Pornography has always had a complicated relationship with our culture. On the one hand, some say that porn is a healthy form of sexual expression, while others believe porn is "an evil" that leads to unrealistic expectations and, sometimes, addiction. True, there is evidence that watching porn can activate the same parts of the brain fired in drug addicts and alcoholics getting a fix — but a new study from Case Western Reverse University in Cleveland suggests that the mere idea of porn addiction can have adverse effects on a person's mental health.

In their study, researchers first established how many men and women actually watch porn; 87 percent of adult men and 34 percent of adult women reported doing so pretty regularly. Based on these responses, researchers estimated that porn accounts for 13 percent of Internet traffic. But what does all of this mean for mental health?

We know porn addiction impacts mental health, so lead study author and doctoral candidate Joshua Grubbs decided to focus the research on how perceived porn addiction impacts psychological well-being. Grubbs and his team defined perceived addiction as the viewer’s belief they are watching porn in a pathological manner that can’t be controlled.

There were two groups of participants: The first represented both male and female internet users, and the second was a group of psychology undergraduate students from three separate universities within the United States. Each group was given a questionnaire that helped to evaluate how often participants watched porn, their perceived level of addiction, and the emotional distress they felt associated with this perception.

Overall, researchers found that those who believed they had an addiction to pornography also experienced psychological issues, like depression, anger, and anxiety. However, this was not a result of watching porn itself, but rather it was a result of the feeling that watching porn was becoming an uncontrollable habit.

“It doesn’t seem to be the pornography itself that is causing folks problems, it’s how they feel about it,” Grubbs said in a press release. “Perceived addiction involves a negative interpretation of your own behavior, thinking about yourself like, ‘I have no power over this’…We know from many studies that thinking something has control over you leads to psychological distress.”

Grubbs added that psychological distress doesn’t always come from a sense of guilt about viewing pornography. In fact, some people have no problem with the porn itself, but instead worry more about what'll happen if they watch too much of it.

“Someone can be called out and publicly shamed, a marriage can become troubled, or maybe you are caught at work and get fired,” said Grubb. “Any of these causes psychological distress.”

Source: Grubb J, Stauner N, Exline J, et al. Perceived Addiction to Internet Pornography and Psychological Distress: Examining Relationships Concurrently Over Time. Psychology of Addictive Behaviors. 2015.