Help with hypersexuality

Help!
I am 31 years old and have had major addictions my whole life. When I was eleven I began masturbating to porn excessively, causing my mother to have a credit card bill of over 3000.00 one month from stealing her card for pornography use. I have spent over 300,000 dollars since I was eleven on pornography, strip clubs, and yes, even hookers. I have had an average of 20-30 sex partners a year.

In my early twenties I also began to be addicted to food, primarily out of shame of my sex addiction. I went from 165lbs to 375lbs now from the ages of 21 to 25 and have stayed at 375 lbs even after numerous diets.

I also had a severe gambling addiction, primarily due to trying to "win" money to either pay off porn/hooker habits or to obtain porn/hookers.

I was diagnosed with bipolar disorder roughly a year ago and have been on carbamanzepine. I have been in a relationship for over 3 years off and on and I finally gave up hookers (not porn) and got married. I thought the medication had completely stabilized me but i find myself during the day at work trolling craigslist for anonymous sex and backpage for escorts. I drove an hour away yesterday when i was supposed to be at work to obtain sex for money. I didn't go through with it because I looked at my wedding ring and did not want to betray my wife, but clearly my medication isn't working or helping.

I am afraid of telling my psychiatrist about my sexual behavior, he just knows about mood swings. I do not want to get arrested for soliciting prostitutes. I also have no idea how to stop my porn addiction. On average I download 15-20 different porn movies a week and now I have a hidden collection on my hard drive of over a terrabyte of pornography.

My life is spiraling out of control. Please help me. I dont know what to do.

All of the counselors in my area are Christian based, and I am not religious. I live in the bible belt and am deathly afraid of confiding with anyone locally. I have no idea what to do I feel so lost.

I would think that there would be some sort of confidentiality and privacy if you disclosed this to your pdoc?

You could straight out ask your pdoc: "What specific scenarios, if we spoke about them, would you be liable to report me for?"

If no mention is made of your behavior go wild and tell your pdoc so you can get help.

My pdoc is only obliged to report / intervene the following scenarios that she told me:

*threat to self
*endangerment to others
*reporting to driver Licence authority if habitual illicit drug user for license suspension

Yeah I am just paranoid it will get out. Writing this post is the first time I have told ANYONE. I don't know if it's because im bipolar or what I have no idea where this addiction comes from. I tell myself I will stop and then cave within a day or two. I get sex twice a week from my wife shouldn't that be enough?? I have seriously contemplated suicide but I have a 13 year old daughter and could never do that to her

You need to tell your psychiatrist about your addiction like you did on here and maybe even tell your wife before she find out from someone else . I know it wont be easy but you must tell her before she find out the hard way . Maybe bring your wife with you and tell the psychiatrist at the same time .

Ask your psychiatrist if they know of a good T that treats porn addiction .

Get help before you get arrested !

Yeah I'd agree with the above. I don't think treatment with meds alone for Bipolar would even be nearly as effective as treatment with therapy and other "talking treatment" for sex and/or porn addiction.

You are making a wrong conclusion about Tegretol. From what you have written, you clearly are doing much better on Tegretol than you were doing without it. You cannot expect that a medication will erase all your symptoms; you need to have realistic expectations and adopt the glass half full approach, whereas yours is the glass half empty. Because Tegretol is so old, as far as anti-mania drugs go, and so well studied, that you get help from it is actually quite a good development. You seem to be a bit out of touch with reality, possibly because you feel so much shame, because you present vastly different facts as if there were valid parts of one series.

For example, how much porn you download and the TB that you own seems in line with what a lot of other people report. You do not seem to be an outlying case here.

However, how much you spent on sex-related stuff as a teen is completely odd and an outlying case and makes me wonder who provided the money. In Oklahoma and your parents are so rich that they paid over $300K on your behalf? Can they loan me a bit? I'd be most grateful. For seriously, I find it hard to believe that your parents paid that much and did not nip the problem in the bud. So I am led to conclude that you stole the money. How did you steal the money? From whom? Or did you sell drugs?

Please stay as far as possible from those therapists who would promise that they will:

- cure your sex addiction, if you have it
- cure your food addiction, if you have it
- cure your gambling addiction, if you have it

All of those promises would be broken and you would become further embittered. You basically identify that you are mired in a web of interdependent problems: you become ashamed of what you do sexually and you turn to food or you try to win money in gambling to erase the debt to hookers, etc. So you identified that you are in a complex situation with various moving parts affecting one another. The unifying thread is compulsivity/impulsivity. It could be that you have no addictions but are simply inordinately compulsive AND impulsive. Note that impulsivity is part of bipolar.

You also are all black and white.

You could have written along the lines of "just the other day, I drove for a whole hour to obtain sex for $$, but, guess what, my Tegretol (or my self-discipline) is finally working! I was able to stop myself and make a U-turn". Instead, you wrote: " I didn't go through with it because I looked at my wedding ring and did not want to betray my wife, but clearly my medication isn't working or helping. "

If you do not understand the difference between driving for an hour to pay for sex and paying for sex AND driving for an hour to pay for sex yet making a U-turn, then that's your problem in a nutshell. You cannot give yourself credit; you are unable to think in terms of subtleties, nuances, and degrees; most importantly, you are unable to see that between driving to pay for sex and paying for sex lies a very big divide. What you seem to be wanting is some sort of a complete cure; you seem to be wanting to not even want to pay for sex. So you do not want to have impulses. How realistic, for somebody like you, is to go from having all those destructive impulses to not having them overnight? With medication or with therapy or with positive affirmations or with a beneficial position of the stars? It is not realistic - the probability of this happening is zero, and by expecting a zero probability positive event (not having the impulse to pay for sex) you are setting yourself up for failure WITH CERTAINTY.

How do you react to failures? Well, we know how you react - you turn to another source of what you call "addiction". Say, had you actually paid for sex that last time instead of making a U-turn, you would have felt bad afterwards and would have either tried gambling to "win back" the money you spent for sex, or, turned to food, or, both.

So you need a comprehensive approach. You need a therapist who will work with that whole picture. No eating disorder or gambling or porn whatever specialists for you but someone to take it ALL in.

As has been explained above, what you have been doing definitely gives YOU that feeling of your life spiraling out of control and you certainly deserve compassion for being in such a helpless position, but all of those things taken together do not rise to the level at which a therapist is mandated to disclose your intentions to state agents (the police etc.). A lot of people do indecorous deeds, some of which might be illegal. People steal, embezzle, shoplift, patronize prostitutes, deal in drugs, and many more. None of those activities, and much less intentions to possibly engage in those activities are reportable. So you need to tell your psychiatrist about what has been going on and ask for a referral to a long-term therapist.

I also would recommend that you cross-post this on the Bipolar forum because you have a lot going on in terms of bipolar. A lot. For example, both your reporting suicidality and excessive shame and otherwise unexplained weight gain that was so large might be symptoms of lingering depression. Tegretol primarily acts as a anti-manic agent, and, in you, it seems to be quite successful since your impulsivity has gone down A LOT. But you are not taking anything to take the edge off the depressive phase of bipolar. Tell your psychiatrist about your fleeting suicidal thoughts that you do not plan to act upon because you have a kid but are worried about; tell your psychiatrist that you sometimes eat because you cannot handle the feelings of shame; maybe the psychiatrist would prescribe Lamictal or even a straight AD (antidepressant) because your Tegretol would protect you from AD's flipping you into mania. You need a more comprehensive approach to your care and for that you need to tell a lot of things to the psychiatrist.

Finally, your goals in terms of curtailing your porn use are unrealistic, and, as I hope has become clear, your tendency to set completely, wildly unrealistic goals results in your feeling like a total failure, which in turn fuels all of those activities which you dubbed "addictions".

Think along the lines of legality. Porn can be adult and underage. Do you keep underage porn? No? Great news!

I assume that patronizing prostitutes is illegal in OK. And adult porn is not. So viewing porn is better for you than patronizing prostitutes - you keep yourself on the right side of the law. Great news, once again!

So when you write: " I do not want to get arrested for soliciting prostitutes. I also have no idea how to stop my porn addiction. " you are not making sense. These two things should be separated because one is riskier than the other. I am not clear what the reason for stopping porn use it, but whatever it is, that reason is less urgent than staying on the safe side legally. So your goal for now should be not soliciting prostitutes, period, and even if you end up watching MORE porn in order to really erase the issue with prostitutes, that would be a worthwhile tradeoff. When you feel secure in that you would not one day drive away for an hour to have sex with a hooker, then, MAYBE, if you by then still feel that it is a sensible goal, you would try to curtail porn use.

Basically, precisely the qualities that lead you to dangerous behaviors are currently keeping you from stopping these dangerous behaviors. You cannot set realistic goals, you cannot apply a graduated scale - behavior A is risky, but behavior B is extremely risky, while behavior C is a little embarrassing, but not really risky - cannot see the glass half full, and want everything at once, NOW. This is basically an angry child's stance on life - wanting everything his way NOW. An adult is aware of his limitations and works WITH them and not AGAINST them. So you have a lot of growing up to do, and hopefully a thoughtful, patient therapist would help you tremendously, but some self-work and SENSIBLE self-discipline can be practiced on your own without waiting for professional intervention.

I realize that it is harsh to call a guy whose daughter is already a teen a child, but I wanted to make sure that you see that your current strategy - you are only telling the psychiatrist about the mood swings - is bound to fail, as would any similar strategy, e.g. engaging a "porn addiction" or "food addiction" "helpers" and only telling a bit about sex to the "porn addiction" specialist and a bit about food to a "food addiction" specialist, etc. Nobody would be able to help you unless you basically go into a contract arrangement with the T committing to telling the truth about sex, suicidality, money, and the whole 9 yards. Instead of presenting just one tip of the iceberg as you are currently doing with the psychiatrist, you would need to honestly open up and solve that big and old web of problems.

I think Nature's suggestion to tell your wife is going to bring you TREMENDOUS relief if you summon the courage to implement it. You would feel accountable; you would not feel that you have to hide from literally everybody in your life; the draw of a hidden fruit may lessen and may lessen so much that the compulsion to use porn so much would evaporate without intervention; your anxiety level will go down.

With all of that I would once again recommend that you post in the Bipolar forum and ask people how they deal with impulsivity. E.g. a long list of strategies has been developed to deal with the impulse to go on a shopping spree. If you read the archives, trying to think as a problem-solver and ask yourself if those strategies are adaptable to your needs, you will be well on the path to getting your life on track.

PS If you get a therapist referral from the psychiatrist, great, but if you do not, you need to make sure that the psychiatrist would agree to talk to the T and vice versa. Not everybody would agree to work in this team approach, so you need to ask in advance and make it a condition of treatment.

Today I visited the website of the Board of Behav. Health of California which licenses and regulates, among others, marriage and family therapists. I had a narrow task visiting the website so I did not browse around; however, when I was looking for the page I needed, I came across the mention of "online therapy". Could you engage a California therapist over Skype? at least it is worth finding out.

I thought more of your many troubles and it seems that you are like a child who cannot tolerate delayed gratification and who wants reality to mold to him.

Example of inability to tolerate delayed gratification: You want medication to solve ALL the problems.

Example of wishing that reality molded to you: you want the frequency of sexual encounters with the wife be sufficient for YOU just because such frequency might be sufficient for others.

The issue with accepting reality might be solvable with DBT=Dialectical Behavior Therapy. DBT teaches radical acceptance. DBT also teaches distress tolerance skills. I think it is right up your alley. DBT might equip you with enough new skills to unlearn wanting instant gratification, too. DBT is fairly well vetted as a treatment modality so if you go that route, you would get the benefit of a toolkit that has been proven helpful to many other folks. Most importantly, DBT is comprehensive - it would help you address MOST of the issues in one fell swoop. Many of the DBT approaches are universal - you simply adjust them based on your situation.