"Sex was the biggest high to fuel my mania," Suzy Favor Hamilton tells PEOPLE

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Three-time Olympian Suzy Favor Hamilton is now revealing the story behind the scandal that shocked fans in 2012, when it was discovered that she lived a secret life as a Las Vegas escort.

In her new memoir, Fast Girl, Hamilton, 47, explains how her then-undiagnosed bipolar disorder led her to thrill-seeking behavior, and how the wrong medication exacerbated her illness.

After a stunning disappointment at the 2000 Sydney Games, where she collapsed before reaching the finish line, Hamilton’s depression plummeted to new depths.

“Falling down at the Olympics is where my spiral down started,” she tells PEOPLE. “I felt like such a failure.”

After being prescribed a new antidepressant after the birth of her daughter, she says, “I suddenly had more energy than I could remember having. I wanted to live like I had never lived before.”

For their 20th anniversary in 2011, Hamilton suggested to her husband, Mark, that they have a threesome with an escort to spice up their struggling marriage.

“It was a six-month process from the threesome to becoming an escort,” she says. “Admittedly, it was an extreme step. I presented it to [Mark] as a fantasy. It would be just one or two times with their top clients. It would be very discreet and low-risk. There was no way I was going to get caught. I know it was crazy. He’ll say it was crazy and he shouldn’t have ever even agreed to it. If he had known I was bipolar? Absolutely not.”

Hamilton says once she was diagnosed, she realized her mental illness was a cause of the risky behavior.

“My bipolar was driven toward sex. It could have been driven towards drugs and alcohol, or gambling. I found sex was the biggest high to fuel my mania, which is common with bipolar people,” Hamilton says.

“Sex was the biggest high to fuel my mania,” she says. “I still crave that high. I can’t say I’ll never act out in that way again.”

For more on Suzy Favor Hamilton’s struggle with bipolar disorder, pick up the new issue of PEOPLE, on newsstands Friday.