Last month, 3000 doctors of the American Society for Addiction Medicine released a public statement bringing the definition of addiction into line with decades of addiction research. “[Addiction] is about brains…. It’s about underlying neurology, not outward actions,” explains ASAM’s Dr. Michael Miller.
ASAM’s definition captures the key elements of addiction described by NIDA head Nora Volkow, MD and her team in the review Addiction: Decreased Reward Sensitivity and Increased Expectation Sensitivity Conspire to Overwhelm the Brain’s Control Circuit Addiction behaviors are the consequence of measurable brain changes—and recovery entails reversing these changes. The telltale changes center around the reward circuitry of the brain: a numbed pleasure response, extreme sensitivity to addiction-related cues, and decrease in frontal-cortex function.
ASAM also affirms that sexual behaviors can be addictive:
We all have the brain reward circuitry that makes food and sex rewarding. In fact, this is a survival mechanism. In a healthy brain, these rewards have feedback mechanisms for satiety or ‘enough.’ In someone with addiction, the circuitry becomes dysfunctional such that the message to the individual becomes ‘more’, which leads to the pathological pursuit of rewards and/or relief through the use of substances and behaviors.
If you view porn, are you an addict or merely a user?
This question used to be a silly one for most porn users. Prior to the Internet, porn use (if any) bore some relation to authentic libido. When one had had enough, the magazine went back under the mattress. Internet porn, however, has the power to override natural satiety mechanisms in many brains. This increases the risk of the addiction-related brain changes ASAM addressed.
With respect to porn, it’s not time spent viewing or what you’re looking at that determines whether your brain has changed. Instead, watch for these signs:
- Inability to abstain;
- Impaired impulse control;
- Diminished grasp of one’s problems; and
- Problematic emotional responses. (Detailed ASAM list)
Curious how these telltale symptoms might show up in today’s porn users? We’ve culled the following questions from actual reports of self-identified porn addicts. Many users do not make the connection between their symptoms and their porn use until they abstain from porn for weeks, but these questions, and the remarks below them, may help you determine whether you need to seek help to reverse unwanted changes and restore your brain to balance.
- Have you tried to stop using porn and failed? Did you notice withdrawal symptoms?
- Do you experience intense cravings when you have no access to porn for several days?
- When you use again do you notice rapid escalation to more extreme material?
- Have you noticed changes in your sexual tastes?
- Have you explored new types of porn in order to attain earlier levels of excitement?
- Are you viewing things that never turned you on?
- Are you using porn that does not match your sexual orientation?
- Is porn viewing the most exciting thing in your life? Does life seem dull otherwise?
- Do you feel powerless to stop yourself from using porn if you see or experience something you associate with porn use, such as:
- being alone in the house,
- seeing a TV show with your favorite fetish hinted at or portrayed,
- seeing news about a favorite porn star?
- Do you see potential mates differently—more as body parts than as people?
- Since using Internet porn, do you feel more tongue-tied, unsafe, awkward or anxious around other people—especially potential mates?
- Is it harder to connect with others? Do you feel lonelier? Are you more worried about what others think about you?
- Have you (or those who care about you) noticed you:
- procrastinate more than before using, have lower motivation (don’t care), chronic fatigue, brain-fog, or difficulty concentrating or remembering things?
- have become more anxious, restless, impulsive, stressed, irritable, unhappy, pessimistic, emotionally numb, or depressed?
- have become more secretive, or isolate more?
- Have you noticed declines in your sexual function during sex: more rapid ejaculation (PE), inability to maintain an erection without self-stimulation, porn or porn fantasy (even if you can get rock-hard to porn), delayed ejaculation (or inability to orgasm), less satisfying orgasm, need the lights on during sex to get aroused, not turned on by attractive partner, no desire for sex?
- Have you noticed declines in your sexual function during masturbation: unable to masturbate without porn or porn fantasy, need for more vigorous masturbation (“death grip,” faster strokes), weaker (or rapidly fading) erections, climaxing with a semi-erection, more frequent urination?
- Since using Internet porn, do you feel like you’ve lost your “mojo,” or sex appeal? Do you doubt your attractiveness or feel more anxious about the dimensions/appearance of your genitals?
- Does your voice feel more nervous, shallow, tight, or unnaturally high? Shallow breathing?
- Have you masturbated to the point of abrasions or other physical damage?
- Can you fall asleep without using porn? Do you have more trouble sleeping soundly through the night?
- When under stress do you use more porn?
- Do you have intrusive porn flashbacks?
- Are you risking your job, education or relationship to watch porn, or spending too much money on it?
- Have you lost a relationship or job, or dropped out of school due to your porn use (or symptoms related to it)?
- After climaxing, do you notice more intense mood swings (irritability, depression, anxiety)?
These users have noticed symptoms that may indicate brain changes:
Juan: I’m 23. My family told me on numerous occasions I was a shell of myself compared to when I was 18 (in a loving way). My friends weren’t as direct with me, but it was clear. I wasn’t close to the same person. In only a few years of heavy porn use, I developed debilitating social anxiety, depression, lack of drive, physical exhaustion, mental exhaustion, couldn’t hold a job, couldn’t even walk down the university halls without feeling scared to death of people, felt creepy around females from young to old etc.
Greg: Every relapse to transsexual porn was my last one. (I’m straight.) Why was this material suddenly so enticing, in such a short time period? I was masturbating to material that disgusted me before, and would still disgust me after I orgasmed.
Ryan: I am afraid of binging if I use porn. I know from my recent experience that if I masturbate while watching porn, I do it continuously for days.
Davy: I had no concept that I was suffering from porn withdrawal. I had simply given up porn, as was my custom when dating a new girl. Apparently, I had never before reached this level of addiction. 90% of these symptoms were things I have NEVER experienced in my life. ALL of them have either been alleviated, or are significantly improved, by this point (13 days no porn/masturbation/orgasm).
- Anxiety, chest tightness, panic attacks, high heart rate and blood pressure
- Feelings of impending doom. Depression to the point of suicidal thoughts
- Chronic Fatigue symptoms
- Inability to take pleasure in anything whatsoever: eating, reading, watching a movie, playing music or creating artwork (I am a musician and an artist.)
- Strange enjoyment of physical pain
- Severe insomnia: total of about 18 hours of sleep over the course of three weeks
- Increased urge to masturbate—up to 10 times in a day
- Sexual fatigue, loss of libido, loss of interest in life, testicular and groin pain, but still a strong urge to masturbate (figure that one out)
- Incoherent speech
- Digestive problems
Adrian: I never really knew how bad I was addicted until I tried to quit. I realize I can only get aroused with porn.
Tyrone: I have felt so emotionally numb for years now that I really feel like I have lost who I am. I don’t know what I feel about things. Nothing makes me happy/sad.
Ben: Had no idea I was addicted, which is funny considering I would spend hours a day in front of the computer watching increasingly novel video after video. If my Internet was running slowly and I couldn’t watch, I would go into rages and fits. I could do nothing else but wait until the video started again.
Tim: For about a month after giving up porn, I really couldn’t get hard enough to masturbate, and when I “forced” it my orgasms were pretty unsatisfying.
Will: I go all night until I’m exhausted, and then I go some more. I feel so tired the next day it’s unbelievable. I feel physically sick with body aches, a sore throat, red eyes, etc. It is very hard to focus on work. I stare at the computer screen, and forget what I am doing. Social anxiety is high after a relapse. I don’t want to be around anyone, and get irritated very easily. My body is extremely exhausted after a binge, but it is hard to fall asleep because my mind is worked up with anxiety. It’s like I’m only half there, just a shell of the man I could be. My voice is higher pitched, and sounds somewhat frail. I don’t even like looking in the mirror. Last time, there were a couple of girls interested in hanging out with me, but I got horribly stressed out at the thought of hanging out with them. I have zero libido after my masturbation marathon, and no desire to be around real women. All I feel is anxiety.
Kyle: I kinda just felt separate from everyone, and as a result would drink to excess in hopes of appearing more confident… Didn’t work LOL. Thing is, I used to be so confident and popular. I even saw a counselor about my ED, lack of confidence and social anxiety etc., but never was I asked about porn use.
Andrew: For a while at least, I always went back to the “tame” stuff in order to get off. There seemed to me something unseemly about getting off to something I was watching only out of a car crash rubber-necking, morbid curiosity. But then one day, I actually started masturbating to these kinds of videos. That’s when I knew I’d crossed the line. I was getting off to something I found repellant, not sexually arousing in the conventional sense. I could easily become aroused and orgasm via masturbation, but not when having sex with my wife. When you have difficulty being aroused or ejaculating with real partners, you know you’ve got an addiction. When you find yourself asking your spouse to put a live eel in her p—- while you f— her a–, and she says “No,” and you say, “You’d do it if you loved me. This is my fantasy.” That’s how you know you’re addicted.
Brains are plastic. That’s what makes them vulnerable to addiction, but it’s also what makes recovery possible. If you want to make a change, get support. Change is entirely possible. See additional self-reports of symptoms, escalation and withdrawal distress. Also see self-reports of effects reversing themselves after stopping.