Internet sex addiction can have several causes according to the American Association for Sex Addition Therapy. The first cause is the neural physiological attachment that occurs during orgasms - reinforcing and attaching the images or scenarios to the addictive behavior concurrently. Secondly, psychological defects like abandonment, unimportance or lack of genuine attachment are sometimes medicated by the instances of sex addiction behavior. Thirdly, the internet sex addict may be using the addiction to balance a legitimate chemical imbalance due to major depression, a bipolar disorder or a manic depressive disorder. The cybersex addict may also struggle with intimacy anorexia since the cyber world feels safer than real relationships.