The Impact of Bipolar Disorder on Sex

The Impact of Bipolar Disorder on Sex Bipolar Disorder Symptoms Mania and Hypomania Print The Impact of Bipolar Disorder on Sex By Marcia Purse Marcia Purse is a mental health writer and bipolar disorder advocate who brings strong research skills and personal experiences to her writing. Learn about our editorial policy Marcia Purse Medically reviewed by Medically reviewed by Steven Gans, MD on January 01, 2015 Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital. Learn about our Medical Review Board Steven Gans, MD Updated on January 03, 2020 Bipolar Disorder Overview Symptoms & Diagnosis Causes Treatment Living With In Children Your Rights Deux / Stone / Getty Images Sex is an important part of most of our lives and no less so for people living with bipolar disorder. But maintaining a healthy sexual relationship when bipolar can be as complex as the disease itself. Depending on the individual, behaviors can swing from periods of excessive sexuality to ones where sexual libido and function are seriously diminished. This high level of variability can impact a persons ability to date or maintain a long-term relationship. On the one hand, the impulsivity associated with bipolar mania can fuel unhealthy and even hurtful behaviors, while the rigors of depression can strain even the most committed relationships. Mania and Hypersexuality Hypersexuality is one of the behaviors that may manifest as a symptom of mania.?? It is defined as the increased need for sexual gratification, characterized by lowered inhibitions and/or the desire for forbidden sex. It is not unusual for people to experience a heightened sense of sexuality during a manic episode. In and of itself, this is not a problem. It is when it is paired with impulsivity, risk-taking, poor judgment, and expansivenessâ€"all features of bipolar maniaâ€"that hypersexuality can be destructive. When the pursuit of sex becomes compulsive, it may even be classified as a sex addiction.?? While the classification is still considered controversial, a person is said to have an addiction when he or she spends inordinate amounts of time in sexual-related activity to the point where important social, occupational, or recreational activities are neglected. Characteristics of sex addiction may include:Compulsive masturbationCompulsive sex with sex workersAnonymous sex with multiple partnersMultiple affairs outside a committed relationshipFrequent patronizing of sexually-oriented establishmentsHabitual exhibitionismHabitual voyeurismInappropriate sexual touching While hypersexuality and sex addiction are not inherent facets of bipolar mania, it is important to recognize the signs. Not only might like these behaviors hurt otherwise stable relationships, but they can also place the individual at increased risk of sexually transmitted infections and other harms. As such, finding the right combination of medications to control mania is considered essential to keeping hypersexuality from becoming destructive. Depression and Loss of Sexual Function Depression can kill the sex drive. And its not just the mood disorder itself that contributes to this; the very drugs used to treat depression can stifle libido and a persons ability to sexually function.?? People with bipolar disorder will sometimes go for months or even years with little to no interest in sex. This makes either pursuing or sustaining a relationship all the more difficult. Depression, by its very nature, fuels feelings of inadequacy and self-blame that translates to how one feels about sex in general. Bipolar disorder can challenge sexual relationships in a number of distinct ways: The bipolar person will often feel physically unattractive and undesirable.Lack of hygiene and grooming will often accompany these feelings.Feelings of inadequacy, vulnerability, and worthlessness interfere with intimacy.Exhaustion can make even the pursuit of sex emotionally and physically draining.The less sex a person has, the more he or she may feel guilt and self-doubt.Certain medications used to treat bipolar disorder (particularly selective serotonin reuptake inhibitors, or SSRIs) can decrease a persons sexual desire and/or ability to achieve an orgasm or erection. A lack of sexual interest is only one of the possible consequences of bipolar depression. In some cases, a person will behave in just the opposite manner, exhibit symptoms of hypersexuality as a means to compensate for these negative feelings. While treating bipolar depression must always remain the primary focus, it doesnt necessarily have to be the detriment of ones libido. There are ways to manage the sexual side effects of bipolar drugs without compromising treatment. By and large, SSRIs have not been found to be particularly effective for bipolar disorder. Mood stabilizers like lithium, Depakote (valproic acid), and Lamictal (lamotrigine) are considered more effective and typically have fewer sexual side effects.