Hello everyone. Right now I'm kind of freaking out because I think I caught an STD. But first let me tell you about some problems I've been facing in the past few months. I've been diagnosed with bipolar disorder for 10 years and have been on medications since. My mood has been pretty stable and productive for many years to the point where I believed I DIDN'T actually have bipolar disorder and felt I wanted to be taken off meds. During these years, I WAS NOT sexually active, sex hardly crossed my mind and I was so preoccupied with my personal endeavors. Last year I told my doctor to try taking me off meds, and she cautiously started lowering all my meds to the minimum dose. I also switched some meds. Afterwards, I ended up spiraling into a MAJOR depression ever since and have become EXTREMELY sexually active and engage in risky behaviors. This may seem strange because normally increased sexual libido is characteristic of manic episodes, however I become sexually active when I am depressed. I suppose it's because I think about myself not being in a relationship with someone. I experienced the same pattern when I was first diagnosed with bipolar disorder back in college. Anyway, last October I discovered two adult bookstores/sex shops that I live very close to that are frequented by all types of people looking for sex on the spot. As you might expect it's mostly men seeking sex with other men and the place is busy from morning til night. The shop owners are extremely liberal and don't care what goes on in the backrooms or how long you stay. I've been frequenting this place very often now and my behavior is becoming increasingly risky. I performed oral sex on many men and I always used a condom. But then I stopped using condoms and after one particular experience I had a mild sore throat develop that only lasted two days. I went to see a new doctor for the first time who I ended up not liking...she wasn't friendly and she quickly jumped to conclusions that it was caused by "allergies" after I hardly described my symptoms. I was to nervous to tell her about my sexual activities. However, about a week ago I gave a blowjob to a Marine in uniform and some other guy who told me he was "straight". I didn't use a condom and the former ejaculated in my mouth. Two days later I developed a sore throat and now I have a pain in my throat when I swallow. I read these are symptoms of oral gonorrhea and chlamydia. I've scheduled a doctors appointment next week with a different doctor, but I'm really nervous about admitting what I did. Another worry I have is that I live with my mother who is a nurse and she always interrogates my health status after I visit the doctor. I'm really scared I'm developing a sexual addiction. What's worse is that each sexual encounter gives me temporary pleasure followed by more depression. Even when I go to the adult bookstore I go feeling depressed and am disgusted. I really want things to go back to the way they were and I'm trying to eliminate sexual urges from my system.
Hi, and welcome. First, it's more likely than not that what you have is a garden variety sore throat rather than gonorrhea or another STI. What you're describing is a pretty common after oral sex, and if you search the archives here, our former medical advisor, KaraBulut, wrote about very similar circumstances a number of times and if I'm remembering correctly, he indicated that in most cases this isn't a big cause for concern. Of course, it's always wise to get checked. The bigger issue -- how to address what's going on for you -- is more complicated. It seems likely that your bipolar disorder and/or the aftereffect of lowering the medications may be contributing to this, but I'd also be willing to wager that there's a psychological/emotional piece in addition to whatever is going on with the bipolar dx and the meds for it. For many people suffering with depression, low self esteem and the shame that goes with it are major factors. Add to that the fact that there's a major dopamine "hit" (not unlike a momentary drug high) that comes from sexual activity and arousal, and you can see that sexual acting out, depression and low self-esteem are a potent combination. The first thing I'd say is... don't judge or condemn yourself for what you're doing. My guess is there's probably a bunch of shame associated with the behavior, otherwise you probably wouldn't be coming on here and talking about it. So the thing to recognize is, whatever is motivating the behavior, it doesn't make you a bad person, or a slut, or anything else... it is, essentially, a coping strategy, a means of self-medication. So one thought I have is to explore what goes on when you feel the urge to go to the adult store. Does it happen when you're particularly depressed? lonely? angry/upset/anxious? Identifying the feelings/behaviors that happen prior to the acts will help you understand yourself and take steps to change the behavior. There's nothing inherently wrong with participating in casual sexual acts, but the ones you are participating in are high risk, because the people you're engaging with are likely people who do this all the time, and are therefore at higher risk... and that isn't the best idea for your own health and safety. Additionally, if the underlying reason has to do with feeling lonely, the act of engaging in these sorts of behaviors is likely, in the long term, to actually increase shame and loneliness because while you're seeking connection, love and belonging with doing what you're doing... as soon as the other person orgasms, he's done and the "connection" disappears. So another approach might be to think about what's going on behind the desire for the hookups, and work on finding a healthier and more long-term fulfilling way of meeting those desires. Finally, it would be a good idea to speak with your prescribing doctor in detail about what's going on. Are you seeing a psychiatrist or a general practitioner? You really should be seeing a good psychiatrist who will take the time to listen, talk about the possible side effects of the medications, and explore how much of what's going on is a byproduct of the meds and how much of it is driven by self-esteem and a desire for connection. (Physicians, by the way, whether psychiatrists or general practitioners, are not very good therapists and have limited knowledge of the psychology behind sexual behaviors. You'd probably have better success working with a good psychologist to explore this, in combination with whomever is prescribing your meds.) If what I've said above connects with you, and you can expand some on what's driving the behaviors, we may be able to offer you some clearer advice. If the above resonates with you
I would echo what Chip has said. I have been in pretty much the same place that you're in right now. I do identify as a sex addict, and the sexual acting out certainly is a 'coping mechanism' that is becoming itself a problem. And with no other coping mechanisms to turn to, when we feel bad about the sexual experience we've just had, we look for another sexual experience to mask that pain and sadness. It can become a terrible cycle. As hard as it seems like it will be, it really is a good idea to tell your doctor what you're doing. They will then be able to request to right tests to ensure that you're OK. They might also have thoughts on your medication as well as suggestions for counselling. I would agree that talking about what is going on with a professional of some kind is the best thing you could do right now. Don't beat yourself up over all this. But don't keep doing it either. It will not make you feel better - only worse. Write back here in this thread or you can write to either Chip or I directly if you want to talk one on one. I can totally understand where you're coming from and would be happy to help.
