Keeping a Healthy Marriage When One of You Has Bipolar Hypersexuality

More than 4 percent of Americans experience bipolar at some point during their lives. During manic episodes, a person with bipolar may have surges in energy, an elevated mood, and sometimes a sense of invincibility. Around 40% of people with bipolar also experience hypersexuality.

When a person’s sex drive is significantly higher than their partner’s, it can cause stress and conflict. In a person with bipolar, difficulties with impulse control can exacerbate these common relationship issues.

Couples in which one partner has bipolar hypersexuality may worry about the effects of bipolar. But bipolar hypersexuality does not have to undermine a relationship. A 2016 study found that when it comes to establishing and maintaining relationships, people with bipolar have similar outcomes to people without mental health issues. Couples may, however, report differences in sexual satisfaction as the person with bipolar experiences mood cycles.

What is Bipolar Hypersexuality?

Most people with bipolar experience cycling moods. This includes times of depression (characterized by low energy, sadness, and hopelessness) and times of mania (characterized by periods of exuberance and high energy). Some people become more interested in sex during mania.

Hypersexuality is not a medical diagnosis. The American Psychiatric Association (APA) rejected its including in the latest version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Other organizations, such as the American Association of Sexuality Educators, Counselors, and Therapists (AASECT) also reject the diagnosis. This is because religion, cultural influences, gender norms, and a couple’s own history all influence their views on what is acceptable sexual behavior. No specific frequency of sex or sexual thoughts is in itself harmful or excessive. What seems very excessive to one couple might be completely normal for another.

Couples concerned about hypersexuality should instead look at changes over time and how those changes affect their life. It is common for couples to differ in their understanding of how frequently they should have sex. Some signs that one partner may be experiencing bipolar-related hypersexuality include:

• A sudden, unexplained increase in sexual feelings.
• Overwhelming sexual urges that cause immense distress. A person might continue thinking about sex even when they don’t want to.
• Feeling intense and painful feelings of rejection if a partner is not interested in sex.

Does Bipolar Hypersexuality Increase the Risk of Infidelity?

Most couples are in monogamous relationships, so an episode of hypersexuality may trigger fears of infidelity. Consensually non-monogamous couples may have other concerns, such as dishonesty about sexual relationships, unsafe sex practices with other partners, and sexual risk-taking.

While there are many studies on bipolar and sex, research on bipolar and infidelity is limited. Estimates of infidelity in bipolar relationships can vary wildly.

There is no right amount of sex to have and no wrong way to feel about sex as long as all involved parties consent. In a 2005 review, 40% of participants with cyclothymia reported “episodic or unexplained promiscuity or extramarital affairs.” However, the study’s definition of sexual excess included “overt bisexuality” and “sexual activity many times per day.” Neither of these factors fall under the category of infidelity, meaning the actual rate of extramarital affairs was likely lower.

A 2016 study compared sexual behavior of people with bipolar to those without bipolar and found very different results. Researchers found no significant difference in sexual risk-taking between bipolar and non-bipolar participants. Sexual risk-taking included items such as “sex with strangers” or “recreational substance use during sex.” The study did not measure infidelity directly though.

There is little evidence to suggest bipolar, or even bipolar hypersexuality, is a significant risk factor for infidelity. Other factors, such as age or gender, seem to play a much larger role. However, hypersexuality may affect couples in other ways, such as creating chronic conflicts over libido.

How Bipolar Hypersexuality Can Affect Couples

Many couples struggle with differences in libido. The effects of these differences depend on each partner’s views about sex, relationships, and intimacy. Some common themes include:

• Issues with attachment and intimacy. When one partner wants sex much more frequently than the other does, the partner who wants sex more often may feel rejected. The partner with the lower libido may feel that their partner ignores other forms of intimacy.
• Sexual coercion and pressure. Hypersexuality may cause some people to frequently make sexual overtures to their partners. This can feel like sexual pressure and may even become coercive.
• Fears of cheating. The partner who has a lower libido may fear infidelity.
• Anger and frustration. Both partners may struggle with anger and frustration about their sexual disagreements, especially if they find those disagreements difficult to discuss.
• Shame. Many cultures and religions promote very specific ideas about what type of sex, at what frequency, is acceptable. A couple who deviates from these norms may feel embarrassment or shame.
• Bipolar-related stress. Cycling moods can be stressful to both partners. This stress may compound the challenges of managing differences in libido.

Coping Strategies for Couples with Bipolar Hypersexuality

Treatment for bipolar can help with feelings of hypersexuality. Couples can also adopt a wide range of coping strategies. Those include:

• Identifying the early warning signs of a manic episode. Some people with bipolar need to change their treatment regimen as a manic episode approaches. Keeping a log of symptoms can help with predicting the next episode.
• Putting the hypersexuality in context. Hypersexuality is a symptom of bipolar, not necessarily a problem with the relationship. Couples may do well to remember that hypersexuality does not define their partnership or who they are as individuals.
• Limiting exposure to triggers. Some people find that certain triggers intensify feelings of hypersexuality. For example, someone who normally uses pornography in a healthy way may find that viewing pornography during a manic episode triggers insatiable sexual desires.
• Relaxation exercises. Bipolar hypersexuality can make both partners feel anxious about their relationships. Doing relaxing activities together, such as meditation, may help. Individual relaxation through yoga or deep breathing can also offer relief.
• Physical activity. Some people find regular physical exercise helps with excessive sexual thoughts. It may also help with other bipolar symptoms.
• Seeking non-pathologizing sex therapy. There is no right amount of sex to have and no wrong way to feel about sex as long as all involved parties consent. Yet shame and humiliation can make both parties feel worse about hypersexuality. It is important to seek treatment from a therapist who will listen without judgment and who is knowledgeable about the continuum of healthy sexual expression.

How Therapy Can Help Bipolar Hypersexuality

Sex often goes hand-in-hand with shame and guilt. Thus, many couples may struggle to talk about bipolar hypersexuality. The person with bipolar may feel simultaneously guilty about their desires and angry about their partner’s inability to match their libido. This can leave them feeling ashamed and unloved. Their partner may feel frustrated or even intimidated by constant sexual overtures. They may worry their partner will leave or be unfaithful, triggering feelings of insecurity and anxiety. Some may judge their partner for their sexual feelings, leading to poor communication and escalating shame.

Couples counseling can offer hope. The right therapist works to help both members of a couple feel safe talking about their emotions and sexual needs. In so doing, therapy can:

• Destigmatize sex, making it easier to talk about differing sexual desires.
• Help couples renegotiate their unspoken understandings about sex.
• Undermine the idea that there is a right or wrong way to feel about or have sex.
• Support couples to move past sexual betrayals.
• Offer each partner coping skills that help them manage anxiety, deepen attachments, and feel less alone.

Individual therapy can help people with bipolar understand their diagnosis and better manage their emotions. It may help the partners of said individuals identify the ways bipolar affects their lives and their relationships.

Many couples find that a combination of individual and couples therapy works best. If you would like get help for bipolar hypersexuality, you can find a therapist here.

References:

1. AASECT Position on Sex Addiction. (n.d.). Retrieved from https://www.aasect.org/position-sex-addiction
2. Auteri, S. (2014). What you need to know about…hypersexuality. Retrieved from https://www.aasect.org/what-you-need-know-about-hypersexuality
3. Bipolar disorder. (2017, November). Retrieved from https://www.nimh.nih.gov/health/statistics/bipolar-disorder.shtml
4. Downey, J., Friedman, R. C., Haase, E., Goldenberg, D., Bell, R., & Edsall, S. (2016). Comparison of sexual experience and behavior between bipolar outpatients and outpatients without mood disorders. Psychiatry Journal, 2016(1). Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4852112
5. Kopeykina, I., Kim, H., Khatun, T., Boland, J., Haeri, S., Cohen, L. J., & Galynker, I. I. (2016). Hypersexuality and couple relationships in bipolar disorder: A review. Journal of Affective Disorders, 195(1), 1-14. Retrieved from https://www.sciencedirect.com/science/article/pii/S0165032715306649
6. Toussaint, I., & Pitchot, W. (2013). Hypersexual disorder will not be included in the DSM V: A contextual analysis. The Medical Review of Liege, 68(5-6), 348-353. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/23888588
7. Wang, W. (2018, January 10). Who cheats more? The demographics of infidelity in America. Retrieved from https://ifstudies.org/blog/who-cheats-more-the-demographics-of-cheating-in-america

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