Sex addiction: symptoms and treatment options

The ICD-11 is specific that a high sex drive or high levels of sexual activity don’t meet the diagnostic threshold on their own.

According to the diagnostic criteria published in the International Journal of Mental Health and Addiction, CSBD requires one or more of the following patterns to be present:

• Sexual behaviour has become a central focus of daily life, to the point of neglecting health, personal care, or other responsibilities.
• The person has made repeated, unsuccessful attempts to reduce or stop the behaviour.
• The behaviour continues despite clear negative consequences, including relationship breakdown, impact on work, or harm to physical health.
• The behaviour continues even when it brings little or no satisfaction.

The BPS also notes patterns including significant time spent on sexual activity, using sexual fantasy to manage stress, and strong urges that feel hard to resist. Men are more commonly represented in research and treatment settings. However, the BPS notes that women are likely under-represented because they’re less likely to seek treatment, not because the condition is less common.

These three conditions are frequently grouped together, and they can overlap. But they are clinically distinct, and treating them as the same thing can get in the way of accurate assessment and effective treatment.

Sex addiction describes compulsive engagement in sexual behaviour more broadly. Porn addiction is specifically about the compulsive use of pornography and may or may not involve other sexual behaviour. Love addiction centres on an obsessive need for romantic connection, the experience of being in love, or the fear of abandonment. It may not involve sexual behaviour at all. 

At Castle Health, we assess each person individually, because the right treatment depends on understanding which pattern is actually present.

Sex addiction doesn’t always look like a problem from the outside. Daily life can appear completely normal while the compulsive behaviour stays hidden. Keeping it hidden can be exhausting.

The BPS identifies a range of consequences including declining relationships with friends and family, feelings of guilt and shame, neglect of responsibilities, and risk of sexually transmitted infections. Financial difficulties and declining physical and mental health are also common.

A 2022 review published in the Journal of Sexual and Relationship Therapy notes that compulsive sexual behaviour is mostly presented in research as comparable to other behavioural addictions, involving loss of control, psychosocial impairment, and risky behaviour. The same review highlights a significant gap in research on partners’ experiences. Female partners of men with compulsive sexual behaviour frequently report emotional, relational, and physical effects following discovery or disclosure. This is an area the researchers describe as seriously under-supported.

A separate chapter by Paula Hall in a volume on sexual addiction argues that assessment needs to account for attachment, trauma, and social context – not only patterns of behaviour. Castle Health approaches treatment as a whole-person process.

Residential treatment is the right approach when previous attempts to change haven’t worked, or when co-occurring conditions – depression, alcohol use, unresolved trauma – need to be addressed alongside the sexual behaviour. Being away from everyday life removes some of the triggers, and makes it easier to focus on therapy.

Castle Health’s residential programme integrates individual therapy, group work, trauma-informed approaches, and 12 Step principles within a clinically supervised setting. Sex addiction frequently comes with other conditions, such as depression, alcohol use, drug dependency, and unresolved trauma. Our dual diagnosis capability means we can treat them together. 

Residential treatment doesn’t resolve everything. What it does is create the conditions for serious work to begin. For more detail on what residential treatment involves, visit our page on treatment for sex addiction.

Outpatient treatment suits people who can’t step away from daily responsibilities, or whose needs don’t require residential care. It can also follow a residential programme as someone moves back into ordinary life.

Outpatient programmes typically involve regular individual and group therapy sessions, with a focus on building practical coping strategies and understanding the patterns that sustain compulsive behaviour. Find out more about our outpatient options for sex addiction.

Cognitive Behavioural Therapy (CBT) focuses on identifying the thoughts and triggers that drive the behaviour, and building different responses. Group therapy means working through this with other people, which tends to reduce the shame around it.

Trauma-informed therapy is often central to the work, as early trauma appears frequently in the histories of people with compulsive sexual behaviour. The 12 Step framework offers a structure that extends beyond formal treatment – one that many people find useful long after discharge. For a full overview, see our page on types of therapy for sex addiction.

Yes. The World Health Organisation’s ICD-11, published in 2019, includes Compulsive Sexual Behaviour Disorder (CSBD) as a recognised condition. The classification also explicitly states that a high sex drive or high levels of sexual activity do not meet the diagnostic threshold. What is required is loss of control, significant distress, or clear impairment in daily functioning.

The clinical distinction is about control and consequence, not frequency. The ICD-11 is explicit that CSBD should not be diagnosed on the basis of high levels of sexual interest or behaviour alone. What defines the condition is the inability to control the behaviour despite wanting to, and the continuation of that behaviour despite harmful consequences. A high sex drive that does not cause distress or impairment is not a clinical condition.

A GP can be a useful first point of contact and may be able to refer you to a specialist. But a formal assessment for CSBD requires a clinician with specific expertise in behavioural addiction. If you would prefer to speak to a specialist directly, Castle Health’s team can carry out an initial assessment in confidence.

The cost of treatment depends on the type of programme (residential or outpatient), the duration, and the location. Our admissions team can give you a clear overview of costs during an initial conversation. Some people are eligible for funding through their employer’s Employee Assistance Programme or private health insurance – our team can advise on this.

Yes. S-Anon and COSA (Co-dependents of Sex Addicts) are the main peer support networks for partners and family members affected by compulsive sexual behaviour. Both operate in the UK. Castle Health also offers couples therapy as part of our treatment offering, which provides professional support alongside any peer group involvement.