THE LOOSE GIRL, MENTAL ILLNESS, AND RISKY BEHAVIORS
Seventeen-year-old Gigi has slept with twenty-two boys. She knows her number because she keeps a careful log of every one, noting what they looked like, what she found most attractive about them, and how they dumped her. Many, she said, just never contacted her again. All times, she was drunk. She hated how she felt each time, but she kept going back for more. Then she would lie in bed, numb, unable to move herself for hours. She also cut herself, which she believed helped with the numbness. Some days she didn’t leave her apartment and just moved between the bed, where she lay staring at the ceiling, and the bathroom, where she used a razor to cut.
She had a boyfriend once. It was a yearlong relationship that ended badly. The first four months or so were OK, but soon after, things started going sour. They had fights that always ended with her screaming for him to stay. A few times she held his legs, like a child might. She threw things at him sometimes, once narrowly missing his head with a television remote. When he left for good, she tried to kill herself by taking a handful of Advil PM pills, but she called her friend soon after, terrified she might really die. Her friend took her to the hospital, where they pumped her stomach. That was when a social worker came to see her; soon after she was diagnosed as having borderline personality disorder.
One might say that Gigi is a loose girl. She was promiscuous and always felt terrible afterward. She used boys to fill her emptiness. Gigi is indeed a loose girl for these reasons. But her case is more complicated than that. She has a personality disorder, which means that she needs to work on much more than her behavior around guys and sex to feel better about herself. Indeed, personality disorders are notoriously difficult to treat because they are defined by enduring and persistent abnormal behaviors and thoughts. People with personality-disorder diagnoses often deal with the conditions for life.
Janet was diagnosed with bipolar disorder as an adult, which is a mood disorder, considered more treatable than personality disorders. But when Janet was a teen, few people had even heard of such a thing. She was a heavy drinker and pot smoker from a young age. She knows now that those things were a way to self-medicate, to stop the fast-moving, obsessive thoughts that plagued her day and night. She had a lot of sex, too, usually with strangers, and she berated herself for it later. Sex drive can increase a great deal while manic. The problem comes later, when the person—usually a female—realizes she wants more than just sex in her life. Because men are trained to think of women who are easy to sleep with as not relationship material, the sexual behavior rarely turns into more than a night or two.
Add this rejection to the shame people often feel after manic episodes. For women, promiscuity connected to mental disorders is particularly hard. The shame that comes with having a mental health disorder in the first place multiplies the shame that many girls feel about having and wanting sex, and the ways in which they get punished for it through rejection or derogatory labels (“slut” and “whore,” for instance). This sort of shame is pretty prolific, of course, when it comes to young women and promiscuous behavior. A culture that finds sexual behavior among young women unconscionable will only further punish girls who have sex because of an unresolved pain.
Gigi’s and Janet’s loose-girl behavior does not stand on its own; for them both, it’s affected by all of the issues that arise from having a personality disorder and a mood disorder. For most loose girls, it’s the same: their promiscuity does not exist in a vacuum. Promiscuity is commonly associated with almost every disorder you can imagine—bulimia, attention-deficit/hyperactivity disorder, conduct disorder, borderline personality disorder, and bipolar disorder, to name just a few. Promiscuity in teenagers is also typically associated with adolescent depression. Sexually active girls are more than three times more likely to be depressed than girls who are not sexually active. They are also three times more likely to commit suicide.{75}
Behaviors can compound these conditions. In middle adolescence, we see the highest levels of coexisting behaviors with promiscuity, such as substance use, alcohol use, and arrests.{76} We know, too, that those adolescents engaged in more promiscuity also tend toward more risky sexual behaviors, such as not using condoms.{77} Likewise, with other types of risky behavior, we are likely to find negative behaviors around sex.
Teens fourteen and older are twice as likely to have sex under the influence of alcohol or drugs. Older teens who drink alcohol are seven times more likely to have sexual intercourse and are twice as likely to have four or more partners. Drug-using older teens are five times as likely to have sex and three times as likely to have four or more partners.{78} A Washington University School of Medicine study found that alcohol dependence and conduct disorder contribute to having a higher number of sex partners among older teens.{79} And a relatively notorious study that came out of a U.K. university noted that women who drank were 40 percent likelier to have abortions—notorious because pro-choice parties were dismayed by the researchers’ choice to point to abortions rather than something less politically charged, such as sexual activity.{80} The other criticism leveled at this and the previous study was the lack of attention to the stigmas applied to drunkenness among women and how that relates to abortions or sexual intercourse. There is a long history of the alcoholic woman as an acceptable target of sexual aggression, with more than one court proceeding leading to the “blame the victim” status given to women who drink and then become victims of rape.{81}
Eighteen-year-old Niesha told me she only has sex when she’s drunk or high. For her, all the activities together are what she’s after. She likes the whole experience, the sense that she can get pulled out of her life, which currently has very little direction. Her parents made her move out the day she turned eighteen, and so she lives with a couple of friends in a tiny apartment. They all work in chain restaurants during the day, and at night they party. They invite some of the guys they work with, who bring fifths of liquor, cocaine, and pharmaceuticals, and they party until four or five in the morning. Invariably, one of the guys winds up in Niesha’s bed. It’s been a rotating cycle; she sleeps with whichever one gets there first. The next day she is always late for work, with a pit in her stomach about what happened the night before.
When I talked to her, she asked me whether I thought she had a drug and alcohol problem. I told her it sounded as though she were using a number of substances and situations to try to soothe something inside.
Of course, adolescence is a time of risk taking. Most adolescents use these years to experiment with their own boundaries, with what they can handle, and with identity. Promiscuity is, in many ways, a perfectly normal part of that experimentation. But as with substance use, because sexual behavior is stigmatized, many teens turn it into self-destructive behavior. When we see other types of self-harming behaviors in teenagers, we tend to also see sex used in negative ways. This is important, because it describes the difference between normative sex—normal sexual exploration—and sex used to harm oneself.{82}