Obsessive-compulsive disorder (OCD) is a mental health condition in which people may have intrusive, recurring thoughts and repetitive behaviors that they cannot control. OCD can manifest in many ways, including in a sexual manner. Some people may be unable to control their sexual urges, behavior, or impulses to the point of causing distress in their life, known as hypersexuality.
Hypersexuality related to OCD is less about seeking sex as a source of pleasure and more about having issues with impulse control.
It may involve intrusive sexual thoughts that can be distressing, compulsive sexual urges that may be contrary to what the person may want, and obsessive worries and fears about such thoughts and compulsions.
According to the Diagnostic and Statistical Manual, 5th edition, text revision (DSM-5-TR), the American Psychiatric Association does not recognize hypersexuality as an official disorder, but it does recognize how obsessions and compulsions related to OCD
This article will explain how OCD can manifest as hypersexuality in response to intrusive, unwanted, or anxiety-provoking thoughts. It will also explain the treatment and causes of OCD and how to manage symptoms of OCD and hypersexuality.
OCD describes a chronic, long lasting disorder in which a person
When these obsessions and compulsions are sexual in nature, OCD may manifest as hypersexuality. Hypersexuality describes a condition in which a person
With OCD, obsessions or compulsions may present in various ways, including:
- inability to control unwelcome thoughts or ideas
- inability to control urges or compulsions
- pervasive anxiousness about a person’s compulsions or obsessive thoughts
- repetition of certain behaviors or activities to ease the mental discomfort
Additionally, with OCD, a person’s inability to control compulsive thoughts or behaviors may be heightened by a fear that not acting upon them may result in some harm.
When OCD is of a hypersexual nature, it can result in feelings of guilt and shame and cause issues with people’s partners. It is important to remember that these compulsions and behaviors may not actually be sexually gratifying but result from underlying anxiety and worries.
Read more about OCD and hypersexuality.
Those with OCD and hypersexuality may experience obsessions or compulsions relating to sex. The DSM-5-TR states that there are two specific criteria for OCD:
- Obsessions: These are unwanted thoughts and images that cause mental discomfort.
- Compulsions: These are repeated activities that attempt to relieve anxiety.
For a doctor or psychiatrist to diagnose OCD, a person must have either or both simultaneously, causing significant distress and lasting around or up to 1 hour per day. However, the topic of hypersexuality and OCD is difficult to distinguish because many practitioners have opposing views on it. Further, hypersexuality is not classified in the DSM-5-TR.
Symptoms of hypersexuality and OCD
- uncontrollable thoughts about sexual fantasies, including distressing thoughts
- uncontrollable sexual urges
- sexual behavior that causes distress or impairment to daily life, such as needing to masturbate excessively
- uncontrollable urges to engage in inappropriate behavior
- symptoms occurring that are not due to taking drugs or substances
- the urge to engage in sexual fantasies or behavior in response to moods such as depression, anxiety, or boredom
- the urge to engage in sexual fantasies or behavior in response to distressing situations
- repetitive or unsuccessful attempts to control or decrease sexual obsessions or compulsions
- fear of relationship issues arising due to hypersexual obsessions or compulsions
- repeating certain actions or behaviors to ensure that no intrusive thoughts “come true”
The main difference between hypersexuality and OCD versus having a high libido is whether it severely affects a person’s daily life, work, relationships, or overall mental health.
Enjoying sex and sexual relationships is a healthy part of life. Still, if sexual urges, obsessions, or behaviors become uncontrollable or distressing or threaten to harm aspects of a person’s life, it may be a cause for concern.
OCD is a common disorder that may arise from several potential causes. Some risk factors
- brain structure
- childhood trauma
- childhood infections, such as streptococcal infection
- anxiety or distress arising from certain situations
- post-traumatic stress disorder (PTSD)
Psychosexual behavior may result from traumatic or emotional situations or triggers. The condition may progress over time, and the brain can associate impulsive behaviors or obsessions with receiving pleasurable neurochemical changes in the brain, becoming addicted to the “high.”
However, if hypersexuality is a symptom of OCD, the obsessions and compulsions may be highly distressing, particularly if they are at odds with what the person wants to do.
An example of this could include a person feeling a sexual urge or having sexual fantasies about another person while in a committed, monogamous relationship with someone else.
Some risk factors for hypersexual behavior include having a condition other than OCD, such as:
- bipolar disorder
- a history of substance misuse
- an injury to the frontal lobe of the brain
- medication use
- another addiction, such as compulsive gambling or alcohol dependency
- an eating disorder
Treatment for OCD and hypersexuality will usually focus on the symptoms of OCD. There is currently no one treatment for hypersexuality, but some treatments may include a combination of therapy, medication, and support communities.
A doctor or a psychiatrist may recommend medications that help with symptoms, such as:
- antidepressants, such as selective serotonin reuptake inhibitors (SSRIs)
- mood stabilizers
- hormone therapies
Antidepressants can take around
Treatments for OCD may include:
- Cognitive behavioral therapy: This therapy focuses on how a person’s thoughts may influence and alter their actions, as well as their beliefs, attitudes, and behavior.
- Cognitive therapy: This therapy focuses on identifying negative thoughts about oneself as a way of disrupting certain behavior patterns.
- Exposure and response prevention (ERP): This type of therapy encourages a person to confront and acknowledge obsessive thoughts while resisting the urge to carry out compulsive actions and behaviors.
- Psychodynamic psychotherapy: This therapy can help a person identify subconscious thoughts and work toward changing their behavior.
- Meditation: This can help focus and calm the mind through breathwork and mindfulness.
Read more about meditation and other ways to cope with OCD here.
As hypersexuality can be a symptom of OCD, a doctor may look to diagnose OCD first. A person who thinks they may have OCD may also want to consult a psychiatrist to discuss obsessive, intrusive thoughts and compulsive behaviors.
Doctors look for certain criteria, such as:
- having obsessions, compulsions, or both at the same time
- obsessions and compulsions that cause significant distress or impairment in social, work, or other life settings
- OCD symptoms that do not result from the use of medications or substances
- OCD symptoms that are not the result of other medical issues
- obsessions and compulsions that are unreasonable or excessive
For diagnosing OCD of a hypersexual nature, criteria may include:
- a consistent pattern of failing to control sexual urges or behavior, not resulting from another source (e.g., a manic episode or substance effects)
- repetitive sexual impulses that result in repetitive sexual actions
- sexual activities being the focus of a person’s life, in detriment to other focuses, such as work, relationships, responsibilities, or personal care
- repetitive sexual behavior that offers no real sexual pleasure
- repetitive sexual behavior despite severe consequences
- symptoms lasting 6 months or more
With the right treatment, a person can overcome hypersexuality due to OCD and manage its symptoms.
It is important for a person to get help as soon as they recognize a problem to minimize any negative consequences or distress resulting from obsessive thoughts and behaviors. Many people seek help when it has reached a severe stage, such as resulting in the loss of a job or legal concerns.
Communities and support groups can help with managing symptoms of OCD and hypersexuality. The Substance Abuse and Mental Health Services Administration (SAMHSA) offers a treatment locator where users can find treatment and support groups in their area.
The International OCD Foundation also offers support for people and families affected by OCD.
Talking about OCD and hypersexuality can help people overcome feelings they may have associated with the condition, such as guilt and shame.
Hypersexuality and OCD can center on repetitive behaviors and recurring thoughts about sex or sexual urges. People may be unable to control these sexual obsessions and compulsions, and they may cause significant distress or impairment to daily life.
Treatment for OCD includes therapy such as CBT, which can help a person acknowledge the obsessions and compulsions without engaging, and medications such as antidepressants.