The Bible addresses a sorrow that leads to repentance and states that such sorrow is the will of God (2 Corinthians 7:9-10). The same scripture tells us that the sorrow of the world leads to death. We are also warned that one may become lost (devoured, swallowed up) through the experience of excessive sorrow and as Christians we have specific responsibilities to ensure that such excessive sorrow is not a result of our own excess/lack of compassion (2 Corinthians 2:7).
The following graph depicts the generalized relationship between the pleasure derived from some sinful activity (fornication, drunkenness, gossip, etc.) and any associated/resultant pain [physical or mental (guilt, depression, shame, anxiety, etc.)]. When there is little pain associated with a sinful activity there is little motivation for change (repentance). As long as the pleasure continues to exceed the pain there probably will be little motivation for repentance and any change can often be attributed to other factors (boredom, new activities, lack of physical ability, "doctor's orders," lack of opportunity, etc.). As the consequences of sin (pain) are experienced to a greater degree the likelihood of or opportunity for repentance increases with the receptivity of God's message maximizing in the area "where the curves cross." At that point the sinful activity begins to generate a negative return on investment so to speak and an individual will usually either recognize a need for or develop a desire to change. The point at which one is "pierced to the heart" (Acts 2:37) can be some distance from an actual "bottom."
Failure to repent and continuation of the sinful activity in this model will eventually lead to overwhelming despair and physical death, either at one's own hand or from consequences of the activity itself (liver or heart disease, AIDS, etc.). It should be understood that there is also spiritual death for the unrepentant (1 Corinthians 6:9-10, Galatians 5:19-21, Revelation 21:8, etc.). For some with hardened hearts and seared consciences the mental/spiritual pain and subsequent motivation for repentance never approaches, much less exceeds, the pleasure derived from the activity and, consequently, repentance is unlikely without some fundamental and profound change in their heart. This model differs from the 12 step concept of "hitting bottom" in that the true "bottom" is overwhelming despair and death, both spiritual and physical.