Sex, Love, and Bipolar Disorder

Bipolar disorder affects approximately 93,000 adults in the United States alone. Naturally, many of those adults are married or in a committed relationship. Bipolar disorder (what used to be called "manic depression") is a severe mood disorder in which the individual experiences mood swings from energized to depressed. When a person with bipolar disorder (BPD) is energized, they feel great but can have behaviors that are destructive to themselves and their relationship, such as:

繚 Spending large amounts of money without concern for the consequences

繚 Having bigger-than-life ideas that they try to carry out despite a large risk for failure

繚 Pressured, rapid speech and quickly changing ideas that can leave the listener exhausted

繚 Elevated mood, feeling too good for the situation they are in

繚 Being hypersexual or sexually promiscuous and engaging in risky sexual behaviors

繚 Having a severely depressed mood after a hypomanic or manic episode

It's enough to make anyone with bipolar disorder and his or her partner distressed. Even after the diagnosis is made and the partner with bipolar disorder is medicated, there can be lingering emotional pain. For example:

繚 The person with bipolar disorder may be ashamed of their behavior, particular sexual acting out

繚 The partner may doubt the relationship because of sexual acting out and have difficulty with trust

繚 The couple may be unable to sort out what can be attributed to the disorder and what to the sufferer's character

繚 The couple may feel unable to share their sexual struggles with a therapist or psychiatrist

繚 Medications can have sexual side effects, which many people are unaware of, making sex confusing instead of comforting

These are complicated issues that don't have easy answers, but opening up and communicating about them is the first step. Sometimes, though, there is so much anger and misunderstanding that couples cannot sort things out alone. Finding a sex therapist that is also a licensed psychotherapist can be a tremendous help for couples in which one partner has bipolar disorder. Even if the disorder hasn't been diagnosed but is suspected, a psychotherapist can help the couple sort out symptoms and an appropriate treatment plan.

To find a sex therapist in your area, visit the website for the American Association of Sexuality Educators, Counselors, and Therapists. Be sure to ask the therapist whether or not he or she is licensed and if they have experience diagnosing mental illnesses. When a couple is in crisis due to a psychological problem like bipolar disorder, the treatment plan can be quite complex, so be prepared to spend more than a session or two discussing symptoms and history, and multiple sessions not only learning how to cope as a couple, but how to address concerns around intimacy and sexuality.