The truth behind paraphilia and co-occurring disorders
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Paraphilic disorders are characterized by atypical sexual urges. However, as the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) notes, paraphilia is “often misunderstood as a catch-all definition for any unusual sexual behavior.” A diagnosis for any of the serious mental health disorders that fall under the umbrella of paraphilia lies in extreme emotional distress. For this reason, anxiety and depression often co-occur in those with paraphilic disorders.

The true prevalence of paraphilic disorders is unknown, since many individuals are hesitant to come forward and seek treatment after having legal troubles directly related to their related behaviors. As the National Institutes of Health (NIH) confirms, “Prevalence rates for paraphilias are difficult to obtain due to changes in criterion over time and between cultures.” However, pedophilia, exhibitionism and voyeurism are believed to be the most common paraphilic disorders today. The causes of paraphilia, which is more common in men than in women, are believed to be a combination of psychological and behavioral, typically stemming from childhood or early sexual experiences.

According to diagnostic criteria, people who enjoy mild masochistic or sadistic tendencies with consensual adults without any emotional distress regarding their behaviors are not classified as struggling with paraphilia. The DSM-V expands on this, noting that the individual must “feel personal distress about their interest, not merely distress resulting from society’s disapproval… [or] have a sexual desire or behavior that involves another person’s psychological distress, injury or death, or a desire for sexual behaviors involving unwilling persons or persons unable to give legal consent.” This also indicates an individual does not need to engage in paraphilic behaviors to be diagnosed if distressing thoughts and desires are present.

Individuals with paraphilic disorders often concurrently struggle with anxiety or depression. These symptoms “may be accompanied by an increase in the frequency and intensity of the paraphiliac behavior.” Behavioral therapy and hypnosis are the most common forms of treatment for paraphilia, including aversive conditioning. The goal of aversive conditioning is to have the individual associate negative or unpleasant feelings with his or her atypical sexual behaviors, no longer deriving pleasure from them. Many individuals are also prescribed anti-depressants, including selective serotonin reuptake inhibitors (SSRIs), which typically decrease sex drive. Anti-androgens can also be prescribed for this purpose, lowering testosterone levels, sex drive and the capacity for mental imagery in those with atypical sexual fantasies and behaviors. Though high levels of testosterone and high sex drive are not always associated with paraphilia, anti-androgens are able to mitigate sexual urges to make therapy and conditioning more effective.

If you or a loved one is struggling with a paraphilic disorder, anxiety or depression, help is available. Sovereign Health Group specializes in treating individuals struggling with mental health disorders, substance abuse issues and dual diagnosis. Call to speak with a professional today.

Written by Courtney Howard, Sovereign Health Group writer

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