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Dr. D. Love
Dr. D. Love, Doctor
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Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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I desperately need some advice as I am going through a very

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Hi, I desperately need some advice as I am going through a very difficult and shameful time in my life.
A few years ago I was diagnosed with cyclothymia (mild bipolar), anxiety and low self esteem. I tend to cope with my problems by self medicating using cocaine which makes me feel more confident at the time but unfortunately suicidal afterwards. I've also noticed that my sexual arousal is intensified and I do things that I would never ever consider when sober. I've started talking to strangers on sex chat sites and sending videos etc of myself but the conversations are getting worse. There has been conversations about young people in a way that makes me feel sick and disgusted when sober especially as I hate this type of thing. Truth is, as horrible as it sounds I pretty much can't stand the sight of children in fact when my nieces and nephews come around I'm heading straight out the door and I certainly don't look at them in an attractive way. I often wonder though if these feelings when high are caused from problems I encountered as a child. When I was younger I found that I became too interested in sex at a very early age, I was exposed to pornographic material as my parents owned a newsagents so I used to read the magazines. I found that I was trying to imitate the poses etc. When I was 9 and my cousins came around our house (one older and one younger) I would always try and engage them into some sort of sexual activity, nothing ever happened though, the worst that happened was I took my younger cousin to the toilet when he needed to go because I wanted to see what a penis felt like (I was 9) but never has anything happened since and certainly not as an adult, it seemed to be a passing phase. I feel disgusted with myself and often wish I was dead, what would be the best thing to do? Is there something really wrong with me?

Hello from JustAnswer.

Sexual promiscuity, including high-risk sexual activity, is a common feature of bipolar disease, and to a lesser extent of cyclothymia. This is actually one of the criteria for making the diagnosis, although it is usually worded differently, such as engaging in risky behavior or excessive pleasurable activities that have significant risk for adverse consequences.

If recreational drugs are also used, that can exacerbate the engaging in sexual activities.

As for whether there is something really wrong with you, there is no reason to think that there is anything wrong with you beyond what is already known - the cyclothymia and recreational drug use.

As for what to do, there are a couple of options. You certainly can consider the use of medicines that may be able to get better control of your symptoms than the recreational use of cocaine. There are a number of mood stabilizers that can help with cyclothymia and bipolar disease. Some of these medicines were first marketed for seizures and later also found to help as mood stabilizers, such as valproic acid, carbamazepine, or lamotrigine. Other medicines are primarily used for mental health conditions, such as lithium, aripiprazole, or rsperidone. It also may be very helpful to consider counseling. Counseling can help you to learn techniques to control intrusive thoughts, behavioral management strategies to reduce risky behaviors, and method for stress reduction that can ease prevent relapsing symptoms.

If I can provide any additional information, please let me know.

Customer: replied 1 year ago.

So that fact that I have unusual conversations under the influence of cocaine is purely down to being cyclothymic and high, I just hate myself for saying such awful things when I know I wouldn't possibly dream of it in real life.

Yes, it would be due to the cyclothymia and being high. Obviously, there would be a different discussion if this were happening without the cyclothymia or drug use, but if the only time that you have these conversations is during the episodes of symptoms from the cyclothymia that you are then self-treating with the cocaine, then that would indicate that it is related to these issues.

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