People with bipolar disorder may experience libido changes, impulsive sexual behaviors, and other intimacy challenges.
We all approach sex and relationships in different ways based on our unique experiences. This is especially true for folks who live with mental health conditions or mood disorders, such as bipolar disorder.
How you navigate intimacy and sexual health can be affected by:
- the type of bipolar disorder you live with
- if you’re experiencing a manic or depressive episode
- whether your condition is diagnosed and managed well or not
But rest assured, it’s totally possible to have a healthy sex life and successfully bond with partners if you have bipolar disorder.
“There’s so much stigma around mental health, mood disorder, and specifically bipolar [disorder], that the person and their partner(s) are left with a ton of questions and fears,” says sex educator Rebecca Blanton, who also goes by Auntie Vice and lives with bipolar I disorder.
Sex and gender exist on a spectrum. We use “women” and “men” in this article to reflect the terms historically used to gender people. However, gender identity is solely about your personal sense of self, independent of your physical body.
Sex drive symptoms in women with bipolar disorder versus men and other genders can vary greatly, as with any other person with or without a condition.
Still, some research highlights nuances between men and women.
For example, men with bipolar disorder may:
- have a higher number of sexual partners
- have higher rates of casual sex
- get their sexual dysfunction treated more often by doctors
On the other hand, women with bipolar disorder may have a higher libido during manic episodes.
A 2016 study with a small sample size suggests that women are more likely to experience a higher libido during elevated mood states. Researchers also indicate that “increased sexuality” was seen within 65% of manic episodes.
“Very typically, an individual’s desire for sex changes during bipolar episodes,” says Kara Hicks, a clinical social worker who practices in Fort Lauderdale, Florida. “However, this isn’t true of every individual with bipolar disorder.”
Does having bipolar disorder make you more sexually active? Not exactly.
Hicks notes that folks with bipolar disorder might experience the following changes:
- increased arousal
- euphoria related to sexual gratification
- impulsive decision making related to sex
The Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) notes that increased sex drive, fantasies, and behaviors are common as well.
“In depressive phases, the sex drive for many people with bipolar disorder is depressed as well,” says Blanton.
She notes that people with bipolar disorder:
- might have a low sex drive (or none at all)
- may not be able to become aroused
- may not be able to emotionally connect with a partner deeply or at all
Mood stabilizers and other medications for bipolar disorder can cause a decreased sex drive, too.
Impulsive sexual behavior
A 2016 study suggests that men with bipolar disorder have more sexual partners and have sex with strangers more often than women with bipolar disorder.
Hicks says some bipolar disorder symptoms can trigger behaviors and impulses that may put the person with bipolar disorder at risk of:
- sexually transmitted infections (STIs)
- sexual violence
- unintended pregnancy
According to the DSM-5, two of the main criteria for a manic episode are:
- increased “goal-oriented activity” (which can be sexual in nature)
- “excessive involvement in activities that have a high potential for painful consequences,” including “sexual indiscretions”
Blanton says some sexual activities that may have unwanted consequences can include:
- casual sex
- having sex without negotiating boundaries and consent
- engaging sex workers (if this is usually atypical behavior)
Safer sex practices, such as using barrier methods like condoms and being clear on consent, may not be prioritized during manic episodes, either.
“Many of the drugs used to help people with bipolar disorder suppress the sex drive, cause vaginal dryness or erectile dysfunction, and make people feel emotionally numb,” adds Blanton.
She also points out that certain bipolar disorder treatments that cause sexual dysfunctions are addressed more often for men than women.
“While a doctor will be open to prescribing erectile dysfunction medication to a man, the stigma of addressing a woman’s sexuality will lead many doctors to simply tell her to ‘deal with it’ or ‘buy lube,’ neither of which addresses the real issue,” Blanton explains.
Changes in stimulation needs
Manic and depressive episodes can also change how each person experiences touch and stimulation, says Blanton.
“For some, a manic or depressive phase may require more intense stimulation, more frequent sexual need, and [create] a higher pain tolerance than when they’re balanced or depressed. For others, mania or depression can heighten sensations, requiring partners to be more gentle than usual,” she explains.
Can folks with bipolar disorder bond intimately?
Yes, of course they can! People with bipolar disorder may experience unique challenges surrounding intimacy, but bonding and fostering healthy relationships is entirely possible.
This is especially true if they’ve received a diagnosis, are in therapy, taking medication, and openly communicating with their partner(s) about their experience.
Is cheating common with bipolar disorder?
The DSM-5 does suggest that a person with bipolar disorder may engage in sexual behavior that is not typical for them, which may include infidelity.
But this does not mean every person with bipolar disorder will cheat on their partner. Anybody can cheat. There are many reasons for infidelity other than a mental health diagnosis.
“However, there’s no clinical research which shows people with bipolar disorder
People with bipolar disorder can experience many different sexual changes (or no changes at all!) during mood episodes. Sex and bipolar disorder share a unique relationship for each person.
“Finding a clinician who understands that love and sex are critical to well-being is incredibly important to helping folks with bipolar disorder manage their conditions,” says Blanton.
Leaning into available resources and a caring support network can help you find relief, too.