What Is Sex and Love Addiction?

Sex and love addiction is not an official psychiatric diagnosis. Instead, it is a colloquial (slang or informal) term used to describe a compulsive preoccupation with romantic relationships that negatively impacts a person’s daily life, relationships, work, or mental health.

The term is generating conversation and controversy in part because of a new memoir by author Elizabeth Gilbert. In All the Way to the River, Gilbert opens up about a side of her life that bears almost no resemblance to the joyful self-discovery of her best-selling Eat, Pray, Love. She describes herself as a sex and love addict, recounting her all-consuming affair with her best friend in graphic, painful, and often unflattering detail.

While Gilbert’s relationship was the most destructive and dramatic of her life, it reflected what she views as a long-standing pattern of compulsive intimacy and romance.

Her candidness about the experience is shining a light on a condition that is both widely talked about and hotly debated: sex and love addiction.

Sex and love addiction is often described as a behavioral addiction, similar to gambling or compulsive shopping.

“People feel compelled to engage in sexual behaviors or romantic relationships despite negative consequences. This is like how someone with substance use disorder might continue using drugs or alcohol despite harm,” says Amer Raheemullah, MD, a psychiatrist who specializes in addiction at Stanford Health Care in California.

Addiction is not primarily about the substance or behavior itself, but about the reward it provides, says Dr. Raheemullah. “When something is highly rewarding, it drives repeated engagement. Over time, repetition can turn the behavior into a habit, and if the reward is strong enough, it may develop into an addiction,” he says.

While sex and love addiction isn’t an official diagnosis — and people can have problematic relationships with just sex, love, or both — mental health professionals can evaluate and address the harmful patterns and behaviors associated with it.

Raheemullah says the signs of sex and love addiction can look a lot like other addictions.

Symptoms of sex and love addiction can include:

• Repeated unsuccessful attempts to cut back or stop.
• Neglecting responsibilities at work or in social life.
• Escalating behaviors to achieve the same level of excitement or satisfaction.
• Persistent craving or preoccupation.
• Emotional distress, guilt, or shame after acting on compulsions.

People with love addiction don’t have to have all the symptoms, but two key traits are especially important and must be present, says Kerry Cohen, PsyD, a licensed professional counselor and author of Crazy for You: Breaking the Spell of Sex and Love Addiction:

• Your feelings and behavior around sex and love consistently lead to negative consequences and distress for yourself and those around you.
• You rely on sexual or romantic partners to meet your needs and avoid emotional pain.

There’s no single cause of sex and love addiction, but several factors can make someone more vulnerable.

“The brain systems involved in reward, motivation, and impulse control are thought to be dysregulated,” says Raheemullah.

Risk factors associated with sex and love addiction, according to Raheemullah:

• Childhood experiences, such as trauma, neglect, or inconsistent caregiving
• Psychological factors, including stress, high impulsivity, anxiety, or mood disorders
• Cultural influences, such as exposure to hypersexualized media or unstable relationships

Another significant risk factor, he says, is the modern proliferation of dating apps, online pornography, and anonymous encounters. “That immediate availability arguably represents the most significant risk factor,” Raheemullah says.

• Attachment Anxiety Fearing abandonment, worrying a lot about a partner leaving, or relying heavily on constant reassurance
• Low Self-Confidence or Poor Social Self-Confidence. When people feel unsure of themselves, unworthy, or believe they lack leadership abilities, they become more vulnerable
• Emotional Dependency Needing one person to put you above all others, feeling helpless if deserted, or being upset when someone discovers your mistakes
• Low Autonomy or Independence Not feeling able to do things by yourself or feeling you need others to make you feel good (When people aren’t comfortable or confident in being at least partly independent, they tend toward more addictive relational behaviors.)

Although there is overlap, sex addiction and love addiction aren’t the same condition, and neither is formally recognized in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association to help clinicians and researchers identify and classify mental health disorders.

Compulsive sexual behavior disorder (CSBD) is not listed as a potential diagnosis in the DSM-5, but it is included in the ICD-11 (International Classification of Diseases), developed by the World Health Organization for diagnosing and classifying medical conditions, says Raheemulla.

“It’s acknowledged that maybe sex addiction may exist, but they’re [the American Psychiatric Association] not ready to declare it as an official addiction,” says Steven Sussman, PhD, an addiction researcher and professor of population and public health sciences at Keck School of Medicine of USC in Los Angeles.

The research on love addiction is only starting to happen now, with some barriers that may prevent it from ever becoming an official diagnosis, says Dr. Sussman.

“When you make something a diagnosable condition, one thing you have to consider is how the condition would be insured if it did become a diagnosis,” he says.

“The lack of formal recognition doesn’t mean the condition doesn’t exist. It just reflects the absence of consensus on how best to categorize it,” says Raheemullah.

Sussman agrees that although love addiction may not be diagnosed in an official capacity, it can cause significant distress for the people who have it.

Because there isn’t an official diagnosis for sex or love addiction, it’s challenging to create clinical trials to test potential treatments, says Sussman. However, that doesn’t mean that there aren’t potential therapies that may help.

“The first step is often blocking immediate access to rewarding behaviors. If online content is part of the ritual, software that restricts certain websites and apps at both the server and device level, or that provides accountability, can be very effective,” says Raheemullah.

Treatment can involve one or more of the following:

Therapy Cognitive behavioral therapy (CBT), mindfulness-based approaches, and trauma-informed counseling can help.

Support Groups Twelve-step programs like Sex and Love Addicts Anonymous have helped many people. Online meetings offer anonymity and accessibility.

Lifestyle Strategies Nonmedication strategies emphasize coping skills, structured routines, supportive relationships, and relationship education.

Medication No drugs are approved specifically for sex or love addiction, but antidepressants (such as SSRIs) may help if depression, anxiety, or compulsivity is present, says Raheemullah.

“Addressing co-occurring mental health issues and building healthier relationship patterns remain essential parts of recovery,” says Raheemullah.

Recovery from sex and love addiction is possible, though it can be challenging, says Raheemullah.

“Many people experience significant improvement with the right support, and this looks different for different people. It may come through counseling, lifestyle changes, spirituality, support groups, or a combination of these,” he says.

Without those changes, compulsive behaviors may continue — you can’t count on them to “simply fade with aging, marriage, or other commitments,” says Raheemullah. Ultimately, motivation and consistent support are key to long-term progress, he says.

Sex and love addiction often occur alongside:

• Substance use disorders
• Depression or bipolar disorder
• Anxiety disorders
• Attention deficit disorder (ADHD) or impulse-control disorders
• Obsessive-compulsive disorder

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“These comorbidities can complicate treatment and make it even more important to address underlying trauma, emotional regulation, and coping strategies,” says Raheemullah.

• Sex and love addiction (together or separately) may not be official diagnoses, but associated behaviors can cause real distress, interfere with daily life, and harm relationships.
• Risk factors include childhood trauma, attachment anxiety, low self-esteem, and easy access to sexual or romantic experiences.
• Treatment options such as therapy, support groups, and addressing co-occurring conditions can help people regain control and build healthier relationships.
• If you feel trapped in destructive patterns with sex or love, reach out to a qualified mental health professional. Help and recovery are possible.