hypomania and hypersexuality

I wanted to put this in the bipolar section instead of sexuality, I think it's more appropriate here.

I've had bipolar (1) disorder for about 28 years. I'm noticing my sex drive is always in full throttle. Actually, I've noticed this for at least 10 years, but my doctor and counselors just say it's normal to be this charged up as a normal male. So I haven't spoken up because I thought it was normal. But it can't be. My doctor denies that I could be having bipolar hypersexuality in the context of hypomania. Actually I think I have depression and hypomania at the same time, and so on my next doctor visit, I'm going to suggest taking away the sertraline from my mix. My lithium level is pretty normal, and I hate to add to it.

We who suffer from bipolar disorder sure have to sift through a lot of confusing advice, don't we? I know this isn't a normal level of sexual thoughts. This is the same doctor who claims Abilify won't affect your motivation level, and that it doesn't play a role in addictive behavior. Right.

I wish I could get to see a different doctor. My insurance will not cover anyone but him in this area, and it has to be a state run clinic.

I guess my question is: this is becoming problematic, and I don't want to ruin my relationship with my girlfriend. Is this a pretty common problem for people with bipolar disorder?

How on earth could your insurance plan only have a single psychiatrist on its panel? That just does not make any sense to me.

It does sound like you are dealing with hypersexuality of hypomania. If you don't get it addressed somehow, you are very likely to damage your relationship with the GF beyond repair. Maybe look into Depakote. I have had good luck with it recently for a pretty severe mania. I hope you can find a way to get that done.

I've never actually been diagnosed as having Bipolar Disorder although one psychiatrist I saw said she thought there might be a "bipolar element" to what was going on with me (whatever that means.) Having read just a little bit on the subject of Bipolar II I can see where that diagnosis might actually have fit though.

I guess the thing I wanted to say was that, when I was young (I'm an old geezer now) my own hypersexuality led me down some dark, disturbing & destructive paths. You asked if hypersexuality is a common problem for people who have bipolar disorder. And I can't answer that. What I can say is that, whatever my diagnosis might have been way back then, hypersexuality was certainly a big problem for me.

Here's a link to an article, from PC's archives, on the subject of hypersexuality, sex addiction & bipolar disorder:

Bipolar Hypersexuality or Sex Addiction? | The Impact of Sex Addiction

hartbroken, I think it's wrong for your doctor to casually brush off your concerns. You know, I kind of wonder if your doctor's response would have been different if you were a female and not a male? I remember once mentioning hypersexual behavior to my male psychiatrist and he made a big deal about it, sternly and loudly saying "WATCH IT!" I often wonder if one of his male patients would have received such a strong warning. But the fact, in my book, is that there should be no difference.

I think that any symptom that can cause distress must be taken seriously. I'm not sure how you can get that through to your doc, but he really should pay more attention.

My past hypomanias and full blown manias did not always include hypersexuality. Sometimes that category of symptom showed itself in other ways. Some people hyperspend or gamble. Others sleep around in a disinhibited way. Some take on other dangerous pursuits. Maybe some might result in getting arrested by cops, but those are not so very different than wanting sex 24/7 and being disinhibited or impulsive enough to seek it from others they shouldn't seek it from.

I've got great respect for you for wanting to address this issue. Your insight into it as a problem is also admirable.

Whenever I've mentioned my hyper sexuality to my pdoc or case manager as a symptom, they kind of blow me off as if its not a symptom at all. But I know that I've had serial sexual relationships- just go from one guy to the next for just sex (maybe dinner). That's all they wanted and that's all I wanted. Not that the sex was good- it wasn't; I'd have to find a long-term relationship to find that. Still, I have periods when I'm just really "revved up" sexually, and you'd be hard-pressed to tell me "no"!

I read the article you posted a link to. It's interesting about the high percentage of bipolar patients and sex addicts who had an experience of childhood sexual abuse. I can't remember anything really early on, but when I was 18 I was pretty naïve and simple minded, and I was seduced into sex with a woman who was 31 years old and seemed mentally unstable in some ways. Although part of me was curious, I really didn't want to do anything with her, and I let her know that after the first sexual encounter. She emotionally manipulated me into more sex, which was followed by more pleading on my part to stop the whole roller coaster ride. After a year, I found the strength to end everything. It was about 5 months later I had my first psychotic break and severe mania.

The point about the differential treatment of women is so true, BirdDancer. Thank you for pointing it out!!!!

Yes experiencing hypomania is a symptom of specifically bipolar 2, which you’re in luck I’ve been diagnosed with. It has resulted in many reckless sexual exploits with many random people. Medication that treats bipolar disorder usually will decrease your sex drive relieving you of your symptoms. I will warn you that the medication can also cause something known as hypo-sexuality, meaning you're sex drive is non existent. The trick to treating this disorder is finding the right meds. I’m sorry your struggling from this the guilt it brings is not pleasant.

Hypersexuality is usually my first sign of hypomania. I take my prn seroquel and half an hour later I no longer have to deal with it.

So for me it is a part of my bipolar symptoms.

Also when I was younger and not diagnosed with bipolar but with major depression, looking backwards, I probably was having mixed episodes and hypersexuality was part of it.

Absolutely, yes. I've been married for 33 years, but along the way I've had three affairs. They were extremely sexual. Do I regret it...I regret one of them. The other two, honestly they were a time and place that made sense.

Is the revved up sex drive only problematic while hypo, or is it a constant issue?

If you're experiencing it outside of your hypo cycle, my best guess is that it probably is physiological and maybe being male actually does have something to do with it, not coz your mind's in the gutter but coz you're testosterone levels could be sky rocketing.

I have this problem when manic. Before I was married (and even shortly after I met my husband almost) I ruined lots of relationships because of it. Now I just (sorry for tmi) release the tension through masturbation. It’s the only thing I know to do when I get that way. During the worst manic episode I’ve had to date, I literally masturbated 10 times in one day. My husband has no idea either. It would be really awkward I think to fill him in on it.

Also, my t and pdoc (this one and ones of the past) have ALL always acknowledged hyper sexuality.