Just to clarify for myself. I always confess to the bishop and I don't lie to get a recommend. My comments were addressed towards how 1 Bishop does almost nothing about it, and another takes your recommend away for 6 months to a year. I'm not saying one is right or wrong, but it makes it hard to date when 1 slip up during the year means you won't have a temple recommend for 6 months to a year.
I also agree with Ryanh about the mental state change. I admit I'm weak and can't resist. I try as hard as I can, but as the pressure builds I eventually have stretches where I go 5-6 straight days with 0-3 hours of sleep I'm exhausted, can't think straight, my mood is terrible, and that is usually when I break. I can't count the number of nights I have stayed up all night reading scriptures or out doing exercise of one type or another just to keep my mind occupied. I have the hardest time at night when trying to go to bed or waking up in the middle of the night. I am a very light sleeper and it doesn't take much to keep me from falling asleep. I'm not trying to make an excuse or rationalize what I do. I know it's wrong and I admit I'm weak. The only thing I can do is pick myself up and try again.