Bipolar Disorder and Sexuality

Bipolar disorder is a mood disorder characterized by intense highs and lows, often referred to as manic and depressive episodes. In a manic episode, an individual may experience intense euphoria, a persistent irritable mood, or an unusually energetic mood. In a depressive bipolar episode, individuals may experience feelings of “sadness, loss, or anger that interfere” (healthline) with their daily activities. Moreover, “Life events, medication, and drug misuse can trigger mania and depression. Both moods can last from a few days to a few months.” (healthline) Most often bipolar episodes are treated with a combination of medications and psychotherapy. Sex therapy may have the ability to help bipolar individuals, as manic and depressive episodes in Bipolar are also linked to sexual health. An individual in a manic episode may “experience hypersexuality or an increase in sexual activity. It may place you at an increased risk for actions that may have negative effects, such as contracting a sexually transmitted infection (STI).” (healthline)  An individual in a depressive episode “ may lose interest in sex. These sexual issues can create problems in relationships and may lower your self-esteem.” (healthline) The reason why sex therapy may be able to help those who experience hypersexuality in bipolar disorder is that “maintaining a healthy sexual relationship when bipolar can be as complex as the disease itself.” (verywellmind) 

Bipolar Mania and Sex

During a manic episode, a bipolar individual will exhibit behavior that is atypical from their day-to-day lives. When it comes to the expression of their sexuality this can look like a sudden increase in sex drive and sexual impulses along with risker actions during sex. Hypersexuality in bipolar disorder is defined as “ the increased need for sexual gratification, characterized by lowered inhibitions and/or the desire for forbidden sex.” (verywellmind) 

 

Examples of hypersexuality during a manic episode can include:

• greatly increased sexual activity without a feeling of sexual satisfaction
• sex with multiple partners, including strangers
• excessive masturbation
• continuous sexual affairs, despite the potential risk to relationships
• sexual behavior that increases the likelihood of actions that can result in negative effects, such as contracting an STI
• preoccupation with sexual thoughts
• increased use of pornography  (healthline)

The link between bipolar mania and hypersexuality has been researched and it was found that anywhere from “ 25 to 80 percent of people with episodes of mania also experience bipolar hypersexuality”,  (healthline) with the condition appearing more often in biological women than men. It’s important to note that the heightened sex drive that comes along with bipolar mania is not a problem but rather other symptoms of mania such as impulsivity, risk-taking, poor judgment, and expansiveness, can cause hypersexuality to be destructive. Sex therapy may be able to help an individual work through the strain that bipolar hypersexuality puts on intimate relationships, both with oneself and with a partner. Moreover, sex therapy can provide essential sex education for protection against sexually transmitted infections and the dangers of unprotected sex with multiple partners. 

Bipolar Depression and Sex

During a depressive episode, a bipolar individual may experience hyposexuality, the opposite of hypersexuality. Depression has the ability to completely stifle one’s desire for sex leading to a non-existent sex drive. This can be very difficult for individuals who regularly enjoy sex or who are in relationships. Moreover, drugs used to treat depression can sometimes worsen bipolar hyposexuality as they can “ stifle libido and a person’s ability to sexually function.” (verywellmind)  It’s known that “people with bipolar disorder will sometimes go for months or even years with little to no interest in sex.” (verywellmind) This can cause relationship strain because your partner(s) may have trouble dealing with a sudden lack of interest in sex. Due to the ups and downs of bipolar disorder, your partner(s) may feel confused, frustrated, or rejected if “you have extreme mania with hypersexual behavior and then suddenly experience depression and lose interest in sex.” (healthline) Sex therapy can help deal with these emotions and provide a safe space for you to discuss any issues that bipolar hyposexuality and hypersexuality may be causing in your relationship. Bipolar disorder can challenge relationships in a number of specific ways:

• “Lack of sleep: Exhaustion can make even the pursuit of sex emotionally and physically draining.
• Medications: Certain medications used to treat bipolar disorder (particularly selective serotonin reuptake inhibitors, or SSRIs) can decrease a person’s sexual desire and/or ability to achieve an orgasm or erection.
• Negative cycle: The less sex a person has, the more he or she may feel guilt and self-doubt.
• Self-care: Lack of hygiene and grooming will often accompany these feelings.
• Self-esteem: The bipolar person will often feel physically unattractive and undesirable. Feelings of inadequacy, vulnerability, and worthlessness can also interfere with intimacy.” (verywellmind)

For people with bipolar disorder, our number one priority is treating the disorder. However, our treatment does not have to be the detriment of our libido. We can have normal, healthy sex lives with the help of therapy and personal introspection. Sex therapy can be a great help for bipolar individuals who experience hyposexuality or hypersexuality because it provides a safe space for us to explore triggers of mania and depression that relate to our sexuality. Moreover, sex therapy would allow for proper sex education surrounding healthy sex and relationships. 

 

By: Alyssa Morterud