Can People with OCD Have Hypersexuality Tendencies?

Struggling with intrusive thoughts, urges, impulses, beliefs, and/or mental images can be challenging, especially when they revolve around sex. Some people perform specific acts or engage in certain behaviors to counter these “annoyances.” Non-stop thoughts, urges, mental images, impulses, beliefs, fears, doubts, etc., regardless of their nature, and compulsive behaviors are hallmark signs of OCD. When sex is the main component of the obsession, it can trigger a host of problems, such as intense anxiety, embarrassment, shame, guilt, social isolation, mood swings, etc.

When OCD is intertwined with hypersexuality (an obsession with sex, sexual acts, and/or sexual fantasies), it can be confusing and scary. Part of this shame, guilt, embarrassment, and fear stems from how others, in society, in their families, in their friend circles, etc., would “see” them if they found out that they have a preoccupation with sex (obsession) – so much so that they cannot get thoughts about and urges to have sex or engage in sexual activities out of their minds – with the only relief coming after performing certain rituals or routines (compulsions).

Ironically, most people do not associate OCD with hypersexuality or “sex addiction,” but it happens. In other words, they can occur together. The good news is OCD with hypersexuality can be treated with lifestyle changes, self-help tools, psychotherapy, and/or medication. With the right OCD treatment, your obsession with sex will diminish and eventually stop. Sex does not have to occupy your mind and life; you can kick your obsession to the curb and develop healthy behaviors.

If you are unsure of what hypersexuality is or if it is a component of your OCD, look no further. This article will not only define what hypersexuality is but also help you better understand the relationship between OCD and hypersexuality.

So, can people with OCD also have hypersexuality tendencies? Absolutely!

What Is Hypersexuality?

Approximately 3% of people struggle with hypersexuality. Hypersexuality is more common in males than females. In fact, for every two out of five males with hypersexuality, only one female is affected. Hypersexuality (sex addiction) typically presents around the age of 18. However, most hypersexual people do not seek treatment until they are around the age of 37. About 88% of hypersexual people also have another mental health condition.

Hypersexuality is often interchangeably used with sex addiction, compulsive sexual disorder, or hypersexuality disorder. It is characterized as an unhealthy obsession with sex. Hypersexuality involves extreme or repetitive sexual urges, impulses, activities, thoughts, and/or mental images. It can also lead to negative consequences, such as erectile dysfunction (ED), anxiety, depression, failed relationships or marriages, porn addiction, unemployment or job-related problems, like low productivity, frequent absenteeism and/or tardiness, legal issues, lost friendships, low self-esteem or self-confidence, etc.

Hypersexuality also involves a sudden boost in sex drive (libido), desires, and/or sexual behaviors. It is either a primary condition or a symptom of another condition, like bipolar disorder or OCD. People, who are being treated for Parkinson’s disease may also become hypersexual in response to the medication.

Because hypersexuality involves intrusive thoughts and urges (obsessions) and ritualistic behaviors (compulsions), it is considered a “behavioral process addiction” (i.e., excessive gambling, masturbating, shopping, eating, using porn, etc.), rather than a “substance addiction” (drugs and/or alcohol).

Although sexual thoughts, urges, mental images, desires, and activities are innate, when they become a coping mechanism or when they start to cause damage in multiple areas of your life, there is a good chance that you are experiencing hypersexuality. In the past, hypersexuality (a high libido) in women was called, “nymphomania” and “satyriasis” in men.

Hypersexual people also have a hard time stopping unwanted thoughts and compulsive behaviors, despite trying. These individuals may have intense, extreme, and intrusive sexual fantasies and urges that are hard to challenge, change, manage, or stop. These thoughts and/or behaviors can adversely impact various areas of your life – i.e., work, school, relationships, self-esteem and self-confidence, job prospects, relationships, etc.

Experts suggest that hypersexuality is a form of obsessive-compulsive disorder (OCD) or at the very least, a symptom of it. Hypersexuality, hypersexuality disorder, and sex addiction are not recognized by the American Psychological Association (APA) or the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) as legitimate mental health conditions or addictions.

However, “compulsive sexual behaviors” is recognized as an impulse condition (ICD-11) that involve having sex with multiple partners, a “fixation” on an unwinnable partner, excessive masturbation, pay for sex, cybersex, phone sex, frequent trips to strip clubs, serial romantic relationships, etc.

How Can I Tell If I Have OCD with Hypersexuality?

Although symptoms vary, some symptoms appear to be common in hypersexual people.

These symptoms include the following obsessions and compulsions:

• Repetitive, involuntary, and intrusive sexual thoughts, urges, impulses, images, and/or behaviors
• “Heavy porn use”
• Depression, anxiety, shame, guilt, regret, feelings of hopelessness and helplessness, doubt, suicidal ideation, etc., due to your sexual thoughts and ritualistic behaviors
• Failed attempts to change, manage, control, or reduce your sexual fantasies and/or behaviors
• Excessive masturbation (several times a day)
• Sexual thoughts that go against your values, morals, religious beliefs, societal expectations, etc.
• Spending an inordinate amount of time thinking about or planning sexual encounters
• Lying about or trying to hide your sexual thoughts and compulsive behaviors
• Being unable to properly develop or maintain healthy relationships with other people

Note: The emotional distress that hypersexual people experience is almost entirely based on society’s perceptions, judgment, and/or disapproval of “taboo” or inappropriate sexual desires, behaviors, and practices.

What is it Like to Live with OCD with Hypersexuality?

Listed below are examples of what it is like to live with OCD with hypersexuality:

Liam

“Hi, I’m an OCD sufferer who has been in a relationship for 3 years. The problem is I am constantly overwhelmed and consumed by sexual urges, sexual fantasies, and sexual thoughts. I am also always searching online for things to “cure” or stop my obsessive thoughts. I have always had a high sex drive, but never to this point where it was on the verge of ruining my life. Feeling this way is probably necessary for me to get my OCD under control, but I cannot help but constantly question if this is helping or hurting me. The sexual thoughts, urges, etc., have ramped up recently, triggering a massive load of guilt, shame, anxiety, and depression. Can anyone else relate to this?”

Summer

“Hi everybody! I feel quite embarrassed about posting this on the forum page as I am usually very active on OCD zoom support groups, however, I just really need advice on this embarrassing situation. Lately, I have been focusing on the feeling of being ‘sexually aroused’ and now I do not know if I actually am (which means it is hypersexuality) or if it is the OCD messing with my mind differently?

Regardless, it is causing me so much distress as I will be at work, and then this completely unwanted feeling pops up. During this time, I will start feeling extremely ‘sexually aroused’ to the point that it causes me to want to throw up. I told my boyfriend and he said, ‘Well somebody in the office must be making you feel that way.’ His comment was extremely insensitive and rude, as that is not the case. I do not know if it is a part of OCD or if hypersexuality is linked to another undiagnosed condition. I know you can have OCD and hypersexuality but it is all so confusing.

I did some research to see if I should treat it as OCD or go to the doctor about it. But I could not find a definitive answer. I also have not been able to find a lot of stories on OCD and hypersexuality, a part from stories about ‘compulsive masturbation’ and ‘sex addiction,’ which freaks me out even more. I do not know if it is because I am focusing on it. Maybe, that is why it is not going away.

That is why I thought it has something to do with my OCD. I just do not know. And, it is stressing me out, but I am too embarrassed to ask anybody, even my doctor about it. But, then again if it is a part of OCD, I will just treat it like I have been treating my OCD. I just wanted to ask if anybody has gone through something similar? Whenever I become ‘sexually aroused’ now I just want it to go away because the feeling is so unwanted.”

What Causes OCD with Hypersexuality?

The truth is more research is needed to determine the true cause(s) of OCD with hypersexuality.

However, researchers have identified several factors that may contribute to OCD with hypersexuality, such as:

• Medication side effects, especially those that alter dopamine production and release in the body (i.e., SSRIs).
• Changes in brain function that create new neuropathways or “habits”
• Substance abuse (i.e., cocaine, amphetamines, and/or alcohol)
• Damage to the parts of your brain (i.e., amygdala or prefrontal cortex) that control sexual behavior, such as with dementia, Alzheimer’s disease, Kleine-Levin syndrome, or other neurological conditions
• An interruption, imbalance, or overactivity in neurotransmitters (chemical messengers in the brain) like dopamine, serotonin, and norepinephrine (increasing sexual desires and behaviors in some people)
• Easy access to sexually explicit content, videos, magazines, erotica books, clips, movies, etc.
• Personal or familial history of anxiety, depression, bipolar disorder, suicide attempts, personality disorders, impulse control disorders, attention-deficit hyperactivity disorder (ADHD), OCD, and/or addiction
• Parkinson’s medications, like levodopa (which can increase your risk of becoming hypersexual)

How is OCD with Hypersexuality Diagnosed?

Because hypersexuality or hypersexuality disorder is not included in the DSM-5, clinicians often use the criteria for “compulsive sexual behaviors” (ICD-11) to diagnose this condition. The first step is usually to rule out other health conditions, addictions, and medication side effects. The next step of the diagnosis process involves evaluating your sex-related thoughts process and behaviors and helping you determine why you are having a hard time managing, controlling, or stopping them.

After that, your psychologist or sex therapist may ask you about your previous relationships, sex life, substance use, financial or legal issues, regarding your hypersexuality. Lastly, the clinician may present you with a questionnaire about your previous sexual traumas, stressful life events, feelings of guilt and shame, regret, and/or low self-esteem and self-confidence to craft a treatment plan that will help you get a grip on your OCD and hypersexuality

Note: To date, there are no universal guidelines for diagnosing or treating OCD with hypersexuality.

Can OCD with Hypersexuality Cause Problems?

Absolutely!

Listed below are the possible problems you may run into if you struggle with hypersexuality and OCD:

• An unhealthy or dysfunctional relationship with your partner and/or family
• Poor work performance and loss of employment due to an inability to focus and complete tasks on time and/or due to viewing porn at work
• Mental health conditions, like chronic stress, anxiety, depression, and/or suicidal ideation (thoughts and attempts)
• Possible jail or prison time for viewing or distributing porn with underage people in it
• Guilt, shame, and/or feelings of hopelessness and helplessness
• Low self-esteem and self-confidence
• Lost friendships
• Broken marriages and failed relationships
• Emotional detachment

How is OCD with Hypersexuality Treated?

Many times, people with OCD and hypersexuality refuse to seek help for the condition until they have sunk as low as they can go and have experienced severe repercussions from their behaviors – i.e., multiple breakups, divorces, loss of employment, lost friendships, low self-esteem and self-confidence, anxiety, depression, legal issues, chronic stress, etc.

To recover from OCD and hypersexuality, you must take responsibility for your behavior. Understand, however, that you will most likely be unable to permanently stop the intrusive thoughts and compulsive behaviors without lifestyle changes, self-help tools, psychotherapy, and/or medication(s). Similar to the diagnosis process, OCD with hypersexuality treatment is based-off the treatment of “compulsive sexual behaviors.”

Thus, the OCD treatment may involve the following:

• Mood Stabilizers

  Mood stabilizers are usually prescribed for people struggling with depression, bipolar disorder, anxiety, or OCD. Hypersexuality is more prevalent in people, who struggle with conditions that affect their moods.

• Antidepressants

  Antidepressants, like SSRIs (i.e., Luvox, Paxil, Prozac, Zoloft, etc.), can reduce or eliminate sexual thoughts, urges, and impulses (hypersexuality) in people with anxiety, OCD, and depression.

• Anti-Anxiety Meds

  Anti-anxiety meds may be prescribed if the hypersexuality is being triggered by anxiety or OCD symptoms. One of the most popular anti-anxiety meds used to treat OCD and hypersexuality is buspirone.

• Anti-Psychotics

  Anti-psychotics may be considered when OCD and hypersexuality symptoms trigger extreme agitation. These medications can help lower sexual desire and reduce arousal. Anti-psychotics also prevent you from taking unnecessary sexual risks to quell intrusive sexual thoughts and urges.

• Anti-Androgens

  Anti-androgens are medications designed to reduce overactive androgens (male sex hormones). Researchers suggest that anti-androgens may help reduce obsessive thoughts.

• Naltrexone

  Naltrexone is often prescribed to people, who are having a hard time managing their sexual urges, thoughts, and impulses, and have turned to alcohol and illegal substances to cope with them. Naltrexone is often combined with individual, family, couples or marital, and/or group therapy – in an inpatient or outpatient setting, depending on your needs.

• Psychodynamic Therapy

  Your doctor may suggest psychodynamic therapy if you are having a hard time identifying your OCD triggers. Psychodynamic therapy will not only teach you how to identify these sexual triggers but also help you better understand how these triggers may be contributing to your hypersexuality.

• Cognitive-Behavioral Therapy

  One of the most common therapies for people struggling with OCD and hypersexuality is cognitive-behavioral therapy (CBT). A cognitive-behavioral therapist can teach you how to spot unhealthy and unrealistic beliefs about yourself and your sexual behavior, provide you with tools and resources to help you better manage your intrusive thoughts and negative emotions (obsession), and teach you healthy coping skills and strategies so you do not feel compelled to perform certain rituals or routines (compulsions) to make them stop. The therapist may also incorporate acceptance and commitment therapy (ACT) and mindfulness meditation practices into your treatment plan to help you gain control of your OCD symptoms and hypersexual tendencies.

• Acceptance and Commitment Therapy (ACT)

  Acceptance and commitment therapy (ACT) can be extremely beneficial for people with OCD, who are also struggling with hypersexual tendencies. ACT involves both “acceptance” and mindfulness to teach you how to “accept” or “embrace” the “uncomfortableness,” so it loses its power over you. Acceptance and commitment therapists believe that “accepting” or “embracing” your thoughts, instead of trying to ignore or dismiss them, can help you conquer them. Thus, the goal of ACT is to change how you “see” or “perceive” your thoughts, rather than changing the actual thoughts.

• Motivational Interviewing

  Motivational interviewing is a type of psychotherapy that is designed to help people with OCD and hypersexuality connect their sexual thoughts, urges, and compulsive behaviors to their personal goals, ethics, morals, and values.

• OCD Support Groups & Forums

  OCD support groups and forums can be beneficial for people struggling with OCD and hypersexuality. One of the great things about OCD support groups and forums is they can be used with therapy and/or medication(s) to help you combat your hypersexual tendencies and OCD symptoms.

  One popular support group is Sex Addicts Anonymous. Sex Addicts Anonymous is based on the Twelve-Step Addiction Model and is designed to provide support, advice, guidance, and a sense of “belonging” to people, who are trying to better manage their OCD symptoms and hypersexual tendencies. Reddit offers a variety of OCD and hypersexuality forums that can provide you with answers to your questions and some much-needed support.

• Lifestyle Changes

  Lifestyle changes, like a healthy diet, regular exercise, adequate sleep, spending time with supportive people, etc., can help you cope more effectively with your OCD and hypersexuality symptoms. Researchers suggest that OCD worsens when you do not get enough rest and when you do not consume healthy foods. Junk foods, processed foods, and foods chocked full of salt and sugar can trigger inflammation, and inflammation can trigger or worsen OCD symptoms.

Note: According to a 2013 study, approximately 72% of people with hypersexual behaviors also have a mood disorder, 38% have an anxiety disorder, like OCD, and 40% struggle with substance abuse. Keep in mind, that your partner will also need support as you work through your OCD and hypersexuality issues. However, with time, effort, and patience (from both you and your partner), your relationship will likely rebound and your sex life will likely improve. But first, you must get control of your OCD and hypersexuality behaviors.

References

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• ICD-11 for Mortality and Morbidity Statistics. (2022). Compulsive sexual behavior disorder. Retrieved from https://icd.who.int/browse11/l-m/en#/http://id.who.int/icd/entity/1630268048
• Derbyshire, K. L., & Grant, J. E. (2015). Compulsive sexual behavior: a review of the literature. Journal of Behavioral Addictions, 4(2), 37–43. Retrieved from https://doi.org/10.1556/2006.4.2015.003
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