Demystifying Bipolar Disorder’s Effect on Sex

Understanding the relationship between your mental health and sex is extremely important–it can help alleviate unnecessary pressures and questions you may be having about your body. Bipolar disorder is a complex mental health condition that is highly misunderstood and stigmatized in media and society. Respark offers a positive perspective on mental health disorders and helps demystify the relationship between bipolar disorder and sex. 

What Is Bipolar Disorder?

According to the Mayo Clinic, bipolar disorder is a mental health disorder that causes “extreme mood swings that include emotional highs (mania) and emotional lows (depression).” These mood swings can affect people’s day-to-day activities like sleep, energy, and general behavior. 1 in 40 American adults is diagnosed with bipolar disorder, making it the sixth most common disability in the world.

Depressive Episodes and Sex:

Depressive episodes begin with a significant energy drop, causing anxiety and hopelessness. Understandably so, when in these episodes, it is hard to find anything pleasurable so these episodes certainly impact people’s relationships with sex. One such way is by causing hyposexuality. Homosexuality is a dramatic decrease in a person’s sex drive, which is most prevalent in depressive episodes. Medical News Today lists these as the main symptoms of hyposexuality in people with bipolar disorder: 

• Feeling undesirable 
• A disinterest in hygiene and grooming
• Physical exhaustion, making sex and intimacy difficult  
• Absolute no interest in sex 

Hyposexuality can be difficult for individuals with bipolar disorder, especially if they have a partner or partner(s) who rarely or never experience disinterest in sex. Feeling undesirable can also perpetuate a sense of guilt, making it difficult and frustrating for people with bipolar disorder to communicate their feelings and needs. 

Manic Episodes and Sex:

Opposite the depressive episodes one with bipolar disorder may experience are the manic episodes. Manic episodes cause intense hyperactivity; for example, they can give a person an inflated sense of confidence resulting in poor and dangerous decision-making. Those experiencing manic episodes will also be unusually upbeat, unusually talkative, and overall “wired.”

Similar to depressive episodes, this manic state can affect one’s sex life. One such way is the opposite of hyposexuality, which is hypersexuality Hypersexuality is a dramatic increase in a person’s sex drive, driven by manic episodes. Hypersexuality makes it difficult for people to control their sexual urges and desires, ultimately increasing sexual activity. Hypersexuality can also result in a lack of satisfaction, meaning people will masturbate or have sex for an extended time without feeling gratification or fulfillment. Medical News Today lists these as the main symptoms of hypersexuality in people with bipolar disorder: 

• Increased sexual confidence 
• Risky sexual activity, having unprotected sex with multiple partners 
• Frequent masturbation that disturbs everyday activities 
• Sexual affairs 

How medication can impact people with bipolar disorder’s relationship with sex: 

Medication is valuable and effective when treating bipolar disorder. Still, it is essential to note that most drugs can alter a person’s desire to have sex and overall sexual performance. Lithium, which helps decrease the frequency of manic episodes, is the most commonly prescribed medication for those with bipolar disorder. However, this drug can have side effects that impact individuals’ sex drive. A medical study indicates that 14% of participants experienced a decreased sex drive and had difficulty orgasming. Some patients may also take lithium with benzodiazepine, a depressant that relieves anxiety. When participants took lithium and benzodiazepines together, 49% experienced sexual difficulties. 

How to navigate a sexual and romantic relationship when an individual you or your partner(s) have bipolar disorder: 

In an article by Vice, a couple, Cassie and Cameron, opened up about their experience with bipolar disorder and how it affects their relationship. Cassie shares how her past partners used her bipolar diagnosis to take advantage of her sexually: “When I was hypomanic, he knew I was willing to do things and take risks I otherwise wouldn’t,” said Cassie, “so he got me to have a lot of sex with him that I wouldn’t have consented to.” 

Consent is critical, especially when a partner has bipolar disorder. Like Cassie’s past boyfriend, partners can take advantage of their partner’s hypersexuality, knowing they aren’t in a safe, sound mind. To prevent muddying the waters of consent, partners with bipolar disorder must set clear signs of communication.  

Cassie and Cameron have established that when Cassie is showing signs of hyperactivity that sexual behavior is off the table. This boundary sets clear expectations for when sex is and isn’t appropriate. If Cameron is unsure whether sex may be an option, he calls Cassie’s friends for advice. 

“[Cameron] knows that if he’s ever in doubt about anything, he can call my close friends and tell them, ‘Hey, Cassie’s been really energetic and jumping all over me,” shared Cassie, “I don’t know if it’s appropriate to be sexual with her right now,’ And they’ll have an honest and informed conversation with him.” 

Cassie shared that this relationship helped her gain the courage to recognize that consent is ever-changing and never permanent. You can always stop. “If I realize that I’m not feeling it during sex, I used to push through,” said Cassie, “But now I know I can say, ‘We need to wrap this up,’ and we will. That’s really helpful when I’m depressed, and I may still want to have sex, but I can’t do it for a long time.” 

Cassie and Cameron’s relationship is an excellent example of how people with bipolar disorder can develop a healthy relationship with sex. Partners of those with bipolar disorder must learn the signs of hypersexuality and hyposexuality to avoid pressuring or taking advantage of their partner’s sex drive and develop a habit of transparent communication about whether sex is willing or unwilling. Consistent check in’s for how a partner feels is necessary when in a romantic or sexual relationship. 

Understanding your sex drive and desires can be complex and is constantly changing, especially when handling any mental health disorder. Bipolar disorder can be challenging to navigate, especially in a romantic or sexual relationship. Relationships can thrive and overcome mental health challenges through consistent communication and set boundaries.

Working with a therapist through Respark can help illuminate any roadblocks in your communication and provide realistic goals for growth. Therapists can help support you in your journey of becoming more confident in your sex life, relationships, and body. To connect or learn more about our therapy services check out our page here. 

By Abby Stuckrath