What is hypersexuality? Is it just about having a lot of sex, or is there more to it? And why don’t we hear more about this common symptom of bipolar disorder?

What could be the downside to having a lot of sex? Join us as Gabe and Dr. Nicole Washington explain the truth about hypersexuality.

Gabe Howard

Gabe Howard is an award-winning writer and speaker who lives with bipolar disorder. He is the author of the popular book, Mental Illness is an Asshole and other Observations, available from Amazon; signed copies are also available directly from the author. He also hosts Healthline Media’s Inside Mental Health podcast available on your favorite podcast player.

To learn more about Gabe, please visit his website, gabehoward.com.

Dr. Nicole Washington
Dr. Nicole Washington

Dr. Nicole Washington is a native of Baton Rouge, Louisiana, where she attended Southern University and A&M College. After receiving her BS degree, she moved to Tulsa, Oklahoma to enroll in the Oklahoma State University College of Osteopathic Medicine. She completed a residency in psychiatry at the University of Oklahoma in Tulsa. Since completing her residency training, Washington has spent most of her career caring for and being an advocate for those who are not typically consumers of mental health services, namely underserved communities, those with severe mental health conditions, and high performing professionals. Through her private practice, podcast, speaking, and writing, she seeks to provide education to decrease the stigma associated with psychiatric conditions.

Find out more at DrNicolePsych.com.

Producer’s Note: Please be mindful that this transcript has been computer generated and therefore may contain inaccuracies and grammar errors. Thank you.

Announcer: You’re listening to Inside Bipolar, a Healthline Media Podcast, where we tackle bipolar disorder using real-world examples and the latest research.

Gabe Howard: Hey, everybody. My name is Gabe Howard and I live with bipolar disorder.

Dr. Nicole Washington: And I’m Dr. Nicole Washington, a board-certified psychiatrist.

Gabe Howard: And today we’re going to be talking about hypersexuality. I feel I feel some ways, Dr. Nicole. Like it’s, like it’s dirty in some way. Do you find that a lot of your patients feel that way?

Dr. Nicole Washington: I think it depends on their upbringing and how they were raised. I have some people who are very, very open talking to me about sex because they see it as a very healthy bodily functions and they say, hey, you’re a doctor, let me tell you what’s going on. And then there are those people who are extremely shy and extremely hesitant to talk about it.

Gabe Howard: Hypersexuality has this problem in which people, I don’t think understand exactly what it is. Hypersexuality is not having a high sex drive. Hypersexuality is not having a lot of sex. In my mind, and this is not a medical definition, we’ve got Dr. Nicole for that here in a moment. In my mind, hypersexuality is a compulsion. It is a need. You have to do it because if you don’t, something bad will happen. It’s not about enjoying the act. It’s about completing the act.

Dr. Nicole Washington: When we tend to think about hypersexuality, we’re thinking about these sexual urges. It can be actual intercourse, it can be masturbation, it can be watching a lot of pornography that they just can’t control. I think it’s the control piece is where we kind of really hone in on when we’re talking about hypersexuality.

Gabe Howard: The whole hypersexuality conversation in society is a fascinating one. Because, I experienced hypersexuality and before I experienced hypersexuality, I saw the Hollywood version of it, and I thought, oh, hypersexuality is awesome, right? Because I believed that the definition of hypersexuality was just having lots of sex.

Dr. Nicole Washington: Yeah. I mean, the context is what’s important, right? It’s what leads you to have lots of sex that makes it hypersexuality.

Gabe Howard: There’s this idea that because you’re having lots of sex, it must be good. It is a lot of sex. But why are we automatically putting the word good in there? You can eat a lot of food. And it doesn’t mean that it’s good food, it doesn’t mean that it’s food that you like, it doesn’t mean that it’s quality food and it doesn’t mean that you’re enjoying the food.

Dr. Nicole Washington: Okay. So what you’re saying is, what I’m understanding is that you didn’t enjoy it? You were just doing it just to do it?

Gabe Howard: So once again, nothing is 100%. Right? I’m not saying that during bouts of hypersexuality there was never any good sex in there.

Dr. Nicole Washington: OK, OK.

Gabe Howard: It’s never 100%. But I personally would say that it ruined 90% of it. Maybe the first time. You know, the hypersexuality urges, you know, start to come up and, you know, you know somebody that you’re compatible with and you go and you’re like, hey, this is nice. All right. But the problem is, is for most people, it’s like, hey, they have satisfied the urge. The urge is complete, and then they can go on with their day. The problem that I would have is, yes, that sex was great. You know, I’m going to call it phenomenal. And then that person would leave and I’d have to do it again. Okay, well, maybe I can find phenomenal sex twice in a row, three times in a row. But the compulsion never ends. At some point, you’re just doing it to do it. You’re not even enjoying it anymore. And this is a big thing that I want people to hear. You start taking dangerous risks because partners do, in fact, dry up.

Dr. Nicole Washington: Right.

Gabe Howard: So you start visiting sex workers or you start injuring yourself in some way. And for me, full disclosure, I was married during some of these episodes, which meant I started cheating on my spouse. And I’m not, I don’t want anybody to hear that it’s okay that I cheated on my spouse because I had hypersexuality. It’s not. But it is a discussion that needs to be had for a lot of people. It is a symptom of bipolar disorder. It’s not as clear cut as, oh, he’s a cheater, throw, throw him out. It’s difficult for everybody.

Dr. Nicole Washington: Yeah, I see that a lot. So I’ve seen tons of couples, whether it’s the husband or the wife or, you know, have these hypersexual because their partner can’t keep up. Right? Like you said, they’re like an Energizer bunny and their partner is like waving the white flag, tapping out and the person is like, okay, well, if not you, it’ll be somebody because I got to get this done. And that’s what, that’s what happens. Which is really sometimes irreparable damage is done, you know, so, fortunately, you know, you were able to not have irreparable damage be done.

Gabe Howard: Oh, no, we’re divorced.

Dr. Nicole Washington: Oh.

Gabe Howard: The damage was irreparable. That marriage is over. I also want to point out, you know, people talk about hypersexuality and they think of sex. They think of sex. See, hypersexuality manifests itself in other ways, too, like chronic masturbation. And look, self-stimulation is fantastic. I’m not shaming that at all. But if you’re not enjoying it, if you’re doing it because it’s a compulsion and if you literally complete the act, you know, get up, take a shower, and 2 minutes later you’re back doing it again? At some point you have to ask yourself if this is not fulfilling your sexual urges, why are you doing it? And that to me is where the conversation around hypersexuality really takes a turn. If it is not meeting your sexual urges, why are you doing it?

Dr. Nicole Washington: But during mania, I mean, are you thinking that about anything? I mean, when you’re, when you’re in a manic state, are you thinking, oh, I’m going to spend $1,000 on lip gloss? Why am I doing this? It doesn’t make good sense. I mean, I mean, isn’t that part of the whole, like, doing it but not thinking about the consequences of it?

Gabe Howard: There are, there are so many things about bipolar disorder that I think that people don’t consider. And one of them is, as you illustrated in the way that we talk, I’m talking about it like it happened in the moment. Right? Like I’m on masturbation session number ten and I’m thinking, oh, this is bad. No, no, no, no, no. I’m not thinking that until a week later when I reflect back and I think, what? What the hell was going on? Why did I skip work for a day? Because think about this for a moment. See, these are the, this is the compound thing that I don’t think that people think about. In order to sit at home all day and masturbate, it means you’re not doing anything else. What did you miss? Did you miss a promise to your parents? Did you miss a promise to your spouse? Did you miss work? What was going on there? And then when these people are upset, Gabe, where were you? You know the answer. The answer is in your head. How do you look at your mom and tell her that you missed that family function because you stayed at home masturbating? And then shame starts to creep in.

Dr. Nicole Washington: First of all, let’s not tell mom that that’s why you missed it. Like,

Gabe Howard: Exactly.

Dr. Nicole Washington: Think this is, I think this is one of those times we can probably come up with some other response as to why. But I don’t ever want my kid telling me, hey, I missed this family event because I was masturbating all day. I don’t want that.

Gabe Howard: So, Dr. Nicole. First off, I agree with you. And I want everybody to know, lied to my mother. Honesty is important in this show. I straight up lied to her because I wasn’t telling her. But but but here’s the thing. Now, now, think about this for a moment. You’re a doctor. Now. Now, my mom is not a doctor. But you, Dr. Nicole, are a psychiatrist. So if your child, son, why did you not do this or daughter, why did you not do this? And they said, well, I, I stayed at home and I masturbated 15 times in a day. How many red alert bells are going to go off in your board-certified psychiatric brain that something is wrong and that your child needs help?

Dr. Nicole Washington: Oh, they’re getting a full psychiatric evaluation right there on the spot. We’re going to. We’re going to talk about everything.

Gabe Howard: Right. But they lied,

Dr. Nicole Washington: They did.

Gabe Howard: Right? They lied. So they told you instead? Oh, I fell asleep. Because we’re not good liars when we’re covering up stuff like this. Right? It’s always a bad lie.

Dr. Nicole Washington: That’s true.

Gabe Howard: I fell asleep. I got. And. And now you’re angry. So now not only do they have this untreated symptom that everybody around them is now unaware of, but everybody’s pissed off at them.

Dr. Nicole Washington: True. True.

Gabe Howard: You slept through Nana’s birthday? How could you sleep through Nana’s birthday? You know, I told you, if you stayed out that late, just. I can still hear the lectures reverberate in my brain for commitments that I missed.

Dr. Nicole Washington: Do you wish you had been honest? Like, do you wish looking back that you had said, hey, this is what I’m dealing with. This is why I wasn’t there?

Gabe Howard: I think that my mother would have reacted how any typical person would react to being told that a loved one stayed at home all day masturbating. And I want to be fair to like all the parents out there. If my parents told me that they did. Let’s reverse this. Mom, why didn’t you come to my birthday party? Because I stayed at home all day masturbating. I’m not running to get her help either. I’m like, Oh, I can hear myself screaming, so I’m not getting her help either. So I think we might have ended up in the same place. But I have to ask how many white lies, how many misdirects, does the average person with bipolar disorder tell? Which gets them one, further and further away from their support system. Problematic. And they just get so used to it that when somebody actually, like a Dr. Nicole says, Hey, what was going on last Thursday? You’re just so used to lying that you now believe it.

Dr. Nicole Washington: Right. Right. So was your family aware of your bipolar diagnosis at this point?

Gabe Howard: Nope.

Dr. Nicole Washington: They were not. Okay.

Gabe Howard: Nope.

Dr. Nicole Washington: Because I was thinking, well, you know, maybe that’s part of the thing.

Gabe Howard: I wasn’t aware of it either. I should probably point that out just so we’re we’re

Dr. Nicole Washington: Okay.

Gabe Howard: All playing with a stacked deck. None of us had any idea. See, let’s address another thing with hypersexuality. I was raised Catholic. My parents love me. Everybody loves me. Sex is a shameful act. I don’t like this about our society. But it was a part of my culture and my upbringing

Dr. Nicole Washington: Right.

Gabe Howard: Where sex was still this private thing. We discussed it, you know, kind of like Family Guy discusses it. Like super dirty jokes were okay. But actual facts, not. Not, not so much.

Dr. Nicole Washington: Hmm. Okay. So this was before your diagnosis even.

Gabe Howard: Yeah. And I was a young adult. So this is early twenties. And I do want to point out, Dr. Nicole, that I had a couple of advantages here. One, I was married, and two, I’m a man. So this becomes even more difficult if you are a 20-year-old woman who is unmarried. Looking back, I had it easy.

Dr. Nicole Washington: At what point did you realize, like, oh, I think this is something’s wrong?

Gabe Howard: There was a couple of moments that really stood out to me as very, very problematic. First and foremost, I started hiring sex workers. So sex workers came with a double whammy. One, it’s illegal. I was now committing a crime. So let’s move sex out of the picture for a moment and talk about the fact that I was engaging in illegal behavior. So this upped the ante. Right? We have to be fair and discuss that. Two, it’s expensive. It’s not a, it’s not a cheap thing to do, especially when you’re looking at hiring dozens of times in the average week. Start adding those up and it becomes very, very expensive. Finally, I was exceptionally vulnerable, which means I was exceptionally desperate and I was very easy to take advantage of. And I got taken advantage of a lot as well, which became very expensive. I was scammed multiple times and I was spending hundreds of dollars, thousands of dollars on an illegal activity.

Dr. Nicole Washington: And you know, the doctor in me, the physical risk that you were putting yourself at. The increased risk of disease. Because, you know, I ask my patients after the episode is over and we can have a discussion about it, and not one of them tells me, oh, yes, I was very responsible and made sure I wore condoms and made sure he wore condoms. And yeah, we were very responsible during my mania. So there’s always even the risk of sexually transmitted diseases and things like that.

Gabe Howard: There’s the risk of pregnancy.

Dr. Nicole Washington: Yes.

Gabe Howard: Right. I mean, you’re. One, yes. Sexually transmitted disease. Absolutely. But pregnancy. I just I’ve just explained to you where my mind was and what I was going through. So clearly, I’m nine months away from being a good parent. This is with a stranger.

Dr. Nicole Washington: Yeah. What do you say to that person who’s out there listening to you thinking, I’m not honest about whatever it is, hypersexuality, spending lots of, whatever it is, I’m not honest. Looking back, what kind of advice do you have for that person?

Gabe Howard: The first advice I have is if anybody is listening to this and wondering whether or not they’re hypersexual, you probably are. I’ve really sort of learned that along the way. This is not kind of something that you stumble into accidentally. The second thing that I want to say is this isn’t lots of sex. Don’t think to yourself, Oh, I must be hypersexual because I want to have sex once a day and my partner only wants to have sex three times a week. That’s not what hypersexuality is. This is a compulsion. But I still go back to, if you wonder, this is the part that we need to get checked out, so often, Dr. Nicole, in people that I talk to with mental health issues, psychiatric problems, etc., they believe very strongly that they must know that something is wrong and what it is before they can see a doctor. We don’t feel this way in physical health.

Dr. Nicole Washington: I feel like you’re spying into my life because this is exactly how a lot of my encounters go with people. They come to me telling me. But I do think some of that is because we like to call them behavioral disorders, right? So people think, well, it’s a behavior. I should have control over it. And they don’t really quite understand that there are some things you won’t be able to control. I think you bring up a good point about hypersexuality as a problem is much different than I want to have sex once a day; my partner wants it three times a week. Because even in that, you can control that, right? Like you can say, okay, fine. You might be upset about it, but you can control it. I think what you’re describing is something you can’t control, like it’s an overwhelming urge and you just can’t fight it.

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Gabe Howard: Dr. Nicole, I want to get back to the part about our partners, especially, you know, long-term relationships, marriage, significant others. We have the symptom of hypersexuality. And let’s remove the trust issue of stepping out. So, no affair occurred, but your significant other is now chronically masturbating and hounding you for sex every day and getting agitated because, you know, agitation tends to follow when you can’t meet this need. This causes huge strains in relationships. And again, I want to be clear that nobody stepped out. It’s just I want to have sex. We just had sex. Fine. Then I’m going to go masturbate. What? I’m not good enough? I just. My spouse is watching. My partner is watching all kinds of porn. There’s just porn, porn, porn, porn, porn. He’s an addict. And all of the sudden, this very serious symptom of bipolar disorder has now been reduced to my partner is sinning, or my partner is bad, or my partner doesn’t appreciate me, or my partner doesn’t love me anymore. Or of course, what we often hear is my partner thinks I’m ugly.

Dr. Nicole Washington: Mm-hmm. That’s all 100% accurate. But do you think the time to have the conversation or the time to even deal with it is while it’s going on?

Gabe Howard: Therein lies the rub. Look, no, no. When I’ve been hypersexual, you were. You weren’t going to have a conversation with me. Could you imagine if you could just reason with people who are suffering from the symptoms of mental illness? What kind of nonsense? Just. Oh, he’s got cancer? Just talk to him. Just talk to him and tell him to stop it. No, you can’t reason with somebody who’s actively hypersexual.

Dr. Nicole Washington: But isn’t that what people do? They try to reason with their loved one during a manic episode? Which is

Gabe Howard: They do.

Dr. Nicole Washington: Like beating your head against a wall.

Gabe Howard: It’s exactly like beating your head against the wall for both sides. But you said, is that the time to deal with it? I mean, kind of. You can’t just let your loved ones suffer from a very obvious symptom and do nothing.

Dr. Nicole Washington: I guess I don’t mean deal with it. I mean to have a rational conversation about it. Right? Is it the time to talk through like, oh, you’re doing that thing, you know, is it the time if we’ve never talked about it before?

Gabe Howard: Exactly. If there is not an open dialog before, if nobody knows it before, if this is the first time you’re noticing it, once again, this is where people like Dr. Nicole earn, like this is why we need them. This is where you earn all of my respect because you’re going to get this phone call. And I know you’ve gotten this phone call. This sounds something like this, I think there might be something wrong with my partner. Okay, well, what’s going on? Well, you know, he’s masturbating a lot. Is that, is that wrong? And then what do you say to that?

Dr. Nicole Washington: Well, first of all, I have to figure out, is it wrong? Right? Because so many people think sex is so bad and dirty that if anyone masturbates at all, then they’re like, oh, something’s wrong with them. So I have to kind of tease through like, what’s a lot? Like my definition of a lot and your definition of a lot might be way apart. So I have to figure out. Is this just normal sexual behavior? Right? And then once I find out it is a lot, then we have to go digging through what else that’s going on.

Gabe Howard: I love everything that you said there because there’s so many people that believe if you masturbate once in your life, you’re some sort of evildoer. You’re.

Dr. Nicole Washington: You’re going to go blind.

Gabe Howard: Well, yeah, you’re going to go blind.

Dr. Nicole Washington: You’re going to go blind.

Gabe Howard: I don’t want to shame sex. To all of the people listening, who are like, Well, look, I like to have lots of sex. I, I go to the club, I got my outfits, I, you know, I got 15 people in my phone. I got my sneaky links. I’m just. Look, I’m not judging you.

Dr. Nicole Washington: Sneaky links?

Gabe Howard: Yeah, sneaky links.

Dr. Nicole Washington: Yeah, your sneaky links. Okay.

Gabe Howard: I’m not judging any of that. I just think that we don’t have an understanding of when that crosses a line.

Dr. Nicole Washington: Yeah. I mean, that sounds like I always tell patients when they ask me and what they describe as normal, like, do you. As long as you’re not hurting yourself or anybody else and you have true control over it, I can’t tell you not to do that or that it’s abnormal, but I think we have to figure out then how do you know? Like, how do you decide, oh, this is abnormal? And then what do you do about it? Because treatments are different, right? And hypersexuality in bipolar disorder is going to be treated very differently than someone who has maybe a sex addiction who may also be hypersexual. So I think we really do have to talk to somebody who knows what they’re talking about to get to the bottom of it so that we can fix it.

Gabe Howard: It really sounds like you’re saying see a doctor.

Dr. Nicole Washington: I mean, that is my general recommendation to see a doctor. But yeah, I mean, not just talking to, you know, your friend who also has bipolar disorder, who doesn’t really get it either. Sometimes what I see in my patients is they will tell me once it all comes out. Right? And usually when does it come out? When they’re in the hospital, when they’re in the psych hospital, because they’ve been hypersexual and manic for two weeks and they were found masturbating like, you know, in a McDonald’s bathroom or something because they just couldn’t help it. Right? Like I just had to. So, you know, they’re in front of me and I’m asking the story and they’re like, well, I talked to my friend. Well, who’s your friend? And you find out, well, I met him when I was in here last time and I talked to him sometimes and that’s great. Like, community is fantastic. Having somebody to talk to who understands that, who gets it is great. But you got to think maybe that person isn’t equipped to really give me great advice. So making sure you’re talking to the right people is really what’s going to kind of flip the script for you.

Gabe Howard: I like how you phrased that, Dr. Nicole, and I want to just take a moment to address that. Community is great. Talking these things out with people is great, but your community is allowed to be wide. I think so often people believe that this is an either-or conversation. You’re either talking to the medical community or you’re talking to your friends. Both of those are wrong. You should be talking to everybody. Talking to your friends could give you words, ideas, concepts, better ways to explain what’s going on and advocate for yourself in the doctor’s office. The doctor, training. You went to school for years and years and years. So now that person is saying, look, I feel that I have this in common with Bob or Jane. And, you know, she really explained it this way. And I do feel like this is what I have. And that allows you to better understand because now you’re not dealing with somebody, you know, sort of like scatter shotting around, not knowing what is valuable or what is not.

Dr. Nicole Washington: Right.

Gabe Howard: Listen, could you imagine if we lived in a society where every contractor was only allowed to have one tool? Like, that’s it.

Dr. Nicole Washington: Yeah.

Gabe Howard: Just are are you a general contractor? Yes. Well, what kind?

Dr. Nicole Washington: Here’s my hammer.

Gabe Howard: Hammer. That’s it.

Dr. Nicole Washington: Here’s my hammer.

Gabe Howard: That’s all I can use.

Dr. Nicole Washington: Yeah.

Gabe Howard: I can only use the hammer. This wouldn’t work.

Dr. Nicole Washington: So I have a question for you. Now that you’re well educated on this whole thing, right, like, you know, you get it. How do you talk about it when you’re not in a manic phase to help you out when you are in that phase and the hypersexuality comes? I’m a big fan of the mantra of stay ready so you don’t have to get ready, right? So

Gabe Howard: I love that.

Dr. Nicole Washington: If you know it’s coming when your mania hits, how do you and your support system, how do you preemptively plan for it? Like, what do you do?

Gabe Howard: The first thing is, I’m very, very fortunate. It took four years from the time I was diagnosed to the time that I reached recovery. Which I define as spending more of my time living my life than I do managing bipolar disorder. I have not had a manic episode since then. I’ve been mania free for well over a decade. That said, we really do need to think about an ounce of prevention is worth a pound of cure. During the four years, right? It’s just like, hey, you have bipolar disorder. I didn’t have any coping skills. I’m just now getting onto the medication. So I had a very open conversation with the person that I was in a relationship with at the time, and I gave her a lot of access. I was like, Look, you are in the best position to notice some of these things. And I signed all the HIPPA waivers so that she could talk to my therapist and my doctor and give that information. Another thing that I did is in my mood journal, people are really quick to track things like sleep. When did you take your medication? Are you feeling suicidal? Are you experiencing mania? But people are less likely to track their libido. Put bluntly, they’re less likely to track whether or not they’re horny. And if you have experienced hypersexuality in the past, or if you have experienced full-blown mania, or this is just even a concern that you want to get ahead of, write it down. Write down how you feel. How you feel sexually, maybe whether or not you had sex or masturbated and keep track of that and notice any patterns. And I did that. And I did find out that I did have a higher than average sex drive. But I also found out that, you know, I was I was younger. You know, I was 28 years old having a higher than average sex drive. That’s not a problem. Right. But I didn’t know. Nobody told me what normal was.

Dr. Nicole Washington: Right.

Gabe Howard: And that’s that was really something. So once I figured out, for lack of a better phrasing, what my baseline was, then we could decide whether it was changing. And, Dr. Nicole, I know this episode is about hypersexuality, but we also noticed, my doctor and I, my therapist and I, we also noticed that it dropped significantly right before very depressive episodes,

Dr. Nicole Washington: Right.

Gabe Howard: Not so much anymore because, you know, I got old, but, you know, back in my twenties and early thirties,

Dr. Nicole Washington: Mm-hmm.

Gabe Howard: If my libido would drop and then I’d have trouble sleeping, we could predict depression a week ahead of time, just by using this handy little chart that, listen, I kept on paper. And now there’s like, apps. Kids these days have it so easy.

Dr. Nicole Washington: Oh, my gosh. I did want to add, I think part of your plan, while we’re talking about that plan, when your mood is normal, if it’s somebody who’s let’s say they’re early on in their illness, maybe they don’t have a handle on the right medication. Maybe they’re more likely to have a manic episode because we still don’t have this thing right. Or maybe it’s somebody who’s just struggling with the idea of taking medication for something like this and they’re at risk of having hypersexual behavior because that’s what their episodes have been like before. I usually have a discussion about the sexually transmitted illnesses, the STIs. We talk about them, we talk about prevention. I have some folks who have elected to take some of the PrEP drugs. Right? The pre-exposure prophylaxis, HIV drugs, because they know that because they’re bipolar disorder isn’t very well controlled. Regardless of what the reason is, having that on board, we think makes the biggest sense for them. So if they can take something. So just be thinking about that. I have some people whose partners take it also. And just to get regular testing, seeing your primary care physician after an episode, if you’ve engaged in some risky behavior just to make sure we’re all working together. So you really should have a whole team of people working with you during this time.

Gabe Howard: Dr. Nicole, it’s always super important to have these discussions and have these discussions when you’re not in crisis, if you’re not willing to have these conversations with your doctor, if you’re not willing to talk about hypersexuality with your doctor, if you’re not willing to look into every nook and cranny of bipolar disorder symptoms, including the embarrassing ones like hypersexuality, you’re doing yourself a great disservice. Listen, doctors, they don’t care. I hate to say it that way. You can talk about sex and masturbation with your doctor. That’s what they’re there for. And good doctors like Dr. Nicole, bring it up. Dr. Nicole, do you encourage all doctors to ask their patients about their sex life and just really get in there?

Dr. Nicole Washington: I do encourage them to ask because a lot of times if you don’t ask, they will not tell you. You have to be the one to bring it up. Sometimes it is like opening Pandora’s box. You know, it is very helpful for me to be able to figure out what’s going on and not just about hypersexual behavior. Even sexual side effects from medication, things like that. If I don’t ask, people will walk around with that. And I can tell you that is one of the top reasons that people stop their meds because it interferes with their sex life. So if we don’t ask, we may be setting someone up for failure.

Gabe Howard: Thank you, everybody, for listening. My name is Gabe Howard and I am the author of “Mental Illness Is an Asshole and Other Observations,” which you can get on Amazon or you can find it signed over on my website at gabehoward.com.

Dr. Nicole Washington: And my name is Dr. Nicole Washington, and you can find me at DrNicolePsych.com. D R N I C O L E P S Y C H dot com to see all the things I have my hand in at any given moment.

Gabe Howard: Dr. Nicole and I are both public speakers who travel nationally. You can find out more information on our respective websites and listen, wherever you downloaded this episode, please subscribe or follow. It is absolutely free and do Dr. Nicole and I like a huge favor. Tell a friend. Tell a colleague. Tell a family member. You know that person from high school that you just haven’t talked to in years? Tell them about the Inside Bipolar podcast. We will see everybody next week on Inside Bipolar.

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