Bipolar 2 and sexuality


5 Rules To Keep Your Manic Hypersexual Urges Under Control

By ​Jess Melancholia

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    Here are 5 tips to help you control your hypersexual urges before they control you.

    Over the past few months, I’ve been getting an increased number of people on my blog that are curious as to how I’m able to keep my hypersexuality under control. For me, if I don’t stay focused, I’ll never be able to conquer it. Here are 5 rules I created for myself that have been a tremendous help to me over the past year:

    Rule 1: Limit your triggers.

    I’m not even kidding when I say this is the hardest one to do. Whenever an advertisement pops up on my computer or an erotic scene in a movie starts, I tend to get triggered really bad. What I’ve learned to do is avoid them. That means change the channel, avoid those websites, or switch the radio station. It also mean that I can never watch some of my favorite movies ever again. It’s the world I’ve come to accept if I don’t want my bipolar II to take over my life.

    Rule 2: Write your feelings down.

    This may come as a shock to many of you but I hated writing. I honestly did. I was never the kind of person who would journal or even read. It wasn’t until I started to blog about 9 months ago that I realized exactly how helpful it was. It felt freeing to get all the bipolar clutter out of my head.

    Rule 3: Contact your medical professionals.

    Please don’t ignore the early signs and pretend you can handle them! I know how ridiculously tempting it is to just “ride the wave” and hold onto the mania. No one wants to let go of the natural bipolar high we get. Sooner or later though, the mania takes over your brain and makes you do things you would never do stable. Don’t wait until it’s too late. Get medical help as soon as possible. If necessary, check yourself into the emergency room. Do whatever you can to make sure the situation doesn’t spin out of control.

    Rule 4: Call someone.

    As soon as you start to feel tempted to act out, call a friend or family member. I can’t emphasize this enough! You are powerless against the unearthly draw of a brain malfunction gone haywire. Your primal instincts are trying to make you do things that are destructive to your health and well-being. Unfortunately, you cannot do it alone. You just can’t. You need a third party outside of your brain to set you back on track. Reach out to people in your life who care about you and know your goals for the way you want to live.

    Rule 5: Keep your goal always in mind.

    You may be doing it to stay faithful to a spouse or partner. You may be doing it to protect your children. You also may be doing it to protect yourself from physical or legal ramifications. Whatever your reason, stay focused on the end goal. If you want to live a life free the bondage of acting out, then you need to concentrate on the initial reasons you stopped in the first place. Those are your true beliefs regardless of how you may feel right now. Don’t ever lose sight of them.

    If you follow these guidelines, you’ll be much better off. This doesn’t mean that the urges will go away or that you won’t be tempted ever again. All it means is that you have control over the mania rather than the mania having control over you. What helps me keep things in perspective is equating my hypersexuality to a bear in a cardboard cage. When that bear wakes up, there is nothing I can physically do to stop the bear from tearing that cage apart and going on a rampage. I need help. Once you accept that you are powerless over the lust, it becomes a battle of wits versus brute strength. You are far more capable of outmaneuvering the problem rather than facing it head on.

    Remember, you are force to be reckoned with. Bipolar has no power over you. Don’t be afraid rather step up and take charge of your life. Your behavior is a symptom of an illness.

    Don’t let the symptoms take over and ruin your life.

    • Hypersexuality and Bipolar Disorder: When Impulsive Sexual Behavior Is Part of a Manic Episode

      How Do You Treat Hypersexuality?

      Hypersexuality with bipolar disorder isn’t a separate condition or problem that needs its own treatment — it’s a symptom of bipolar disorder. Once the condition is successfully treated and mood swings and symptoms are under control, those hypersexual feelings will dissipate.

      “When bipolar disorder is not being treated effectively, hypersexuality is often a symptom that can wreak havoc in a person’s personal life and lead to poor decisions with possible serious and negative consequences. Treating the bipolar symptoms and getting hypomania and mania under control will often target and help hypersexuality as well,” explains Viguera.

      “You treat the disease, not the symptom,” she adds. “Treatments usually involve medications such as mood stabilizers or antipsychotics, as well as psychotherapy such as cognitive-behavioral therapy or interpersonal social rhythm therapy,” she says.

      Once the disease is under control, people with bipolar disorder often react differently to sex and their past behaviors.

      “You often see a lot of regret for the past behavior, because they put themselves in very bad situations,” says Viguera. “When they’re well, they reflect on that, and there can be a lot of regret and remorse. It’s just another clue that shows you that it was not their normal state.”

      In addition, hypersexuality can be one of the most difficult and challenging symptoms both for people living with the condition and for those close to them.

      Sometimes the inability to control sexual urges leads to broken marriages and relationships. Both people in a relationship can suffer if these urges result in infidelity: The partner with bipolar may feel distraught over having hurt the other partner, who in turn feels confused and angry for having been cheated on.

      Hypersexual behavior can also negatively affect a couple’s sex life. Studies that examine sexuality in couples with one bipolar partner found decreased levels of sexual satisfaction associated with the diagnosis. (2)

      Bipolar Behavior, Hypersexuality, and Related Conditions

      A meta-analysis published in the December 2016 Journal of Affective Disorders found a high prevalence of comorbidity between substance abuse disorders and bipolar disorder — meaning that a person is experiencing some form of both conditions simultaneously. (4)

      The study found substance abuse disorders to be quite common in patients with bipolar disorder. The disorders with the highest prevalence in conjunction with bipolar disorder were alcohol use (42 percent), followed by cannabis use (20 percent).

      Stimulants in particular can be problematic: The study authors point out that if stimulants are being used or abused, they could mimic symptoms of mania. (4) In addition, alcohol and cannabis use can be linked to poor judgment, which may further contribute to hypersexual behavior. Since addictions often feed off one another, this can lead to cycles of unhealthy behaviors. (5)

      Different Treatments for Bipolar Disorder

      Bipolar disorder is usually treated with:

      • Mood-stabilizing medications
      • Antipsychotic medications
      • Antidepressants
      • Cognitive-behavioral therapy
      • Other forms of therapy and counseling that may include family members
      • Electroconvulsive therapy, also called “shock therapy” because small electrical waves are used

      The right combination of these various therapies can reduce or eliminate bipolar mood changes between mania and depression, as well as prevent or reduce symptoms, including hypersexuality.

      Those symptoms of hypersexuality may be a red flag for some people with bipolar disorder indicating that they are slipping into a manic episode. If a person with bipolar starts to notice themselves thinking more about sex or engaging in promiscuous behavior, she should notify her doctor of this onset of symptoms.

      Additional reporting by Barbara Kean.

      Hypersexuality: A Brief Guide to Understanding

      Have you ever wondered if you or your partner might be just a little too interested in sex? The term “sex addiction,” or hypersexuality, can get bandied around a lot. Sometimes it’s warranted and other times it may just be that you have a higher sex drive than the average person – or than the average person talks about.

      Table of Contents

      What is Hypersexuality or Sex Addiction

      Everyone has a different sex drive, and some people enjoy sex a lot more than others (or are a lot more open about it). But if that enjoyment gets to the point that it’s interrupting a person or other people’s lives it might be time to consider whether they’re hypersexual, or have a sex addiction.

      Hypersexual disorder is more than just a high sex drive – it’s considered to be a kind of addiction. It tends to cause feelings of distress to the person with the disorder it as it gets in the way of ordinary living. It involves “excessive” or compulsive sexual behaviors.

      It’s not a new thing. Terms for an overzealous sex drive have been around for thousands of years, including nymphomania, Juanism, excessive sex drive, satyriasis, and many more. What this shows us is both that sexual desire and activity is an entirely human thing, and that sometimes it does get in the way of leading an ordinary life in society.

      As a clinical diagnoses, it’s controversial. This is largely because the empirical evidence is limited. Defining what counts as “excessive” is difficult to measure and be objective about. It’s often be impacted by subjective viewpoints, like personal world views, culture, and the views of a particular society.

      Sex addiction as an official disorder is viewed in a similar way, although it’s a more commonly used term. It refers more specifically to someone with strong sexual compulsivity, seeking out acts without self control – like compulsive masturbation, viewing of pornography, or even more socially unacceptable sexual behavior.

      The problem with the term “sex addiction” is that it has strong negative social connotations. It’s not clear whether or not to view this kind of compulsive sexual behavior like an addiction that’s similar to drug addiction. Many people believe that a term with less moral connotations is more helpful, and that’s where the term “hypersexuality” can be more constructive. It might not induce the feelings of shame that can sometimes get in the way of seeking treatment.

      Sex Addiction Symptoms

      The causes of hypersexual disorder or sex addiction are not understood, but it’s often linked to a person’s general mental state and sometimes to hormone levels.

      In some cases, a bipolar person will be hypersexual. Impulsive sexual behavior can be part of a manic episode, those dramatic mood swings that characterize bipolar disorder. It can be a symptom of bipolar or just exist on its own.

      Similarly, there are some links between hypersexuality and depression. Sexual behaviors can be a way to seek some relief, however temporary, from a mire of dark emotions. Hypersexuality can mask other issues like anxiety, stress, and depression.

      To count towards a diagnosis, the symptoms of hypersexuality must be present for at least six months. They include:

      Recurring and intense sexual urges, or behaviors

      This includes sexual fantasies, urges, and actual sexual action and behavior. Most people will experience sexual desire and act on it, but when it becomes intense and just keeps happening it could be a sign of obsession leading to a hypersexuality disorder. Some people might argue that the desire for multiple partners is a sign, but in actuality not all those with a sex addiction desire multiple partners – not to mention that the idea that more than one partner is wrong is a moral judgement.

      Disruptive, excessive sexual behaviors

      The time spent engaging in fantasy and hypersexual behavior gets in the way of leading an ordinary life. It can interrupt social life, work, and simple daily rituals.

      Sexual desire or activity in response to low mood

      Fantasies and behaviors occur in response to stressful events or low moods (like anxiety, boredom, depression, irritability).

      Can’t control the impulse

      Although they may try, a person with hypersexuality just can’t control the impulses. However, it’s important to remember that hypersexuality is never an excuse for hurtful or damaging behaviors, including cheating.

      Behavior with little regard for the impact

      They may act out their impluses with little consideration for any physical or emotional harm it might cause to themselves, or to other people. This can be something as simple as compulsive masturbation to the point where it causes physical discomfort, or it could be more extreme, like flashing, public masturbation, or even in extreme cases rape.

      Feelings of distress

      The frequency causes personal distress in some form. Often this comes with feelings of guilt and shame, which can be barriers for someone seeking support. However, it could also be sheer awareness leading to anxiety that sexual desires are getting in the way of achieving other things in life.

      What is Frotteurism

      Frotteurism is a paraphilic disorder (which means sexually arousing) where someone enjoys rubbing themselves (usually the genitals) against another person without their consent, specifically to achieve sexual pleasure. Unsurprisingly, it’s illegal – and not just because it’s a sexual act in public, but because it’s involving another person in a sexual act without their consent.

      Often it occurs in younger males (who might have seemed quite shy, up till that point) between 15 and 25, but it is also seen in older men. It’s quite rare among females, although it can occur.

      Normally frottage takes place in busy public spaces, like trains, elevators, and even crowded streets. We’d like to repeat, this is a form of nonconsensual sex.

      It is diagnosed as a mental health disorder if the urges and behavior continue for more than 6 months, and it’s definitely something to seek help about. Any strong compulsions to engage in sexual activity without someone’s consent should be spoken about with a health care professional. They can provide support and help.

      Sex Addiction vs. Porn Addiction

      Sex addiction is generally focused on activities with real people. It tends to involve activities or fantasies concerning other people – for example, having multiple partners, flashing, frottage, and so on.

      Porn addiction is more focused on screen (at least these days of the internet). It’s about the visual feed, and includes that ongoing search for more porn. And in these digital days, it’s so easy to access porn which can make things even easier for someone with a predilection to develop an addiction.

      Another key difference is that a porn addiction can actually lead to sexual performance difficulties, whereas a sex addiction tends not to.

      Porn Addiction Test

      Like so much around sexual choices and behavior, there can be a lot of moral judgement around pornography. While there are definite issues with a lot of the easily accessible porn online, it’s not by default a bad thing to enjoy.

      If you’re worried that you or someone you know might be addicted to porn, consider these questions:

      Do they lose track of time when looking at porn?

      Do they watch porn throughout the day to the point where it may interrupt their other activities or things they should be doing?

      Do they worry about not having access to pornography?

      Do they look at porn while doing other things, like watching TV?

      Do they spend more time viewing or downloading porn than spending time with real people, or engaging in non-sexual activities?

      Do they feel like their porn habit is getting in the way of their life?

      Do they secretly wish they didn’t want to watch porn as much as they do?

      If yes was the answer to three or more of these questions, maybe it’s time for this person to reconsider the relationship they have with porn. Basically – just like identifying a sex addiction or hypersexuality – if watching porn is getting in the way of leading an ordinary life, consider seeking help.

      Treating Sex Addiction

      Treatment will generally come in the form of counselling or cognitive-behavioral therapy. This is because a lot of the time paraphilic disorders tend to be about mental state and how a person responds to compulsions.

      If there’s an underlying issue, that can also be treated – for example, managing depression or stress, or bipolar disorder. Obsessive-compulsive symptoms can also sometimes benefit from treatment.

      Treatments include:

      Identifying triggers for compulsive sexual behaviors or thoughts. The person affected should spend the time getting to know themselves and their responses – and if they have a partner, it’s important for the partner to be involved in this process too.

      Help with rebuilding relationships. Sometimes sexual addiction can disrupt relationships. It’s important to be willing to communicate. If the person with a sex addiction has a partner, it may be worth considering sex therapy.

      Finding techniques for managing stress, anxiety, and depression. And also shame – because, like we’ve mentioned, shame can really get in the way of dealing with the issue.

      Finding alternative behaviors and ways to channel thoughts that are less destructive.

      Know Your Sexuality

      Sexuality is a part of a healthy, enjoyable life, and everyone’s pleasures will be a little difficult. The main thing to remember is sexuality shouldn’t be getting in the way of anyone living their life. If you’re worried about your urges or behaviors, the first thing to do is take the time to really get to know yourself and identify what it is that’s making you uneasy. If it’s not actually harming yourself or others – maybe there’s nothing wrong.

      Hypersexuality (Sex Addiction)

      Hypersexual disorder is a proposed diagnosis for people who engage in sex or think about sex through fantasies and urges more than normal. These individuals may engage in activities such as porn, masturbation, sex for pay, and multiple partners, among others. As a result, these people may feel distress in areas of life including work and relationships.

      The existence of “sex addiction” is under heated debate. However, in a controversial decision, compulsive sexual behavior disorder was added to the World Health Organization’s International Classification of Diseases. Some researchers see this tendency as a problem of regulating behavior, while other experts wonder whether this behavior derives from a higher sex drive or if it stems from impulse control problems. Because of such disagreement over the validity of this behavior, the number of those affected is also under scrutiny—some say it is 3 percent to 10 percent of adults.

      Other experts believe that the real causes of the behavior include emotional states, namely anxiety, depression, or relationship conflict. For some individuals, shame and morality may also be involved. Whether the condition exists or not, psychotherapy may be useful for individuals seeking to regulate emotions and gain insight into their sexuality.

      Hypersexuality is not included in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. It was previously listed in the DSM-4 as a Sexual Disorder, Not Otherwise Specified with the definition “distress about a pattern of repeated sexual relationships involving a succession of lovers who are experienced by the individual only as things to be used.”

      The 2010 proposal for the addition of hypersexual disorder into the DSM-5 included the criteria of uncontrollable sexual behavior. Supporters of the behavior’s inclusion argued that people who engage in this excessiveness suffer from great distress. In the proposed criteria, hypersexual disorder was conceived as a nonparaphilic sexual desire disorder with an impulsivity component.
      The proposed diagnosis was not added to the DSM-5. Experts note that there isn’t enough empirical evidence to support the diagnosis. Many do not view it as an addiction and believe it has no similarities to other addictions.

      Sex addiction: what it means to be ‘hypersexual’

      Whenever we hear about hypersexuality, it is usually in the context of celebrities who have gotten themselves into trouble and are seeking therapy to remedy their ways. However, most people would be surprised to learn that the root cause of hypersexuality, or so-called “sex addiction,” is hardly ever related to sex.

      “Why am I like this?” is the most common question I encounter, as a sex researcher working with hypersexual men. Problems with pornography and cheating have had severely detrimental effects on their lives and they are desperate for a solution. After ruling out bipolar disorder or borderline personality disorder as the underlying condition (as high-frequency sexual behaviour is a common symptom of these disorders), this is what I have found.

      Men with problems with masturbation will spend inordinate amounts of time, up to 12 hours a day in some cases, viewing pornography or interacting sexually through chat rooms, social media, dating apps, and webcam. Many lose their jobs after these activities leak into their work lives. For example, most will tell me that they are chronically late for work due to staying up the night before, and that they view porn while at work or call in sick because they’d rather be watching it at home. (Less is known about hypersexuality in females, as it presents at a substantially higher rate in males.)

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      These men almost universally have issues with anxiety and depression, and fears around social rejection. Their problem with pornography is not that it is addictive, but that it is used to alleviate stress, boredom, low mood, or to put off doing less fun tasks, like the ones having a job entails.

      Caleb* calls his use of porn a “time sink,” but nevertheless finds it comforting because it helps to distract him from the ever-growing list of things to do at work and feeling overwhelmed by his worries about money and his health.

      Shape Created with Sketch. The world’s most sexually satisfied countries

      Show all 12 left Created with Sketch. right Created with Sketch. AFP PHOTO / GREG BAKER

      2/12 11. Germany


      3/12 10. Nigeria

      PIUS UTOMI EKPEI/AFP/Getty Images

      4/12 9. Australia

      SAEED KHAN/AFP/Getty Images

      5/12 8. India

      NARINDER NANU/AFP/Getty Images

      6/12 7. Mexico

      Chris Jackson/Getty Images

      7/12 6. Netherlands

      BRAM VAN DER BIEZEN/AFP/Getty Images

      8/12 5. Greece


      9/12 4. Brazil

      CHIBA/AFP/Getty Images

      10/12 3. Italy

      Franco Origlia/Getty Images

      11/12 2. Spain


      12/12 1. Switzerland

      Mark Kolbe/Getty Images

      1/12 12. China


      Serial cheating can occur for a variety of reasons, but is most commonly due to a mismatch in sex drive between partners. Most of us would imagine someone with an insatiable sexual appetite, but astonishingly, the “hypersexual” partner’s desire for sex is not usually all that high, and it is their partner’s desire that is low, compared to the average.

      In Noah’s* situation, his wife wants sex with him once a year. He accrued $40,000 in debt, spent on strippers and sex workers, because he likes to have sex once a week. He says he doesn’t want a divorce from his wife because he loves his two young children, but feels trapped and doesn’t know what else he can do.

      Some men cheat regularly because they prefer the novelty of a new sexual partner to sex with someone they’ve had sex with before. They don’t want to be constrained by monogamy. Others are afforded extra sexual attention due to having been blessed with good looks, and choose to indulge themselves. “I love sex,” Reid* sheepishly says. “Why limit myself?”

      Other hypersexual men have paraphilias (or kinks), and they only find sex satisfying when incorporating these kinky activities. If their committed partner is not interested or willing, they will seek sex outside of the relationship with partners who are. Matthew* expresses forlornness when speaking about this, because he finds it alarming to be sexually turned on by things he knows most people don’t find arousing. Some of his preferred sexual activities include cross-dressing, incorporating bodily waste, and being humiliated during sex. He desperately wishes that he could be fulfilled by vanilla sex.

      If you think you might be hypersexual, ask yourself if your sexual behaviours cause you harm or distress, or impairment in your day-to-day functioning. The best way to overcome this, as supported by research, is to address the underlying issues driving your behaviours, as opposed to focusing on the sexual nature of them.

      And be honest with yourself. For example, for someone who is content in pursuing new sexual partners, perhaps monogamous marriage is not the best idea for him. For those who do choose monogamy, partners should be on the same page with regards to the frequency and the kind of sex they prefer. Those with porn use problems should seek more effective ways of coping with stress and anxiety. Counselling with a mental health professional might also be helpful when working through these problems.

      Every man I’ve spoken to tells me that being hypersexual has caused him to feel shameful about himself and to question his self-worth. We, as a society, should undertake to stop stigmatizing sex, because this stigmatization leads to unnecessary suffering in the dark. It hinders our ability to have open discussions about what is really going on beyond what we see on the surface.

      Debra W. Soh is a sex researcher, neuroscientist, and freelance writer at York University in Toronto, Canada. Her writing has been featured in Harper’s, Men’s Health, and many others

      * all names have been changed

      The Independent’s Millennial Love group is the best place to discuss to the highs and lows of modern dating and relationships. Join the conversation here.​

      Women who have sex so frequently that it may cause them problems — sometimes referred to as being “hypersexual” — seem to be characterized more by their high rates of masturbation and pornography use, rather than passive forms of sexual behavior, such as having fantasies, as previous studies had suggested, according to new research.

      Hypersexuality is a highly debated topic among psychiatrists and sexual medicine researchers, who have different opinions about whether “too much” sexual activity is truly a disorder, for either sex. But perhaps more controversial are the views on hypersexuality in women, a group usually ignored in most studies of hypersexuality.

      “A high number of myths concerning female hypersexuality still exist,” the authors of the new study said.

      To get a better idea of what hypersexual women actually do, the researchers surveyed nearly 1,000 women in Germany — mostly college students — and asked them how frequently they masturbated or watched porn, and how many sexual partners they’d had.

      The researchers also assessed hypersexual behavior in the participants using a questionnaire called Hypersexual Behavior Inventory, which includes 19 questions about how often a person uses sex to cope with emotional problems, whether engaging in sexual activity is outside one’s control and whether this sexual activity interferes with one’s work or school. Scoring high on this questionnaire could suggest that a person may potentially need therapy, according to previous research. In the new study, about 3 percent of the participants were classified as hypersexual based on their scores on the questionnaire.

      The results showed that the more frequently women masturbated or watched porn, the more likely they were to score high on the hypersexuality questionnaire. A higher number of sexual partners was also linked with high hypersexuality scores, according to the study, which was published in the Journal of Sexual Medicine in June.

      “The results of the current study do not support the idea of previous research that hypersexual women are typically engaged in more passive forms of sexual behavior, and contradict the assumption that hypersexual women only use sexual behavior to control and influence interpersonal relationships,” the researchers wrote in the study.

      Is hypersexuality different in women?

      It is not clear how common hypersexual behavior is in women, compared to in men. Because most studies have focused on men, there’s an impression that the phenomenon is associated with being male, the researchers said. Another reason for the lack of knowledge about female hypersexuality may be due to cultural biases that keep women from publicly acting out on their desires or admitting to their sexual activities.

      “In many cases, it’s much more permissible for men to engage in hypersexuality as opposed to women,” said Rory Reid, an assistant professor and research psychologist at the University of California, Los Angeles, who was not involved in the new study. “Men would be often just characterized as ‘men being men,'” whereas women sometimes would be labeled with derogatory terms if they engaged in hypersexual behaviors, Reid added.

      The behavioral patterns the new study found in hypersexual women resemble behaviors previously identified in hypersexual men. These behaviors include pornography dependence, excessive masturbation and promiscuity.

      Reid said the findings are not surprising. In his own studies, he’s found more similarities than differences when comparing hypersexual women with their male counterparts.

      However, the new study found that hypersexual women were more likely to be bisexual than were the rest of the participants. In contrast, hypersexual men tend to be heterosexual, Reid told Live Science.

      Is hypersexuality something to worry about?

      There have been debates about whether hypersexual behavior is a disorder — similar, in some ways, to addiction — or just a variation of sexual behavior in people. In the fifth (and most recent) edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the American Psychiatric Association decided against including “sex addiction” as a disorder, saying there is not enough evidence to show hypersexuality is a mental-health problem.

      Still, although it may not be possible to delineate how much sex is too much, experts say hypersexual behavior can become a problem for some people, when it causes stress or shame, or results in negative consequences in a person’s life — for example, the loss of a job.

      “It is still a challenge for to identify individuals who may require treatment, without falsely stigmatizing others and their ‘normal’ (or nonpathological) sexual behavior,” the researchers said.

      Email Bahar Gholipour. Follow Live Science @livescience, Facebook & Google+. Originally published on Live Science.

      7 Ways to Outsmart Bipolar Hypersexuality

      By bp Magazine

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        Hypersexuality is a common, but rarely talked about, symptom of bipolar disorder. Nevertheless, it is vital that you adopt proactive strategies to help you control its impulsive urges. Here are a few to get you started:

        / Pixels

        #1 Limit your triggers

        Hypersexual behavior is often a warning sign of a manic episode, but keeping bipolar disorder managed with meds and therapy can help. Be sure to pay attention to and recognize any triggers or symptoms, including those concerning sexual behavior. Once you are aware of these, you can communicate them to your partner or a friend so that he or she can keep an eye out for such red flags.

        #2 Treat the disorder

        When bipolar disorder is not being treated effectively, the person’s sex life can become unstable. By treating the bipolar symptoms and getting hypomania and mania under control, this will often help manage hypersexuality as well. Treatments may involve medications such as mood stabilizers or antipsychotics and cognitive-behavioral therapy and family counseling.

        #3 Look at medications

        Medication often plays a key role in hypersexual disorder treatment. Some medications may help reduce compulsive behaviors and obsessive thoughts; others may target specific hormones associated with sex addiction or reduce accompanying symptoms such as depression or anxiety.

        #4 Communication is key

        Since high-risk sexual behavior can include having sex with more than one partner, it’s crucial that couples discuss openly the impact that bipolar disorder may have on their sex life. This open dialogue can help reduce negative consequences, including unplanned pregnancies or sexually transmitted diseases.

        #5 Consider sex therapy

        Getting help from a therapist in addition to medical care is important for the patient and the partner in order to resolve sex-related issues in the relationship. Sex addiction treatment could involve some combination of couples therapy, psychotherapy, family therapy and support groups.

        #6 Physical activity

        As part of her treatment for bipolar hypersexuality, that includes medication and psychotherapy, Olympic runner Suzy Favor Hamilton relies on lots of physical activity. She participates in everything from yoga to cycling to hiking to intense cross-training. “I still need the ‘pain’ of working out to feel good,’’ she says. “But I’ve found other outlets. Intense exercise definitely is great therapy for me.”

        #7 Don’t put it off

        Many people can feel shame or humiliation in seeking help for hypersexuality and sex addiction. Unfortunately, medical professionals may seem awkward in talking about this as well. If you are unable to control your sex drive or treat these hypersexuality symptoms on your own, it’s crucial that you don’t put off getting help, especially if it’s hurting your relationships.

        • How Bipolar Disorder Enables Sex Addiction

          As the rates of a multitude of different addictions, including drugs, alcohol, sex, and gambling, continue to climb in the United States, and around the entire world, it is worth examining the root cause of several of these addictions. In many cases, there is a co-occurring mental health disorder that creates the conditions for these addictions to thrive, which sets up a self-sustaining cycle of addiction and mental health issues. In terms of sex addiction, which roughly 6-8% of Americans suffer from, research shows that bipolar disorder is a common co-occurring disorder. Here are some of the ways that bipolar disorder enables sex addiction…

          Bipolar mania

          Everyone knows that bipolar disorder can lead to extreme emotions that are highlighted by polar mood swings. While one side of these mood swings is a severe depression, the other side of the coin is what is called “mania.” Bipolar mania is what happens when a bipolar individual’s brain is hyperactive. During this time, they will have an intense amount of energy, and their thoughts will move at lightning speed. They will also experience senses at a higher intensity than normal. Mania also tends to lead to more risk taking behavior. This concoction of brain activity can lead to conditions where sex addiction can flourish.


          One frequent factor that is associated with bipolar mania is hypersexuality. Hypersexuality means that a person’s mind is obsessively focused on sexually-related activities. This can manifest in an increased intake of pornographic material, as well as a ramped-up sex drive. Oftentimes, hypersexuality leads to sexual behavior that is outside of what a person would normally desire. When you consider the risk-taking personality that comes forward during bipolar mania, this hypersexuality can manifest itself in risky sexual activity. This doesn’t necessarily mean that a person with hypersexuality experiences sex addiction, but it can foster conditions where sex addiction becomes prevalent.

          Sex addiction

          Again, it is important to note that there is a distinction between hypersexuality and sex addiction. Hypersexuality merely means that a person is extremely focused on sexual activities. Sex addiction, on the other hand, has to do with a specific reward process in the brain that makes a person feel like they “need” to engage in sexual activity. In this way, although sex addiction isn’t physically addictive, it is mentally so. However, through the vein of hypersexuality, bipolar disorders can set up the mental conditions where sex addiction may occur, which is why it is such a common dual diagnosis.


          Im curious about my 18 yr old son. Within the last 2 yrs, many times he seemed depressed. He would go to his room and stay in there and sleep. He slept everyday almost his senior year. He use to be a really happy fun loving child. He slowly changed, turned more gothic looking. He didnt graduate, he left home the last 2 months of school. He has since age 12 done things with out caring about the consequence. He is now gay. He at one time was crazy for girls. Im just curious. He has been told by a few people that he seems Manic. And I did experience seeing him somwhat depressed. He has no desire to achieve any goals. He seems to be doing good for a week, then suddenly he is gone, stranded somewhere. Anyway, i spoke to someone and they said sometimes a bipolar person can be attracted to the same sex. So can bipolar and homosexuality be related?

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          Your son’s behavior (sleeping all the time, looking “gothic”, withdrawing, not graduating, etc.) is possibly consistent with unipolar (regular depression-only) depression. I don’t see you describing anything that might make the picture look more like bipolar disorder, however, with the possible exception of the not caring about consequences, which could also be a consequence of regular depression. In order for your son to be bipolar, we’d need you to be talking about periods of very elevated, and energetic mood, usually a good mood but sometimes agitated. I’m not hearing you say that, so I would be thinking more in terms of standard depression rather than bipolar. But, you may have not reported the full picture of what your son is doing, and you may not even be aware of it all, so we can’t really know what is happening.

          To the very best of my knowledge, there is no direct connection between mood disorder (of bipolar or unipolar varieties) and homosexuality. There might be some indirect connections between mood disorder and homosexuality, but these would not be causal relationships in the sense you are looking for. For example, someone who is bipolar tends to become disinhibited when they enter into a manic (energized) phase. During this period of disinhibition and impulsivity, someone might act on sexual impulses that they normally would keep under wraps, but even if this happened, the impulses would be there before the illness and not caused by the illness. Someone who is deeply depressed might be depressed in part because they are homosexual and perceive themselves to be defective or shameful as a result. They would not be actually defective in reality (for homosexuality is a normal variation of human sexuality and not in any way a disorder or problem), but many people in society are quite bigoted and prejudiced about homosexuality and will attempt to shame and cause emotional harm to happen to gay people. If this were part of the scenario that is playing out for your son, it would be the reaction to the homosexuality that was causing the mood disorder, and not the other way around. For the record, homosexuality appears to be determined primarily by fluctuations in hormones that occur during fetal development (during pregnancy). By the time a child has come into the world, their sexual preferences are apparently (in some sense that is not altogether understood just yet) already largely fixed, even though those preferences will not come to be expressed for years.

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          The Bipolar Symptom Nobody Wants To Talk About

          By bp Magazine

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            Lack of definition

            It is listed in the DSM-5 as part of the diagnostic criteria for bipolar disorder, as one of the primary symptoms. It is understood that there are increased incidences of risky sexual behavior with people who have bipolar manic episodes. However, due to ongoing changes to diagnostic criteria, there remains no formal definition of hypersexuality itself as a disorder. The diagnostic criteria for mania include “excessive involvement in pleasurable activities that have a high potential for painful consequences.”

            Understanding the symptoms

            People with hypersexuality stemming from bipolar mania typically have a dysfunctional preoccupation with sex. They may experience the following symptoms: they think about sex constantly, have one-night stands, have multiple sex partners, be more interested in pornography, notice a difference in their sexual behaviors and engage in other reckless behaviors like driving too fast, gambling or spending beyond their limit.

            What hypersexuality is not…

            As bphope blogger Gabe Howard explains: “Hypersexuality doesn’t mean having a lot of sex. It isn’t spring break; it isn’t your honeymoon. There is a world of difference between having a lot of sex and having many partners or sexual experimentation. The primary difference is motivation.”

            A destructive symptom

            It is a pervasive and damaging symptom that has wrecked marriages and caused life-threatening health problems. Olympic runner Suzy Favor Hamilton’s manic-induced hypersexuality symptoms found her reputation damaged when it was publicly revealed the married mother was engaged in escort prostitution. Luckily, Hamilton was able to seek help from medical professionals and from her family.

            Women vs men

            At least one study found that hypersexuality appears to play a larger role in women’s lives than in men’s: “women with bipolar tend to be far more sexually provocative and seductive than their male counterparts … twice as many women as men reported sexual intensity as very much increased during hypomania.” The women in this study also rated sexual intensity as the most important and enjoyable part of mania.

            Hypersexuality in children

            Barbara Geller, MD, professor of psychiatry at the Washington University in St. Louis, is the author of a groundbreaking study about hypersexuality behavior in children with bipolar, and has helped overturn widespread assumptions through her research. She found that flirtatious sexual behavior was a common symptom in 30 percent of young, prepubescent children with mania and in 60 percent of the adolescents.

            Understanding the fixation

            Just as someone coping with mania might not stop at $50 when his credit card allows him to spend $5,000, he may also devote hours each day staring at Internet porn or searching for partners. It’s the excess that gets him into trouble. In his book Electroboy, Andy Behrman said the fixation “becomes your secret little world … you escape to this world of fantasy, your mind I racing, and this is the direction your mind is racing to.”

            An addiction

            Louis J. Cozolino, PhD, a professor of psychology at Pepperdine University, says to think of hypersexuality as an addiction because the compulsion and obsession can feel much the same as what’s felt by drug addicts and alcoholics. “As an addict you never get enough of a drug … with bipolar disorder you have people who are more vulnerable to using sex as an addiction because they use it for soothing.”

            Telltale signs

            Some signs include a person is taking risks, missing school or work, and/or shirking responsibilities because sex has become more important than personal commitments. This may be a warning sign one is “unable to act with an eye toward future consequences of their behavior.”

            Psychiatrists should ask…

            Many psychiatrists refer to hypersexuality almost as an afterthought—if at all—when forming a diagnosis; however, it can be the most challenging parts of bipolar disorder. All psychiatrists should first ask, ‘has your physical energy increased? Has your sexual energy increased?’ This should be followed by a question about impulsive new relationships and impulsive sex during the mood swings.”

            • Brief Overview of Bipolar Disorder

              Bipolar disorder is a brain disorder that causes unusual shifts in mood, energy, and activity levels, as well as the inability to perform everyday tasks. Bipolar disorder, which affects about 6 million people in the US alone, is marked by periods of unusually intense emotions, including alternating episodes of mania and depression.1 During a manic episode, the person feels restless, energized, and agitated. They often talk abnormally fast, have racing thoughts, and engage in reckless behaviors. During a depressive episode, the person feels very sad, hopeless, empty, and tired. They have abnormal sleep and eating patterns, have low energy, and sometimes contemplate suicide. Clearly these two episodes are vastly different, and with each lasting for days, weeks, or even months, the person may feel like they are on an emotional rollercoaster. Additionally, a person might experience symptoms of both mania and depression simultaneously in a period referred to as a mixed state (see picture). With the help of medication and therapy, many people are able to decrease the intensity of their manic and/or depressive episodes and minimize their mood swings. Bipolar disorder is a life-long mental illness that can affect many aspects of a person’s life, including their sex life.2

              Sex During a Manic Phase

              During a manic phase, people often feel indestructible and not concerned with the consequences of their actions. Because mania is often marked by impulsive behavior, it is important to understand sexual behavior during a manic phase, and the implications that such impulsive behavior can have. Although hypersexuality may not initially sound like something to be concerned about, it is often one of the most destructive and challenging aspects of bipolar disorder.4 It is not uncommon for manic people to experience a significant increase in sex drive that they feel cannot be satisfied, leading them to engage in impulsive and risky sexual behaviors.

              Such behaviors include:

              • Unprotected sex

              • Sex with multiple partners or strangers

              • Having one night stands

              • Extramarital affairs

              These behaviors can lead to unwanted pregnancy, contraction of a STI, and can destroy relationships. Bipolar people in a manic episode may also masturbate or use pornography more frequently than they do in non-manic phases.3 These markers of hypersexuality are more common in women than men and affect about 57% of people in manic episodes, according to a meta-analysis of the few studies that have been conducted on the topic.4

              If a person experiences bipolar hypersexuality and finds that it is causing problems in their life, they should talk to a doctor. Medication and therapy, which help manage the underlying bipolar disorder, can help mediate hypersexuality. Because bipolar hypersexuality can put a significant strain on relationships, partners are encouraged to seek counseling and speak with a therapist about any problems or difficulties they are experiencing.3

              Sex During a Depressive Phase

              During a depressive phase, some people lose interest in sex completely, or they feel like they do not have enough energy to become aroused and engage in sexual activities. This lowered sex drive during a depressive episode, especially if it occurs right after a period of mania marked by hypersexuality, can confuse partners and leave them feeling frustrated, confused, and rejected. Depression can also lead to sexual difficulties, including erectile dysfunction and delayed ejaculation in men.5 On the other hand, some people may turn towards sexual activities as a way to help dull the pain, just as many others turn to drugs or alcohol.

              Treatments for Bipolar and their Effects on Sex Life

              Today, the most common treatments for bipolar disorder include:

              • Mood-stabilizing medications: Lithibid (lithium), Depakene or Depakote (valproic acid), Lamictal (lamotrigine), and Equetro or Tegretol (carbamazepine).6 This is the most common type of medication prescribed to treat bipolar disorder, as it helps with both mania and depression.

              • Antipsychotic medications: Abilify (aripiprazole), Clozaril (clozapine), Geodon (ziprasidone), Latuda (lurasidone), Risperdal (risperidone), Saphris (asenapine), Seroquel (quetiapine), Zyprexa (olanzapine) .7 These are used if the person is experiencing episodes of psychosis, marked by hallucinations or delusions

              • Antidepressants: While antidepressants may help with the depressive phases of bipolar disorder, when taken as the sole form of medication, they can trigger mania and rapid mood cycling. If antidepressants are used at all, it is recommended to take them in conjunction with one of the mood stabilizing drugs mentioned above.8
              • Cognitive-behavioral therapy: While medication is often the first step in trying to stabilize bipolar episodes, therapy is very important for maintaining effective treatment. In fact, research shows that people who take medication for bipolar disorder tend to recover much faster and control their moods better if they are also in some sort of therapy.8
              • Electroconvulsive therapy (ECT): This procedure involves attaching electrodes to the person’s scalp and sending small electrical currents through their brain. This is supposed to change the electrical activity in the brain, causing a brief seizure and altering chemicals in the brain. This procedure is used as a last resort if the patient is not responding to any other form of treatment.

              Bipolar medication is most effective when used in combination with other bipolar disorder treatments, including therapy, self-help coping strategies, and healthy lifestyle choices such as exercising regularly, getting enough sleep, eating a healthy diet, and building a strong social support network.8

              Many medications used to treat bipolar disorder can have negative side effects, including decreasing sex drive. The most common class of medications that can have sexual dysfunction side effects (especially erectile dysfunction) are the antipsychotics. However, for the most part, medication that treats bipolar disorder and helps stabilize the alternating episodes of mania and depression can help sex drive return to its normal level. The highs and lows of mood cycles can be exhausting and can take a major toll on a person’s sex life and relationships, but with the proper combination of medication and therapy, people with bipolar disorder can live a much more stable life.

              It is important to talk with a doctor about your specific medication and ask them about changing your dosage or switching medication until you arrive at a place where your sex drive is what you want it to be, while still keeping your bipolar disorder under control. We do not advise you to adjust your own dosage or stop taking your medication without consulting a doctor, as this can send you into a more severe episode of mania or depression.

              6. Healthwise Staff. “Mood-stabilizers for Bipolar.” WebMD. WebMD, 14 Nov. 2014. Web. 19 Apr. 2016. <.

              Last Updated 20 May 2016.


              Case Report

              A 28-year-old homosexual male was brought to the emergency department after he was found destroying property at his home. On presentation, he was very disorganized and stated that he had blood coming from his rectum. On physical exam, no rectal bleeding was found. He appeared euphoric and stated that his mood was happy and scared. He denied any past psychiatric history and any prior use of psychiatric medications. His urine toxicology screen was positive for amphetamines. He was admitted to the acute adult inpatient psychiatric unit for observation.

              Collateral information from his mother confirmed that he had a normal development and childhood and graduated from high school. She stated that he had always identified as a homosexual male, and had never expressed feelings of being a different gender or the desire to be a woman. He did not show any signs of mental illness until 3 years prior to his hospitalization when his mother states that he fell into a depression, which was characterized by talking to himself, lack of self-care, and loss of sleep and appetite. She corroborated that the patient had never taken psychiatric medications. At this same time his mother stated that she believes he started to use alcohol and drugs heavily, although she did not know what type or how often he used them. She denied any other mental illness or substance abuse in their family. During his first day in the hospital, the patient reported that his mood was good and denied any hallucinations, paranoia, or suicidal ideation. He remained disorganized, and spent his first night in the hospital pacing the unit without sleep. He was started on risperidone 0.5 mg twice a day for psychosis and risperidone 0.5 mg as needed every 8 hours for anxiety and agitation. He was placed on precautions for possible alcohol withdrawal due to possible recent alcohol use, which was reported by his mother. On hospital day two, the patient was seen coming out of the bathroom with another male patient. At this time, he was placed on hypersexual precautions and was instructed to maintain a 10-foot distance from all other patients. That same day, the patient suggestively groped a male staff member’s hand while receiving food. He was placed on one to one supervision due to his inappropriate behaviors. During his second night in the hospital he was recorded to have slept 4.5 hours. For the rest of his stay, he slept 7-10 hours each night. Risperidone was increased gradually to 4 mg nightly for psychotic mania and valproic acid extended release 1500 mg at nighttime was started with a goal of improving impulsivity and hypersexuality. Three days following initiation, serum values of valproic acid were 75 mcg/mL, with normal complete blood count and liver function.

              Modest improvement in intrusive and hypersexual behaviors allowed for the discontinuation of the one to one sitter, but continued suboptimal response led to transition from risperidone to quetiapine on hospital day eight. On the 13th day of his hospitalization, the patient voiced that he felt like he was a woman. He stated that he heard voices telling him that he was a beautiful woman, and he asked to speak with a doctor as soon as possible about getting gender reassignment surgery. He continued to voice feeling like a woman for two more days. He also began to wear bright pink lipstick and dance and sing loudly.

              On the 15th day of his hospitalization, his symptoms of mania remained uncontrolled, valproic acid extended release was increased to 2000 mg nightly, and quetiapine was cross-titrated to perphenazine. By the 23rd day of his hospitalization, with valproic acid levels of 88 mcg/mL, he no longer had any hallucinations or paranoid ideation, was no longer hypersexual, did not have feelings of gender dysphoria, and was much improved in his ability to converse rationally. He was discharged home on valproic acid extended release 2000 mg nightly, perphenazine 6 mg twice daily, and zolpidem 5 mg for insomnia.

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