Bipolar Disorder Symptoms Mania and Hypomania The Impact of Bipolar Disorder on Sex By Marcia Purse 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 process Updated on September 17, 2020 Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Daniel B. Block, MD Medically reviewed by Daniel B. Block, MD LinkedIn Twitter Daniel B. Block, MD, is an award-winning, board-certified psychiatrist who operates a private practice in Pennsylvania. Learn about our Medical Review Board Print 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 person's 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 expansiveness—all features of bipolar mania—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: Anonymous sex with multiple partnersCompulsive masturbationCompulsive sex with sex workersFrequent patronizing of sexually-oriented establishmentsHabitual exhibitionismHabitual voyeurismInappropriate sexual touchingMultiple affairs outside a committed relationship While hypersexuality and sex addiction are not inherent facets of bipolar mania, it is important to recognize the signs. Not only might 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. Impact of Depression on Sexual Function Depression can kill the sex drive. And it's not just the mood disorder itself that contributes to this; the very drugs used to treat depression can stifle libido and a person's 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: 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. 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 doesn't necessarily have to be the detriment of one's 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. 3 Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Heare MR, Barsky M, Faziola LR. A Case of Mania Presenting with Hypersexual Behavior and Gender Dysphoria that Resolved with Valproic Acid. Ment Illn. 2016;8(2):6546. doi:10.4081/mi.2016.6546 Kafka MP. Hypersexual disorder: A proposed diagnosis for DSM-V. Arch Sex Behav. 2010;39(2):377-400. doi:10.1007/s10508-009-9574-7 Bella AJ, Shamloul R. Psychotropics and sexual dysfunction. Cent European J Urol. 2014;66(4):466-471. doi:10.5173/ceju.2013.04.art22 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. See Our Editorial Process Meet Our Review Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit Speak to a Therapist Online Advertiser Disclosure × The offers that appear in this table are from partnerships from which Verywell Mind receives compensation.