Bipolar and Sex: 9 Things You Should Know

by John McManamy Patient Expert

A lot of experiences in life are highly over-rated. Sex is not one of them. The trick is navigating through the risks that sex can present in bipolar disorder. Extreme moods and energy levels of bipolar can translate into hypersexuality or disinterest. Although challenging at times, it’s absolutely possible to have a fulfilling sex life as a person with bipolar disorder. You just have to be mindful of the complications and look out for the pitfalls. Here are some tips for “safe sex” with bipolar disorder, ways you can enjoy physical intimacy while maintaining good health.

Couple kissing.

Understand hypersexuality and mania

During periods of mania, those with bipolar may rush into action, without thinking about the consequences. They may also feel hypersexual and experience an increase in their sexual drive, often resulting in impulsive and risky behavior. In their book Manic-Depressive Illness, Frederick Goodwin, M.D. and Kay Redfield Jamison, Ph.D. report that across studies, hypersexuality is observed in 57 percent of manic patients.

Woman holding handcuffs.

Watch for hypersexual behaviors

During a hypersexual phase, people with bipolar might be more willing to experiment with their partner. They might want to try new things or have sex multiple times per day. Or they might engage in risky sexual behaviors such as unprotected sex, sex with multiple partners, one-night stands, extramarital affairs, excessive masturbation, or use of pornography.

Couple having sex in the kitchen.

Don’t self-medicate with sex

A hallmark symptom of depression is a decreased sex drive. Some don’t want it all. Others have sex periodically, looking for it to relieve their psychic pain. In this context, sex becomes a form of self-medication, much like alcohol, drug use, or overeating. Even with a reduced libido, behavior can be risky when persons look to sex to relieve their symptoms.

Casual sex in a bathroom.

Beware of dopamine and bad decisions

When the brain generates dopamine, it’s all too easy to confuse ecstasy with love or to forget about the person who really matters in your life. Sex and its after-glow have a way of turning even the chronically normal into honorary bipolars. This translates to two of you not thinking with your brains. Consider the voice of dopamine when making relationship decisions.


Know the consequences of hypersexuality

Being hypersexual might sound like an exciting state filled with orgasms and ecstatic release. Although it can be fun and exciting – as well as contribute to intimacy -- when tempered and controlled, there are times when it comes with dire consequences: STDs, broken marriages and broken hearts, hours lost to masturbating or searching for a sexual partner, jobs lost because you need sex more than you need to work. Even if you aren’t in a committed relationship, hypersexuality still puts you at risk. Treating the underlying bipolar disorder helps to regulate hypersexuality.

Stressed couple having an argument.

Consider your partner’s perspective

During a hypersexual phase, you might not ever feel sexually satisfied. You want sex all the time. And then, when a depressive phase starts, you are suddenly not interested. This can be confusing and frustrating for a partner. The inconsistency can create feelings of rejection and hurt. If you are in a committed relationship, try to be mindful of your partner’s feelings.

Prescription medication.

Find the right medication combination

Persons with bipolar shouldn’t have to sacrifice good sex for emotional stability. There is a middle path that is worth pursuing. Finding the right medication combination takes work, as several antidepressants have sexual side effects and other medications impact intimacy, as well. However, with time and some trial and error, it is possible to find a treatment for bipolar that can balance out the hypersexual symptoms of mania and the apathetic nature of depression.


Use sexual desires as a barometer for your moods

Your sexual appetite probably changes with your bipolar cycles. Learn to recognize your sexual behavior as a barometer to better manage your bipolar cycles. That isn’t to say every time you aren’t interested in sex, you are headed for a depressive state. Everyone has fluctuations in his or her sexual needs and wants. But there may be times when it helps you recognize what is coming, especially when you suddenly become hypersexual.

Happy couple in bed.

Enjoy yourself. Enjoy your partner.

Engage in sex mindfully and responsibly. Put forth the effort needed to treat your bipolar in a way that allows you to enjoy intimacy with your partner. In the words of the 13th-century Sufi wise man, Rumi: The way you make love is the way God will be with you.

John McManamy
Meet Our Writer
John McManamy

John is an author and advocate for Mental Health. He wrote for HealthCentral as a patient expert for Depression and Bipolar Disorder.