sex Addiction?

The main difference between a person with a high sex drive and a sex addict is that those people who have a high sex drive can control their impulses and may or may not choose to engage in sexual activity regardless of being aroused or not while the latter becomes obsessed with their sexual fantasies and fixated on the idea. They also objectify people and cannot control their impulses which most often than not leads to damaging consequences.

As to the question of ‘how much sex is too much sex crossing the line from high sex drive to sex addiction?’- Well, the answer is that there are no fixed criteria, just like there are no fixed criteria for alcoholism. A person can have multiple drinks every day and still not become alcoholic and be able to abstain when he needs to. Just like that it doesn’t matter how many times a person is having sex, but what matters is the quality of their life at present and their past history.

Usually people who have suffered mental and physical abuse when they were young or were sexually molested are more vulnerable to becoming sex addicts and so do people suffering from depression and low self-worth. They feel that they are not worthy of love which makes them feel detached and to compensate for that as well as to feel connected, they turn towards sex.

According to a survey published in 2013 in the ‘Journal of Aggression, Maltreatment & Trauma’, 38% of the sex addicts suffered emotional abuse, 17% suffered sexual abuse and 16% suffered physical abuse.

Sex Addiction- A Scapegoat for Infidelity

Sometimes people blame sex addiction for their actions, for cheating or for infidelity. That is why sex addiction is so controversial a topic and more often than not the person who is genuinely suffering from the disorder takes the fall. This is not an ideal practice and people should be accountable for their actions.

That is the reason that sex addicts should also take responsibility for their actions. The first step to curing a problem is to accept that you have a problem. The first step of any sex addiction rehabilitation therapy is encouraging patients to own up to their actions, become accountable and then resolve not to do that again without exceptions.

Sexual Sobriety and Partner Co-operation

Contrary to popular belief, sex addicts are not asked to abstain from sex indefinitely. Instead of being celibate, they are in fact asked to engage in healthy sexual activities in a non-compulsive manner. Even though they are sometimes asked to take a hiatus from sex, it is of very short duration at the start of the treatment usually of 30 to 60 days.

This can be quite difficult for the partner but it is imperative that you support the addict as for effectively overcoming the problem of sex addiction, support of partner is invaluable. Besides it will be beneficial for you too if you support your partner as it will not only get him back in the game but will also make your relationship healthy and strong.

Pramod Kerkar, M.D., FFARCSI, DA
Pramod Kerkar, M.D., FFARCSI, DA
Written, Edited or Reviewed By: Pramod Kerkar, M.D., FFARCSI, DA Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:March 10, 2018

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