Think Addiction and Bipolar Disorder aren’t Connected? Think Again.

Quite often when I’m doing interviews, I’m asked about the connection between my bipolar disorder and my alcoholism and pornography addiction. I’ve always felt like there was some link between the two, but I finally did a little research to confirm it. As it turns out, there’s a huge link.

Bipolar disorder, which has made it onto the list of most self-diagnosed conditions (migraines continues to top that chart), actually only occurs in between 1.5 and 2.5 percent of the population according to one 2018 study. Another said that it was 4.4%, so I guess you have to believe the one you want.

I was diagnosed at age 26, although I can recognize episodes of mania and depression going back to my mid-teens, not-so-coincidentally when my addictions first began to surface. Ironically, the average age for onset of bipolar disorder is 25, but I know I had it long before that.

Unfortunately, there is not a lot of research yet on the likelihood of someone with behavioral addictions like sex/porn addiction, gambling addiction or video game addiction also suffering from bipolar disorder, but based on what we know with substance addictions, I think it’s safe to say there’s a link.

To the unaware, bipolar disorder (formerly known as manic depression) is essentially a psychiatric disorder characterized by unstable moods, depression or mixed manic and depressive episodes that are accompanied by drastic changes in sleep patterns and energy levels. Erratic, irrational decision-making can also be a sign of untreated bipolar disorder.

Back when I went untreated, manic was my norm. It was the bouts of depression that indicated to me something was wrong. I’m not going to give my entire history here, but if you’d like to see an article I wrote for my magazine way back in the day where I essentially confessed to the community I had bipolar disorder, click here. It’s a long read, but a good one.

I’m going to try not to turn this into an academic paper, so if you want sources for my statistics, just let me know and I’ll provide them, but I’d rather these be an easier read.

In the US population, roughly 15% of the population are tobacco smokers. Among those with bipolar disorder, anywhere from 60% to 80% either were or are currently tobacco smokers. I was among those in early 20s, but I quit a two-pack-a-week habit in my mid-20s. I took it up again shortly after I was arrested (ironically in rehab) in 2014 and kept it up for about 9 months before quitting again.

In the US, about 1-in-8 people, or 12.5% or the population can be classified as alcoholics. Among those who have bipolar disorder, it’s closer to 42% to 44%, depending on which study you use. I was firmly in this group as well.

As for drugs, someone with bipolar is 14 times more likely to have a substance use disorder than a person without. In fact, over half the people with bipolar disorder (56%) have a history of illegal drug use. One study I saw said that number could be as high as 70%. Although I experimented a little bit, I never embraced illegal drugs the way I did alcohol or pornography.

There is information out there that also links bipolar disorder to populations who report much higher than average anxiety, ADHD and eating disorders.

It’s important to note that it’s just not higher rates of addiction among people with bipolar disorder. You’ll find higher rates of homelessness, violence (both committed by and against), crime and suicide in this population.

There is no known cause for bipolar disorder, addiction, or co-occurrence. It’s just as important to highlight that addiction does not cause bipolar disorder and while the numbers clearly indicate those with bipolar disorder have a much, much higher likelihood of a co-occurring disorder, it is not guaranteed. Researchers believe a combination of factors, such as environment, genetics, biology, etc., are believed to play a role in both bipolar disorder and addiction. Reading between the lines, that seems code for, “We still have no idea.”

When I was at rehab, it felt like two-out-of-three people claimed they had bipolar disorder. I thought they were way overstating it, but as it turns out, maybe those numbers were right on the money.

I hope that the scientists who conduct the kinds of studies and surveys that I referenced above are studying behavioral addictions look to establish a connection between them and bipolar disorder as they’ve done with substance addictions. Anecdotally, based on the sex and porn addicts I’ve known, I think you’ll see very big numbers.

I’m Still Stereotyping Addicts…Are You?

I had a terrific discussion last night with a mental health professional and we talked about the stigmatizing stereotypes around not just pornography addiction, but addiction in general. I recognized that for some addictions, I probably still have a bit of “smartening up” to do.

One of the things I preach whenever I talk to a group or do an interview is that there is no stereotypical porn addict. I was a white-collar, married, father-of-two who was seen as a pillar of the community. Heck, when you think “porn addict,” you probably don’t think of a guy who was awarded the Key to the City. But I know people also don’t think 50-year-old female nurse, or high school art teacher or well-respected dentist, but I met these people and dozens if not hundreds more during my journey.

Do you know who I didn’t meet? The pimply-faced, 19-year-old who is living in mother’s basement who is socially awkward and has never kissed a girl in real life, but I think this is most people’s image of who a porn addict is. I’m sure he’s out there, but I’ve never met him.

We talked about my belief that this kind of stereotyping helped contribute to the opiate/opioid crisis. The drug problem we face today shouldn’t come as a surprise. There are episodes of Dragnet from the late 1970s where they are talking about the dangers of heroin. You can go back to rap music from the late 1980s and early 1990s where they are talking about abusing Vicodin. It’s not like we didn’t see it coming. Opiates/opioids were not invented in 2009, yet it only seems like we’ve cared about it for 10 years or so.

Why? I think it’s because we put such a stigma on drug users in the 1980s through many of the anti-drug campaigns. “Just Say No to Drugs” is a good message, but I think my 8-year-old mind also heard, “…because those who say yes to drugs are dangerous and/or bad people.” I believe as a society, we looked down on drug users as being from the wrong side of the tracks. We may have had a distant cousin or a friend-of-a-friend who had a cocaine issue, never imaging how close to home the opiate/opioid epidemic would eventually hit for most people only a couple decades later.

That same decade, we gave a lot of attention to AIDS. It was really the cause of the 1980s, and I’m not saying that’s a bad thing. Thankfully, a ton of money went into research to create drugs like AZT and societal standards, like how donated blood is handled or needle exchanges for IV drug users, changed. Earlier this month, it was the anniversary of Magic Johnson announcing he was HIV positive. Remember when that happened? Many of you are probably too young because it took place November 1991. Everyone thought he’d be dead in a year because up until that point, people died that quickly. Twenty-eight years later, he’s still here. I bring up AIDS because it shows what we can do as a society when we heap attention, money and research on a problem: We can solve it.

It wasn’t until I went to my first inpatient rehab that I actually met heroin users. I met meth users and pill poppers and people whose alcohol addiction made mine seem like a walk in the park. Essentially, I met people who I would have crossed the street to avoid before I got there.

What I recognized was that these were some of the most real people in the world. They didn’t judge me and they helped create a safe space where I could be myself and share my truth. Unlike the people who I dealt with every day in my professional life, they were open and honest and made me feel OK for being who I really was. Luckily, I adapted quickly and changed my attitude about who drug users really were. I needed to meet these people before I could change my mind.

The same is true about those with eating disorders. At the second rehab I was at there were probably 8 women and 1 man in their eating disorder program. Sex/porn addicts have a lot in common with people who suffer with eating disorders. I’ve only had this proven further to me in the fact that this blog about it is the most read entry in the history of this site.

In getting to know several of these women very well, I can tell you that not all of them were stick thin. I don’t think anything they ever saw on TV or in a fashion magazine led them to become the way they were. Some of them could be quite complimentary toward certain parts of their appearance. Getting to know them one-on-one blew apart 95% of the stereotypes I had about women with eating disorders.

I’ve not met any people who need a 12-step group like Codependents Anonymous, but I don’t have the greatest stereotype of codependent people in my head, nor do I about people who end up with video game addiction or a few other maladies out there. The conversation I had last night made me recognize that I still classify certain people a certain way because I just haven’t had the personal interaction with them, yet I’ve had enough interaction with other kinds of people that I should know better by now.

I’m not going to wait until January 1 to start. My November 22 resolution is to stop stereotyping people who suffer from any addiction or behavioral disorder.

The Piece of Advice that Stopped Me From Relapsing

I’ve mentioned several times that I’ve never relapsed. I’m very proud of that fact, although I think it speaks to my self-centered stubbornness more than anything else. It’s nice that personality trait has finally paid off. I also think my obsessive nature toward statistics constantly reminds me that I’d be into my 50s before I’d have a streak this long again if I relapsed today.

That’s not to say it’s always been easy. There were nights in that first year when I was awake at home after everybody had gone to bed and it wouldn’t have been hard to grab one of the laptops or a tablet and start surfing the Internet. I could have had as many drinks as I wanted, too. The lure toward drinking was always stronger during the day, with porn taking over after dark.

I was given a piece of advice from my favorite counselor at my rehabs (who I’ll tell a longer story about tomorrow, as promised earlier this week) and it was so simple, but it’s been the thing that saved me with drinking quite a few times and porn more than once.

Bob’s advice? Get up and go sit over there.

That’s all. That’s it. Get up and go sit over there.

People will dismiss this as too simple. It’s not.

I never actually tried this until the day I was going to my second rehab in Texas in the late spring of 2015. My wife dropped me off at the airport in Portland, Maine, around 11 in the morning. Portland’s airport isn’t big, but it’s got a couple small restaurants and shops.

As I checked in and found my gate, I found myself facing the Shipyard Brewing Company’s airport brewpub. Here in Maine, Shipyard is probably the most famous craft brewery.

Suddenly, it dawned on me. I had not been in an airport alcohol-free, much less sober, in probably 20 years. I didn’t realize it, but flying was one of my triggers. Apparently the fear of hurtling like a dart into a side of a mountain in a giant tin tube was something I needed relief from.

At this point, I’d been alcohol-free since April 1, 2014, so I was about 14 months sober. It was 14 months more than I’d been since I was 15 or 16 years old, but dammit, I was in an airport and despite my bail conditions forbidding me from drinking, nobody in the airport was about to give me a breathalyzer.

I walked over to the bar, not sure what I was going to do. Aside from the airport thing, I was nervous about heading off to sex/porn rehab and knew the beer could calm my nerves.

As I stood in front of the bar, just far enough back that the bartender wouldn’t ask me what I wanted, I remembered the advice from Bob: Get up and go sit over there.

I had a moment of clarity and realized I needed to get out of there. I walked about five gates down to a newsstand and picked up a Rolling Stone magazine and Gatorade. I headed back to my gate and sat down with the magazine and drink.

About a third of the way into the cover story about Ronda Rousey, I looked up at the brewpub again. Like a siren luring a sailor to his death on the rocks, I thought about a red bull and tequila on the rocks…and how that wouldn’t hurt anybody.

The craving for beer was gone. I wanted my hard liquor. If I went for beer, I’d have two or three. If I went for the hard stuff, I’d only have one. That was better, right? My addict mind was hard at work trying to justify getting a drink.

I put the magazine down and stood up. The only way that I was going to get through this was to listen to Bob’s advice again. I got up and I went to sit over there. In this case, one gate over, so I could still hear the announcements.

Unfortunately, I could still see the brewpub, so I did it again. I got up and I went to sit over there. This time, over there was three gates away, far enough that I couldn’t see the brewpub and in front of a departures board so I could follow what was happening at my gate.

I didn’t drink that day. I didn’t drink any other day. I haven’t had to follow Bob’s advice for several years at this point, but that day it saved me. That was the closest call I ever had to relapsing.

Get up and go sit over there. Do it as many times as you need to until the craving passes. Get up and go sit in your car and let it take you somewhere else. Get up and go sit at the mall and people watch. Get up and go sit on your front steps. Just get up and go sit at a friend or family member’s home.

Just get up and go sit over there.

Hey, Non-Addicts: Want To Better Understand What Addiction and Recovery Feels Like? Try This!

Just about every addict will inevitably be asked what it feels like to be an addict. For the non-addict, understanding the pull of a substance or behavior is mystifying. Further, the idea of stopping something seems easy to them, but in addiction it’s not. Recovery is tough. While I can’t make you feel exactly what it’s like to be addicted to pornography, or what the recovery has been like for me, I think I have a two-day model that can help get some kind of a handle on addiction and recovery for the non-addict.

Day One

You’ll probably want two days off in a row from school or work to run this experiment. Do not let anybody know you are doing this experiment as it could taint the experience.

The first thing that you’re going to do in the morning is to take your cell phone and turn the volume of the ringer and all of your alerts for texting, social media, etc. to the maximum level. Make it loud! Do not look through your phone. Just turn the volume all the way up.

Then, take a Post-It Note and put it on the face of your phone so you can’t see the screen. You could tape a piece of paper to it as well. The point is to not see the screen, but not make it difficult if you decide you want to see it.

Keep your phone next to you all day. Don’t put it in the other room. Don’t put it in a drawer.

Do not use the phone. The phone is the drug or the addictive behavior. You may not call or text or Tweet or Snapchat or whatever. You may not use the phone.

Every call…every chime…every bell…every whistle that comes from someone else; you must ignore them. No excuses. No “good reasons” to interrupt the experiment…NONE!

You may not borrow another person’s phone, nor try to skate your way around the rules. If you feel like you’re bending or going around the rules, you are. Do not participate in any activity that you would normally use your phone for.

That’s it. Sound easy? For some it may be, but I think for the vast majority willing to try it’s going to be much, much harder than you think.

If you use your phone during the day, you fail. You succumbed. Welcome to the world of the addict.

Day Two

Keep your phone in the same state as Day One. The rules to your phone apply exactly the same as they did yesterday.

Today, though, you can figure out a way to do the things you normally do on your phone…you just can’t use your phone.

If you’re going somewhere and don’t know the way, you can’t use Google Maps. You’ll have to use a real map, or get on another computer and print out a map or write down directions.

If you need to talk to somebody on the phone, find a landline. Find somebody else’s cell phone. Go to the gas station and see if they laugh and ask you “What’s a pay phone?” when you ask to use one.

Need to keep up with social media? Facebook started only for desktop computers. Use that, or a tablet. Like to read books on your phone? Pick up a real book. They’re not that heavy. Want your news? Watch TV like we did in the 1990s.

Today’s exercise is about doing everything you would on your phone, just finding out a different way to do it. Were you able to get through today or did you find it too frustrating and resorted to using your phone? That’s tantamount to a relapse.

Results

Day One should be difficult if you’re like most people who don’t realize just how tethered to their cell phone they really are. I think anyone under 30 or 35 will really have some issues as they’ve been raised in a world where the cell phone is almost an extension of the hand.

The reason I say not to tell people you’re embarking on this experiment is because you want completely normal conditions. You need to get the calls, texts, etc., that you’d normally get. After all, the addict lives in the normal, real world. They can’t tell people not to bother them for two days.

I think most will find it easy at first to leave their phone alone, but by that second phone call, or third text, or fifth snapchat chime, it’s going to feel really rough. You’ll wonder if it’s something important, even though you know it’s a 99.9% chance it’s not. You’re going to want to rip that Post-It Note off the phone to see what you’re missing. There’s a whole world living in that phone that you can’t touch.

That’s the feeling for the addict. There’s a whole world in our addiction that we feel like we have to get our hands on. For those of you who cave and look at your phone, which I think will be most, that relief you feel when you finally give in is the relief the addict feels when they give in to their addiction. You know it’s wrong, you know you lost the battle of wills, and sure there is some guilt and shame, but you just feel so much better.

Day Two is about developing the tools and problem-solving skills to still live your life as richly as possible, but without your cell phone. This is what the addict has to learn to do in recovery. We have to develop a set of tools and skills to cope with the real world without the crutch of our addiction. Some of us use to quell anxiety and stress. Some use to forget trauma. Some just want to escape everything. Now, we have to figure out how to get relief and live life on life’s terms in the real world without our addictive behavior.

Every time you pick up your phone on Day One, you’re active in your addiction. Every time you pick up your phone instead of figuring out another way to do things in Day Two, you’re relapsing.

If anybody reading this is bold enough to try this experiment, I’d love to hear about your results and find out if you better understand what addiction is all about come the morning of Day Three.

Of All The People In The World To Teach Me A Valuable Recovery Lesson…

I think there are many components to successful addiction recovery, and that’s why so many people fail. One that many people gloss over, despite the fact it’s preached in 12-step groups, is being available and of service to others. I believe both the kindness of fellow addicts, coupled with my efforts to educate about porn addiction have helped me immensely.

Addicts are selfish. We lie and we take, take, take. To become a selfless person who gives is a massive paradigm shift. This is one of the reasons I tell people that inpatient rehab is important and valuable. While it does keep you away from your drug or bad behavior, it also creates an environment where inner change can happen, and be practiced before returning to the real world.

Early in my recovery, shortly after I returned to freelance journalism, I had an encounter with a recovering alcoholic and drug addict that really stuck with me.

I wrote an article for a recovery website about the history of substance abuse in professional wrestling, tracing the arc of the hard-partying, painkiller-abusing 1970s and ’80s to the radically different modern day with frequent drug testing and much cleaner lifestyles.

One of the reasons I love being a writer is because it allows me access to people I otherwise would never get to talk with, and this was one such time. As a kid, I loved wrestling, but I wasn’t into the guys like Hulk Hogan or Randy Savage who yelled into the microphone. I preferred guys who could talk great smack without raising their voices like Rowdy Roddy Piper, Nick Bockwinkel and especially Jake “The Snake” Roberts.

Roberts has been a poster boy for recovery in wrestling. Among the hardest partiers, it’s amazing he’s still alive. Having essentially spent all of his money on drugs, he was living in squalor in Georgia until seven or eight years ago when fellow wrestler “Diamond” Dallas Page rescued him and put him on a lifestyle regimen that changed things. This journey can be traced in the film “The Resurrection of Jake The Snake” which is a fantastic documentary.

Roberts seemed like a perfect interview subject and while it took a little bit of effort, I was able to connect with him. I admitted to being a huge fan as a kid, as I always do when I interview anybody I admire. It just seems phony for me to pretend I didn’t know his vast body of work.

We talked his recovery for about 20 minutes, and I mentioned that I was very new to recovery. At the time, I was only about three months out of my first rehab and it would be another six before I went to the sex/porn rehab in Texas. I was just really focusing on alcohol at the time.

“You’re taking notes so you got yourself a pen and paper there, right?” he asked.

“Yeah,” I said.

“Write down this number,” he told me, giving me a telephone number with a Georgia area code. “That’s my personal cell number. If you ever find yourself struggling. If you’re at the grocery store and you think you’re going to buy beer or if you’re at a bar and you’re having a bad day. Whenever you need to, just call me and we’ll work through it. I don’t care if it’s the middle of the night.”

“Wow,” I said. “That’s a really nice thing to do. Thank you.”

“We gotta stick together if we’re gonna beat this disease,” he said.

A few minutes later, we said our goodbyes.

I never called him. The few times I felt skittish, I was able to get through the moment on my own. Despite still feeling the occasional craving to this day, I’ve never come what I’d say is close to relapsing.

In truth, I would have felt incredibly weird calling him. I know a former wrestler means nothing to 99% of the population, but he had a big impact on me as a kid. His character was the loner who did what he needed to do to survive to the next day. And as it turned out, the real guy was a lot like me, too. Calling on him to help would have been like a football fan calling Joe Montana or a basketball fan calling Michael Jordan. How do you seek help from people you’ve put on pedestals for decades?

Roberts’ kindness and reaching out really touched me. It sticks with me to this day. Somebody who I view as a superstar, but knew the same challenges of recovery as I did, wanted me to know he was there for me if I stumbled. The “bad guy” who once threw a snake at Andre the Giant wanted to help me if I needed it.

Thankfully, I didn’t need the help, but he did teach me a valuable lesson that day.