Dual Diagnoses: When Bipolar Disorder Is Intertwined With Porn Addiction

“One moment I am on top of the world – happy, jubilant, painless, and confident, but within hours, I am depressed, moody, unmotivated, sluggish, and emotional and physically distressed. I do not know what to do so I turn on porn to ease my stress and angst and distract me for a little while. It works for a couple of hours, then the cycle begins again.”

Bipolar disorder, once referred to as “manic depression,” is a mental health condition that involves rapid and erratic mood swings, sudden behavior changes, and a burst of untamed and limitless energy. Porn addiction, on the other hand, is another complex and serious condition that can negatively affect your life, health, and well-being.

When both conditions occur together it is called comorbid, co-occurring, or dual conditions. When two or more conditions co-exist, it increases your risk of experiencing low self-esteem and self-confidence, financial problems or debt, relationship issues, social isolation, etc. It can also make you feel as if you are alone or an anomaly when in reality, thousands of people across the world also suffer from more than one health condition.

Although neither bipolar disorder nor porn addiction can be completely cured (relapses are always right around the corner), both conditions can be treated using a dual diagnosis treatment (bipolar disorder and porn addiction treatment) approach. A dual diagnosis treatment approach typically involves a combination of behavioral therapy (i.e., cognitive-behavioral therapy (CBT), acceptance and commitment therapy (ACT), etc.), lifestyle modifications, self-help tools, and mood-stabilizing medications (i.e., antidepressants or SSRIs).

The truth is having a dual diagnosis of bipolar disorder and porn addiction can be tricky to treat. Although, it is possible to treat each condition independently (one at a time), most therapists opt to treat both conditions simultaneously (at the same time). Living with two conditions at the same time can feel extremely lonely – lonelier than just having bipolar disorder or porn addiction.

Grappling with porn addiction is typically a solitary endeavor, struggling with porn addiction and bipolar disorder can be even more isolating, often leading to a loss of friends, failed romantic relationships, fractured familial bonds, low self-esteem and self-confidence, and an overall feeling of hopeless or helplessness. When left untreated, having a dual diagnosis, like bipolar disorder and porn addiction can lead to self-harm and/or suicidal ideation (suicidal thoughts and attempts). The good news is there is help available!

You do not have to continue to suffer from wild mood swings and compulsive behaviors, like using porn, because there are people, who want to help you get your mood and behavior back under control. More specifically, there are specialists, resources, and tools, like Stop Together, an online porn addiction recovery program, that can help restore your health and vitality.

If you are struggling with a dual diagnosis of bipolar disorder and porn addiction, you are not alone. Help is on the way! With this article, you will learn what it is like to live with bipolar disorder and porn addiction. You will also learn how to cope with these co-occurring conditions in a healthy and productive way.

What is Bipolar Disorder?

Approximately 6 million US adults (nearly 3%) have been diagnosed with bipolar disorder.

Because we are human, we are bound to have “ups and downs” from time to time. Believe it or not, that is healthy and normal. No one is immune from a “bad day” or mood swings, so it is natural to sometimes feel “sad” or “depressed.”

A problem only occurs when these feelings persist beyond a few days or worsen. If more days than not, you are despondent to the point that you lack the energy to get out of bed or tend to personal household, work, relationship, or child-rearing responsibilities, it is time to see your doctor, get a diagnosis, and start a treatment regimen.

Bipolar disorder can make you feel as if you are going “crazy,” but you are not. You are simply dealing with a mental health illness, no different than a physical one like high blood pressure, diabetes, lupus, asthma, etc. For most, bipolar disorder manifests in life-altering ways.

A person with bipolar disorder will likely experience a fluctuation in mood, energy, and daily functioning that lasts indefinitely. Bipolar disorder episodes or flares may last for weeks or months at a time.

When this condition is left untreated, it can lead to poor job performance (quality and quality), self-harm behaviors, low self-esteem, poor hygiene, child neglect or abuse, absenteeism from work or school, romantic break-ups, social withdrawal and isolation, and in severe cases, suicide. On the flip side, when bipolar disorder is properly treated, it can lead to a stable mood and a happy and productive life.

How Can I Tell If I Have Bipolar Disorder?

Even though bipolar disorder is characterized by sudden and extreme shifts in mood, there appear to be three subtypes of the condition, such as:

Bipolar I Disorder

Bipolar I disorder involves manic episodes or “flares” that persist for at least 7 days or are severe enough to require medical treatment. People, who struggle with this type of bipolar disorder may also have bouts of depression coupled with some manic symptoms that persist for at least 14 days at a time.

Bipolar II Disorder

Bipolar II disorder involves repetitive hypomanic and depressive episodes or “flares,” however, the manic episodes are typically not as severe as those found in people with bipolar I disorder.

Cyclothymic Disorder (Cyclothymia)

Cyclothymic disorder (cyclothymia) involves hypomania (i.e., an elevated mood, increased activity, insomnia, arrogance, racing thoughts, etc.) with periods of depression (i.e., despair, a loss of interest in enjoyable activities, a dull affect, low energy, excessive sleep, etc.) that persists for at least 2 years.

Unspecified Bipolar Disorder

Unspecified bipolar disorder may involve limited mania and depression symptoms or either no mania symptoms or no depression ones. A person with this type of bipolar disorder may not securely fit in any of the categories listed above. When it occurs, bipolar disorder is categorized as “Other Unspecified Bipolar and Related Disorders.”

Mania

Listed below are common manic symptoms:

• Extreme happiness or euphoria
• A feeling of being “high”
• Boundless energy
• Inflated self-esteem and self-confidence
• Risky or impulsive behaviors
• Restlessness
• Irritability and agitation
• Extreme alertness and awareness
• Racing thoughts
• Anxiety
• Distracted easily
• Hallucinations and delusions
• Psychosis

Depression

Listed below are common depressive symptoms:

• Fatigue and lethargy
• A lack of energy or motivation
• A dull affect
• Emotional numbness
• A negative attitude
• Poor hygiene
• An abandonment of task and/or responsibilities
• An inability to focus or concentrate
• A lack of interest in pleasurable hobbies or activities
• Sudden changes in appetite and/or sleeping patterns
• Suicidal thoughts and attempts
• Self-harming behaviors

Note: Some bipolar disorder episodes may consist of a mixture of mania and depression symptoms, while other people may exhibit all or most of the symptoms of mania and depression.

How is Bipolar Disorder Diagnosed?

Similar to other mental health conditions, bipolar disorder is usually diagnosed with blood tests (labs), observation, self-reports (i.e., through journaling or mood charting), a psychological intake (i.e., documentation of family medical history), and psychological assessments.

Bipolar disorder is usually diagnosed during late adolescence or early adulthood; however, it can also be diagnosed earlier or later than this time. Because this condition involves unpredictable mood swings, the symptoms can fluctuate, depending on the type of episode or “flare.”

What is Porn Addiction?

Porn addiction involves an emotional dependency, obsession, or “fixation” on porn so much so that it interferes with a person’s livelihood, relationships, daily functioning, self-esteem and self-confidence, etc. Although porn addiction is not recognized in the DSM-5 or by the American Psychological Association (APA), it is still a problematic condition that affects the lives of men and women throughout the world.

Porn addicts constantly and uncontrollably crave sexually-explicit material – i.e., images, advertisements, books, magazines, videos, etc. Trying to stop the behavior often proves fruitless without proper porn addiction treatment (i.e., porn addiction therapy – cognitive-behavioral therapy (CBT), acceptance and commitment therapy (ACT), trauma counseling, couples or marriage counseling, etc., medications, lifestyle changes like proper sleep, a healthy diet, regular exercise, natural remedies like CBD, vitamin and/or mineral supplements, and/or self-help tools, like Stop Together, hypnosis, mindfulness meditation, etc.

Due to a constant need for porn, your job, academics, relationships and friendships, and/or personal and social lives can be disrupted and damaged. Using porn typically takes precedence over other interests and responsibilities. Some porn addicts can become so consumed with porn that it takes over their lives and robs them of their livelihoods.

When this occurs, the addict can become reckless – i.e., watching porn on school or work computers or in open spaces. It is important to understand that porn addiction is a serious hypersexual or impulse-driven behavioral condition. It resembles other behavioral addictions, like chronic masturbation, gambling, shopping, food, exercise, etc., It also resembles the “high” often associated with substance abuse.

How is Porn Addiction Diagnosed?

Just like bipolar disorder, porn addiction is diagnosed using psychological assessments, observations bloodwork or labs (to rule out a chemical or hormone imbalance, and/or other conditions), self-reports, and a psychological intake (i.e., documentation of family medical history).

How is a Dual Diagnosis Condition Like Bipolar Disorder and Porn Addiction Diagnosed?

Surprisingly, bipolar disorder is closely linked to porn addiction, which is why it is often hard to diagnose and treat. By itself, bipolar disorder involves a variety of subtypes and various manifestations. As a result, this condition is sometimes misdiagnosed as simply “depression,” when in reality it is so much more.

Similarly, when a person becomes “fixated” on porn, it triggers a euphoria or a sensation of being “high.” It can also lead to a boost in energy which can resemble a bipolar-related manic or hypomanic episode. On the flipside, “heavy porn use” like bipolar-related depression, can trigger despair, a lack of energy, low motivation, social withdrawal and isolation, etc. Porn addiction withdrawal can also mimic symptoms of depression or a mixed phase of bipolar disorder.

So, while it is possible to have a dual diagnosis or comorbid condition, like porn addiction and bipolar disorder, one of these conditions could be inadvertently missed or overlooked without close attention.

Is Bipolar Disorder Connected to Porn Addiction?

According to limited studies, 57% of people with bipolar disorder, specifically mania, and porn addiction or hypersexuality.

Because bipolar disorder involves both “highs” and “lows,” it can be notoriously hard to diagnose, treat, and manage. Because, finding the right bipolar treatment can be challenging, some people with the condition turn to “self-medication.” In all honesty, people with bipolar disorder just want to feel better – by any means necessary, so they turn to other “vices” to distract themselves from their symptoms.

Sometimes, “self-medicating” involves alcohol and/or drugs, while other times, it may involve using porn. Regardless of the method, “self-medicating” is never a good idea or an effective way to cope with your distress. Why? Because, it increases your risk of addiction, like porn addiction.

Moreover, people suffering from bipolar-related manic episodes, tend to be impulsive or “rash,” which means that they are more likely than people without bipolar disorder, to engage in dangerous behaviors, such as using porn in public places like a coffeehouse, at work or school, on a bus, or in the presences of family members, friends, a romantic partner, or guests.

Once the “high” of the porn wears off and depression sets in, these individuals return to porn again – to get that “high” again and feel better. This is porn addiction. Researchers believe that bipolar disorder is linked to a chemical imbalance in the brain, genetics, childhood trauma, and/or environmental factors, however, the exact cause varies from person to person.

Nevertheless, “masking” the effects of a mental health condition, like bipolar disorder, through the use of porn is never healthy or productive. Many times, it exacerbates bipolar symptoms – not improve them. But, when people seek help for their bipolar symptoms and porn addictions, they can fully heal from their dual diagnoses.

What Is It Like to Have Both Bipolar Disorder and Porn Addiction?

Listed below is a real-life account of what it is like to live with both bipolar disorder and porn addiction:

Alex

“Porn, to me, is overwhelming and uncontrollable. I am a completely different person during my manic stages. All I care about is what I want. Nothing else matters. All I care about is the thrill of porn.

I am married, but about a year ago, I started watching porn at night before bed. It distracted me from thinking about my conflicting feelings. I was not planning to get “hung up” on porn. But it happened. For me, the online flirting and dirty talk were fun and harmless. At first, I had no idea I was manic. But, over time, feelings of euphoria and energy increased to the point that porn started causing me to do things that were out of character for me.

After a while, I decided to cut porn off. I thought this solved the problem so I went on about my life. I was wrong. The urge to view porn wrapped itself around my brain like a venomous snake. I could not stop thinking about it. And, at one point, the porn urges hurt so bad that I started getting headaches. So, I caved in, powered up my laptop, and clicked on Pornhub. It was the worst decision of my life.

I felt terrible afterward, so I called my psychiatrist and told her what I did. Her solution was to change my antidepressant (Zoloft), so I could “get back on the horse,” so to speak. Since then, I have been fighting the urge to use porn again. When the mania is gone, I hardly even think about porn. But when I start to get manic, it becomes difficult to resist it. This is when I have to remind myself of the consequences of using porn, so I can stay on track and not relapse.

The combination of Zoloft and porn addiction therapy have not only helped me stay away from porn but also helped keep my mania at bay. Thankfully, I have a strong support system consisting of my friends and family, who are there for me whenever I get tempted to start using again. My wife has since forgiven me and we are both working together on creating stronger boundaries to help eliminate my porn addiction triggers.

I am more than happy to share my story. I know that there are thousands of people, who face the same challenge as me, but are too afraid to say anything. I want you to know that if you suffer from bipolar disorder and porn addiction, you are not alone. Get help and stay strong. But, remember that although you are ultimately responsible for your actions, your behavior is a symptom of two conditions – bipolar disorder and porn addiction. This is an explanation – not an excuse. So, do not be ashamed of your actions. Instead, learn and grow from them.

How Are Dual Diagnoses Like Bipolar Disorder and Porn Addiction Normally Treated?

Treating porn addiction and bipolar disorder normally involves addressing both issues at the same time. During dual diagnosis treatment, clinical therapists and porn addiction specialists provide a combination of medications (SSRIs) and behavioral psychotherapies to people suffering from bipolar disorder and porn addiction.

Detoxing typically kicks off the treatment process. But, understand that finding the right dual diagnosis treatment may take time, effort, patience, and persistence. Because both conditions can wreak havoc on your life, treatment is crucial. Thus, treatment should involve medication management, CBT, ACT, and continuity of care to ensure that both conditions are successfully treated – together.

Treatment may also involve mood stabilizers, antipsychotics, and benzodiazepines (also used during the detox process). The goal of the treatment process is to help you achieve mental, emotional, sexual, and physical stability.

After detoxing from porn, you should expect to participate in the following therapies:

• Cognitive-Behavioral Therapy (CBT)
• Individual Counseling
• Group Therapy
• Medication-Assisted Treatment
• Holistic Therapy
• Addiction Counseling
• Trauma Counseling
• Couples, Marriage, and/or Family Counseling

In general, a comprehensive dual diagnosis treatment program can help you sort out your thoughts, feelings, fears, and urges that originally triggered your bipolar symptoms (mania and/or depression). A trained dual diagnosis therapist can also teach you healthy coping skills, so you do not feel compelled to turn to porn to deal with the distress caused by your bipolar disorder symptoms and porn addiction.

In some cases, however, you may need to enter a residential addiction treatment center (porn addiction rehab center) to fully conquer your porn habit and control your bipolar symptoms. Understand that combatting porn addiction and bipolar disorder may be a lifelong commitment. In fact, for most people with a dual diagnosis of porn addiction and bipolar disorder, a combination of intensive treatment, ongoing counseling, and aftercare support is needed to keep your mania and depression in check and remain “porn-free.”

References

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• Aldinger, F., & Schulze, T. G. (2017). Environmental factors, life events, and trauma in the course of bipolar disorder. Psychiatry and Clinical Neurosciences, 71(1), 6–17. Retrieved from https://doi.org/10.1111/pcn.12433
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• National Institutes of Mental Health. (n.d.). Bipolar disorder. Retrieved from https://www.nimh.nih.gov/health/publications/bipolar-disorder
• Kopeykina, I., Kim, H. J., Khatun, T., Boland, J., Haeri, S., Cohen, L. J., & Galynker, I. I. (2016). Hypersexuality and couple relationships in bipolar disorder: A review. Journal of Affective Disorders, 195, 1–14. Retrieved from https://doi.org/10.1016/j.jad.2016.01.035
• Mayo Clinic. (n.d.). Bipolar disorder. Retrieved from https://www.mayoclinic.org/diseases-conditions/bipolar-disorder/symptoms-causes/syc-20355955