Overview
Compulsive sexual behavior is sometimes called hypersexuality, hypersexuality disorder or sexual addiction. It’s an excessive preoccupation with sexual fantasies, urges or behaviors that is difficult to control, causes you distress, or negatively affects your health, job, relationships or other parts of your life.
Compulsive sexual behavior may involve a variety of commonly enjoyable sexual experiences. Examples include masturbation, cybersex, multiple sexual partners, use of pornography or paying for sex. When these sexual behaviors become a major focus in your life, are difficult to control, and are disruptive or harmful to you or others, they may be considered compulsive sexual behavior.
No matter what it’s called or the exact nature of the behavior, untreated compulsive sexual behavior can damage your self-esteem, relationships, career, health and other people. But with treatment and self-help, you can learn to manage compulsive sexual behavior.
Symptoms
Some indications that you may be struggling with compulsive sexual behavior include:
- You have recurrent and intense sexual fantasies, urges and behaviors that take up a lot of your time and feel as if they’re beyond your control.
- You feel driven to do certain sexual behaviors, feel a release of the tension afterward, but also feel guilt or remorse.
- You’ve tried unsuccessfully to reduce or control your sexual fantasies, urges or behavior.
- You use compulsive sexual behavior as an escape from other problems, such as loneliness, depression, anxiety or stress.
- You continue to engage in sexual behaviors that have serious consequences, such as the potential for getting or giving someone else a sexually transmitted infection, the loss of important relationships, trouble at work, financial strain, or legal problems.
- You have trouble establishing and maintaining healthy and stable relationships.
When to see a doctor
Seek help if you feel you’ve lost control of your sexual behavior, especially if your behavior causes problems for you or other people. Compulsive sexual behavior tends to escalate over time, so get help when you first recognize there may be a problem.
As you decide whether to seek professional help, ask yourself:
- Can I manage my sexual impulses?
- Am I distressed by my sexual behaviors?
- Is my sexual behavior hurting my relationships, affecting my work or resulting in negative consequences, such as getting arrested?
- Do I try to hide my sexual behavior?
Seeking help for compulsive sexual behavior can be difficult because it’s such a deeply personal matter. Try to:
- Set aside any shame or embarrassment and focus on the benefits of getting treatment.
- Remember that you’re not alone — many people struggle with compulsive sexual behavior. Mental health professionals are trained to be understanding and discreet. But not all mental health professionals are experienced in treating compulsive sexual behavior, so make sure you find a therapist who is competent in this area.
- Keep in mind what you say to a doctor or mental health professional is kept confidential, except in cases where you report that you’re going to hurt yourself or someone else, you report sexual abuse of a child, or you report abuse or neglect of someone in a vulnerable population.
Seek treatment right away
Seek immediate treatment if:
- You think you may cause harm with uncontrolled sexual behavior
- You have other problems with impulse control, and you feel like your sexual behavior is slipping out of control
- You are suicidal — if you’re thinking of attempting suicide, call 911 or your local emergency number, or the National Suicide Prevention Lifeline (in the United States) at 1-800-273-TALK (1-800-273-8255)
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Causes
Although the causes of compulsive sexual behavior are unclear, they may include:
- An imbalance of natural brain chemicals. Certain chemicals in your brain (neurotransmitters) such as serotonin, dopamine and norepinephrine help regulate your mood. High levels may be related to compulsive sexual behavior.
- Changes in brain pathways. Compulsive sexual behavior may be an addiction that, over time, might cause changes in the brain’s neural circuits, especially in the reinforcement centers of the brain. Like other addictions, more-intensive sexual content and stimulation are typically required over time in order to gain satisfaction or relief.
- Conditions that affect the brain. Certain diseases or health problems, such as epilepsy and dementia, may cause damage to parts of the brain that affect sexual behavior. In addition, treatment of Parkinson’s disease with some dopamine agonist medications may cause compulsive sexual behavior.
Risk factors
Compulsive sexual behavior can occur in both men and women, though it may be more common in men. It can also affect anyone, regardless of sexual orientation. Factors that may increase risk of compulsive sexual behavior include:
- Ease of access to sexual content. Advances in technology and social media allow access to increasingly intensive sexual imagery and information.
- Privacy. Secrecy and privacy of compulsive sexual activities tend to allow these problems to worsen over time.
Also, an increased risk of compulsive sexual behavior may occur in people who have:
- Alcohol or drug abuse problems
- Another mental health condition, such as a mood disorder (such as depression or anxiety), or a gambling addiction
- Family conflicts or family members with problems such as addiction
- A history of physical or sexual abuse
Complications
Compulsive sexual behavior can have many negative consequences that affect both you and others. You may:
- Struggle with feelings of guilt, shame and low self-esteem
- Develop other mental health conditions, such as depression, suicide, severe distress and anxiety
- Neglect or lie to your partner and family, harming or destroying meaningful relationships
- Lose your focus or engage in sexual activity or search internet pornography at work, risking your job
- Accumulate financial debts buying pornography and sexual services
- Contract HIV, hepatitis or another sexually transmitted infection or pass a sexually transmitted infection to someone else
- Engage in unhealthy substance use, such as using recreational drugs or drinking excessive alcohol
- Be arrested for sexual offenses
Prevention
Because the cause of compulsive sexual behavior isn’t known, it’s not clear how it might be prevented, but a few things may help keep this type of behavior in check:
- Get help early for problems with sexual behavior. Identifying and treating early symptoms may help prevent compulsive sexual behavior from getting worse over time or escalating into a downward spiral of shame, relationship problems and harmful acts.
- Seek treatment early for mental health disorders. Compulsive sexual behavior may be worsened by depression or anxiety.
- Identify and seek help for alcohol and drug abuse problems. Substance abuse can cause a loss of control and unhappiness that can lead to poor judgment and may push you toward unhealthy sexual behaviors.
- Avoid risky situations. Don’t jeopardize your health or that of others by putting yourself into situations where you’ll be tempted to engage in risky sexual practices.
How Do You Treat Hypersexuality?
Hypersexuality with bipolar disorder isn’t a separate condition or problem that needs its own treatment — it’s a symptom of bipolar disorder. Once the condition is successfully treated and mood swings and symptoms are under control, those hypersexual feelings will dissipate.
“When bipolar disorder is not being treated effectively, hypersexuality is often a symptom that can wreak havoc in a person’s personal life and lead to poor decisions with possible serious and negative consequences. Treating the bipolar symptoms and getting hypomania and mania under control will often target and help hypersexuality as well,” explains Viguera.
“You treat the disease, not the symptom,” she adds. “Treatments usually involve medications such as mood stabilizers or antipsychotics, as well as psychotherapy such as cognitive-behavioral therapy or interpersonal social rhythm therapy,” she says.
Once the disease is under control, people with bipolar disorder often react differently to sex and their past behaviors.
“You often see a lot of regret for the past behavior, because they put themselves in very bad situations,” says Viguera. “When they’re well, they reflect on that, and there can be a lot of regret and remorse. It’s just another clue that shows you that it was not their normal state.”
In addition, hypersexuality can be one of the most difficult and challenging symptoms both for people living with the condition and for those close to them.
Sometimes the inability to control sexual urges leads to broken marriages and relationships. Both people in a relationship can suffer if these urges result in infidelity: The partner with bipolar disorder may feel distraught over having hurt the other partner, who in turn feels confused and angry for having been cheated on.
Hypersexual behavior can also negatively affect a couple’s sex life. Studies that examine sexuality in couples with one bipolar partner found decreased levels of sexual satisfaction associated with the diagnosis.
Bipolar Behavior, Hypersexuality, and Related Conditions
A meta-analysis published in the December 2016 issue of the Journal of Affective Disorders found a high prevalence of comorbidity between substance use disorders and bipolar disorder — meaning that a person is experiencing some form of both conditions simultaneously.
The study found substance abuse disorders to be quite common in people with bipolar disorder. The disorders with the highest prevalence in conjunction with bipolar disorder were alcohol use (42 percent), followed by cannabis use (20 percent) and other illicit drug use (17 percent).
Stimulants in particular can be problematic: The study authors point out that if stimulants are being used or abused, they could mimic symptoms of mania. In addition, alcohol and cannabis use can be linked to poor judgment, which may further contribute to hypersexual behavior.
Different Treatments for Bipolar Disorder
Bipolar disorder is usually treated with:
- Mood-stabilizing medications
- Antipsychotic medications
- Antidepressants
- Cognitive-behavioral therapy
- Other forms of therapy and counseling that may include family members
- Electroconvulsive therapy, which involves using small electrical waves to treat the brain
The right combination of these various therapies can reduce or eliminate bipolar mood changes between mania and depression, as well as prevent or reduce symptoms, including hypersexuality.
Those symptoms of hypersexuality may be a red flag for some people with bipolar disorder indicating that they are slipping into a manic episode. If a person with bipolar disorder starts to notice themselves thinking more about sex or engaging in promiscuous behavior, they should notify their doctor of this onset of symptoms.
Resources We Love
Depression and Bipolar Support Alliance (DBSA)
This organization supports people with depression and bipolar disorder. Learn more about treatment options for bipolar disorder, and check out the DBSA Wellness Toolbox.
Mayo Clinic
A top U.S. hospital, Mayo Clinic has educational information about bipolar disorder on its website and also offers care for bipolar disorder at its four locations in the United States. Learn more about how to schedule an appointment.
National Institute of Mental Health (NIMH)
NIMH is a part of the National Institutes of Health, which is the world’s largest biomedical research agency. If you’re interested, consider participating in a research trial to help researchers discover more about potential treatments for bipolar disorder.
Additional reporting by Barbara Kean.
