How To Cope With Sexual OCD

Dealing with obsessive-compulsive disorder (OCD) is a daunting experience for the patient and their loved ones. OCD is characterized by obsessive thoughts, an irresistible urge to act on the thoughts, and severe anxiety. Sexual OCD is a subtype of the condition marked by obsessions and compulsions of a sexual nature.

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What is sexual OCD?

Sexual OCD is a type of OCD characterized by intrusive sexual thoughts. Though it may be underreported due to the stigma associated with the condition, sexual obsession is quite common among people with OCD. People suffering from sexual OCD continuously experience obsessive thoughts of a sexual nature, which create distress for them.

OCD affects approximately 1.2% of American adults,¹ or about 3.95 million people. In their study² of nearly 300 treatment-seeking adults, one team of researchers found that 13.3% reported current sexual obsessions, and almost one in four reported having sexual obsessions in the past.

Like all types of OCD, sexual OCD is likely underrecognized and undertreated. Sexual OCD can disrupt intimate relationships through the anxiety, distress, and fears that arise from compulsive behaviors and obsessive thoughts.

Differences between sexual obsessions and fantasies

Sexual obsessions are often confused with sexual fantasies, but they aren’t the same. While fantasies are generally connected to pleasure, sexual obsessions involve anxiety and fear. For people with sexual OCD, sexual thoughts can be invasive, disturbing, embarrassing, and painful.

Sexual OCD sufferers don’t usually act on their obsessions. Most people with OCD view their obsessions as unpleasant or immoral and fight the urge to act on them.

People react to their impulses differently — some become preoccupied with masturbation and pornography, while others are so put off by their obsession that they isolate themselves and avoid interacting with others, including loved ones.

Symptoms of sexual OCD

Sexual OCD sufferers battle sexually obsessive thoughts they find frightening or contradictory to their moral views. 

Sexually obsessive thoughts may include:

  • Thoughts of engaging in unpleasant and inappropriate sexual activities that one has no interest in participating in (including sexual activities with authority personnel or underage people)

  • Thoughts of forcing someone or being forced to engage in sexual behavior

  • Repeating an action compulsively in response to disturbing sexual thoughts

  • Frightening thoughts of being attracted to a family member, children, animals, or close friends

  • Worrying thoughts about sexual orientation or other people’s perception of one’s sexual orientation

  • Fear of becoming violent during sexual encounters

Diagnosing sexual OCD

Like other mental health conditions, OCD is diagnosed based on symptoms and their impact. There are no blood tests or brain scans that can help doctors diagnose OCD.

To assess your psychological state, your physician, therapist, or another qualified mental health professional may ask questions about:

  • Your mental and physical wellness

  • Your sexual thoughts, habits, and behaviors, and whether they cause distress

  • Your recreational drug or alcohol use

  • Your family relationships and socioeconomic status

  • Sexual issues

Treatments for sexual OCD

Psychologists and other mental health professionals can help you understand your condition and work through it. Simply understanding the condition may alleviate anxiety, but sexual OCD is typically treated the same way as other types; through psychotherapy, medications, or both. 

Psychotherapy usually involves a cognitive behavior therapy technique called exposure and response prevention (ERP).³ 

During an ERP session, the mental health practitioner will expose you to situations or objects that trigger your intrusive sexual thoughts. Then, they’ll help you learn healthier ways to deal with them. For sexual OCD, ERP may involve recording a discussion of your sexual obsession on an audiotape, then listening to it over and over until you are no longer anxious or frightened by the obsession.

It is essential that you are completely honest about your sexual obsessions and thoughts, however embarrassing you feel they are. Your account of your thoughts and obsessions will help your doctor or therapist recommend the appropriate treatments. Your therapist is there to help you and will not judge or shame you. Beyond that, the information you share is protected, and you needn’t worry about your therapist sharing it with others.

Along with psychotherapy, serotonin reuptake inhibitors (SRIs)⁴ are the first line of treatment for OCD. Some patients require either therapy or medication, while others require both.

Tips to cope with sexual OCD

OCD symptoms can range from inconvenient to debilitating. Obsessions, compulsions, and anxiety require massive amounts of time and energy.

Though professional treatment is necessary to improve symptoms and prevent the urges from worsening, self-care is also helpful in coping with sexual OCD. Positive self-care habits include:

Eating a healthy diet

When you’re hungry, your body uses stored glucose, causing a drop in your blood sugar. Low blood sugar can cause mood swings, irritability, and fatigue. Start your days with a healthy breakfast and eat small meals instead of heavy lunch or dinner meals. 

Nuts and seeds are packed with healthy nutrients. To keep your blood sugar levels steady, carbs such as veggies, whole grains, and fruits come in handy. Also, ensure to include proteins, which slowly fuel your system for better mood balancing. 

Following your doctor's recommendations

It’s not difficult to lose track of your medications. However, missing or changing a dose without your doctor’s guidance can be dangerous.

Your doctor may recommend quitting smoking. Smoking may make you feel less anxious in the moment but heightens anxiety as the nicotine exits your system.

Staying active

Regular exercise helps to regulate your hormone levels and promote healthy nervous system functioning. Around 150 minutes of moderate activity per week is healthy for most people but speak with your doctor about developing an exercise plan that’s safe for you.

Improving relaxation skills

Relaxation techniques, such as meditation, yoga, or even a stroll outdoors, can help you relax. Just a few minutes a day can help.

Celebrating achievements

Improvement is rarely linear. In your journey toward controlling your OCD, you’ll undoubtedly experience setbacks. Keep your spirits up and stay motivated by celebrating every achievement. 

The lowdown

Sexual OCD is an often overlooked type of OCD that can affect intimate relationships and cause significant distress. If you have sexual OCD, rest assured that a licensed, qualified mental health professional can help you gain control over your condition through medications and therapy.

  1. Obsessive-compulsive disorder (OCD) | NIH: National Institute of Mental Health

  2. Sexual orientation obsessions in obsessive-compulsive disorder: Prevalence and correlates (2012)

  3. Exposure and response prevention (ERP) | International OCD Foundation

  4. How is OCD treated? | International OCD Foundation

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