National Edition

Ubiquitous assailant: The dangerous unasked questions surrounding pornography

Published: Saturday, July 6 2013 12:00 p.m. MDT

Updated: Wednesday, Feb. 19 2014 5:45 p.m. MST

Wilson started YourBrainOnPorn after he and his wife, who are not religious, began noticing a growing number of visitors to her healthy sexuality website identifying themselves as porn addicts with erectile dysfunction, delayed ejaculation and loss of libido.

Wilson says these symptoms are cropping up in younger men because unlike static Playboy centerfolds or a single DVD, the Internet offers an unlimited number of novel "partners." And with continual dopamine rushes, the brain's receptors become so overworked they shut down, sending the user searching for harder images to feel any pleasure.

"Addictions are chasing after dopamine," Wilson says. "Addictions are wanting more, but liking it less."

Dr. Kent Berridge, a professor of psychology and neuroscience at the University of Michigan, says that advances in neuroscience are leading to a better understanding of how dopamine affects the brain, and how it may lead to addictive behaviors. Three decades ago, he says, researchers thought the release of dopamine caused pleasure.

Yet, over time, they found it's possible to strip away dopamine and still have pleasure, and that boosting dopamine doesn't always mean increased pleasure, though it may increase behavior toward the pleasurable activity.

A study of patients with Parkinson's disease found that those individuals taking dopamine-producing drugs to help with depression reported increased sexual desires.

"This is first evidence that it could be an addiction-like thing for sex, but these are people being given dopamine-stimulated drugs," Berridge says. "Whether that happens in spontaneous sex addicts, that would be an open question. I think it's possible, I just think we don't know yet for sure."

Deem says he initially dropped out of college because he couldn't concentrate on anything besides porn and video games. Relationships weren't working and his sex drive was gone. Deem eventually decided to quit looking at pornography to see if he could “get back to normal.”

Wilson calls this a "reboot," a period of complete abstention from pornography, masturbation and sex to allow the body and brain to rest and recover.

Younger men are taking longer to "reboot" than older men, Wilson says, because older men didn't have their initial brain imprinting and education from high-speed Internet pornography.

Debating definitions

Not everyone buys the idea of a pornography addiction or its consequences, mostly because it's not in the DSM — the Diagnostic and Statistical Manual of Mental Disorders — published by the American Psychiatric Association.

Health care professionals use the DSM to diagnose mental disorders, which are "described strictly in terms of patterns of symptoms that tend to cluster together," according to the APA website.

And that's where the APA differs from the American Society of Addiction Medicine, says Dr. Raju Hajela, director, Region IX (International) of the ASAM, and chair of the subsection of definitions.

"In our definition, behaviors are a consequence of the disease, they are neither the disease nor the cause of the disease," Hajela says. "In the DSM, the behavior is the disorder."

In the newest DSM-5 manual, released in May after a 14-year review, a new category on behavioral addictions includes one entry: "gambling disorder."

Dr. David Kupfer, chair of the DSM-5Task Force, says an Internet Gaming Disorder was considered, but a work group determined "it warranted more clinical research and experience" before it could be officially included and was put in a "future study" section. Pornography addiction wasn't mentioned.

The nod to behavioral addictions is encouraging, but the DSM failed to address the huge problem of pornography, says Hilton, the Texas neurosurgeon who writes about addiction.

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