Depression And Sex Addiction: , Secret Life Of The Manic Depressive
Q: “I choose my behavior; the world chooses my consequences” is a phrase
that any recovering sex addict could do well to hold in vivid
consciousness. When the awareness of a pattern of sexual addiction
starts to become clear, a trail of consequences is likely to follow
close behind. Rather than attempt to manage or minimize the
consequences, the sex addict is advised to curtail sexual
acting out and embrace a quality recovery program taught and modeled
by other recovering addicts.
A:Despite the conviction to move toward the rigorous honesty of
recovery, the addict is likely to experience the cold sweat of
repercussions of previous behavior. The secret life is unveiled
revealing affairs, exhibitionism, voyeurism, or other behaviors
comprising a particular sex addict’s modus operandi of acting out.
Like the trapeze artist in the circus, the addict encounters the
moment between letting go of one trapeze and catching the other. Such
a crisis will make one exquisitely aware of hopelessness and
depression.
Hopefully, it will also dawn on the addict that he/she is powerless
and that a Higher Power alone can and will be there in that moment.
Six classes of depressive types expressed in sex addicts
The mental health practitioner who treats sex addiction is called upon
to diagnoses and treat the depression that is likely to be present
before, during, and after the between-trapeze experience. This
depression may present in several different forms, which can be
summarized in the following classes:
1. Most commonly, a chronic, low grade depression or dysthymia in a
shame-based person who has low self esteem and relatively undeveloped
social skills. This dysthymic disorder may be punctuated with major
depression especially likely at the time of significant
relationship losses or at the time of exposure of the pattern of sex
addiction. Shame, loneliness, and awareness of lost time spent in
active addiction may haunt the addict. When shame rolls in, depression
follows the flood. This type tends to have a strong superego and be at
risk for self-punitive suicidal thoughts and behavior.
2. A seeming lack of depression in a perfectionistic, shameless-acting
high achiever. Despite not having a history of previous clinical
depression, this person may experience an overwhelming major
depression as perfectionism and narcissism no longer stem the tide of
mounting negative consequences of sexual behavior. Since this person
may have a lofty professional and occupational position, the sexual
acting out may involve level III abuse of a power position with
employees, clients, or patients. If professional consequences (e.g.
loss of license, termination of employment) lead to a further and more
devastating breakdown in personal relationships (e.g. divorce, marital
separation), the person’s shame can be catastrophic and overwhelming,
making suicide a real and pressing danger. This person may even need
to be hospitalized against his or her will until adequate defenses can
be reestablished and a recovery process begun.
3. The depleted workaholic whose life is without joy, and who has no
balance in social or recreational spheres. This sex addict is likely
to find someone or a series of subjects at work to groom as he/she
presents as a martyr-like victim slaving to support a family yet
deserving of a sexual release. When depression finally breaks through
clinically, after the pattern of sexual behavior is exposed, it is
likely to
be massive because this addict has little to fall back on when the
merry-go-round of work stops. The workaholic pattern becomes a central
treatment issue with both sex addiction and depression seen as
outgrowths of the long term lack of self care. If a workaholic pattern
recurs after treatment, relapse into sex addiction is almost certain,
whether it be in the behavior or thoughts of the addict.
Therefore, a goal in treatment and after for this person is to halt
the pattern of self abandonment expressed previously through
workaholism, sex addiction, and martyrdom.
4. Psychotic depression in a person who may be older (45-60 or above)
and who has a pre-morbid obsessive-compulsive style and a suspicious
temperament. This person may have practiced a type of sex addiction
that included perpetrating children or teenagers, but kept it
concealed for years. When the addiction progresses and the behavior is
discovered, the public outcry and shame may be processed by the addict
via psychotic defenses of massive denial and projection. The addict
may sink into a stuperous depression with psychotic features including
frank paranoid thoughts of feeling acted upon by outside forces and
profound social withdrawal. The reality of the perpetrating behavior
is alien to the denying lifestyle the person has practiced for years.
The recovery from psychosis is gradual and in-depth work on recovery
from the addictive sexual cycle must be put off until aggressive
pharmacological treatment takes effect.
5. Bipolar depression in a person who may or may not be a true sex
addict. Since the manic phase and mixed manic/depressive phases of
bipolar disorder are often accompanied by hyper-sexuality with
heightened sex drive and increased sexual behaviors of boundary-less
type, the clinician, in attempting to make an accurate diagnosis,
should be mindful to search for a true pattern of sex addiction
behavior which transcends the mood swings of bipolar disorder. A
bipolar patient may also be a sex addict, but