What you need to know about hypersexuality and bipolar disorder

Hundreds of thousands of Britons living with bipolar disorder could be experiencing periods of hypersexual behaviour, a new landmark study has revealed. This marks the first time hypersexual behaviour and bipolar disorder have been linked, study authors say.

The research, which has been highlighted in The Lancet Psychiatry journal, was published by mental health charity Bipolar UK. The charity commissioned a survey of more than 1,500 people and found that 88% of respondents said they had experienced hypersexual behaviour.

Dr Clare Dolman, lead researcher and co-chair of the Bipolar Commission, said hypersexual behaviour is a “hugely under-researched symptom” of bipolar disorder. The charity carried out the survey to understand how prevalent the behaviour is and what impact it has on individuals with bipolar disorder and their families.

“Not only do the vast majority of those living with bipolar experience hypersexual behaviour, but over half (54%) have experienced more than eight periods of hypersexual behaviour, with two-thirds saying that each period of this behaviour had lasted for a month or more,” she continued.

Hypersexual behaviour during bouts of mania - a phase that is characteristic of bipolar disorder’s extreme mood swings - can come with many risks, including putting the individual in dangerous situations.

The survey found that most respondents said they were more sexually active during these periods of hypersexuality. 69% said they tried to seduce someone, and more than half (54%) said they put themselves in potentially dangerous situations as a result, said Dr Dolman.

Here's everything you need to know about hypersexuality and its impact.

What is hypersexuality?

Marie Morice, clinical sexologist and founder of Lilith Your Life, explains that hypersexuality is a condition characterised by an excessive preoccupation with sexual thoughts, feelings or behaviours that may interfere with an individual’s daily life and relationships.

Also known as compulsive sexual behaviour or sex addiction, hypersexuality often manifests as persistent and uncontrollable sexual impulses and urges, Morice adds.

“This is not to be confused or amalgamated with high libido; having a high sex drive is never a concern unless it interferes with a person’s relationships and daily life or mental health.”

While it is not known how common hypersexuality is, research suggests it may be more common in certain populations, such as among people with mental health conditions like bipolar disorder. The exact cause of hypersexuality is not known.

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Symptoms of hypersexuality include:

• An inability to control or reduce sexual behaviours

• Engaging in sexual behaviours despite adverse consequences, such as failed relationships and issues at work or school

• Engaging in sexual behaviours despite experiencing little to no satisfaction from doing so

Morice emphasises that experiencing periods heightened sexual desire and activity are normal and not indicative of hypersexual behaviour. But hypersexual behaviour can result in severe impact to those who experience it. They may:

• Neglect their responsibilities

• Develop unrealistic expectations of sex and relationships

• Feel shame and experience a decrease in their self-esteem

Reflecting on the survey results, Dr Dolman added: “The consequences of this can be devastating. Over half (54%) lost a relationship, with a quarter saying that they had contracted an STI, and 19% saying it had resulted in an unplanned pregnancy.

“Disturbingly, 22% of respondents said they had been raped during a period of hypersexuality (28% of women, 9% of men), and more than a third said they had been sexually assaulted (42% of women, 15% of men).”

In addition, 40% of respondents said this symptom left them feeling ashamed, with a further 61% experiencing suicidal thoughts.

How is hypersexuality treated?

According to Morice, treatment for hypersexuality may involve therapy, medication, or a combination of both. “Cognitive behavioural therapy (CBT) and psychotherapy can help individuals understand and manage their sexual behaviours, while medications such as selective serotonin reuptake inhibitors (SSRIs) may be prescribed to address underlying mental health issues.

“As researchers have documented the enormous diversity of healthy sexuality, the professional consensus has shifted to the view that while a tiny fraction (2%-6%) of the population struggles with sexual compulsivity, sex addiction is not an official mental disorder,” she added.

“For the substantial majority of those diagnosed as sex addicts, the real issue is not their sexual activity but having been raised with sex-negative beliefs and/or suffering from an underlying mental health condition.”

Why is the link between hypersexuality and bipolar disorder important?

Researchers say the findings of this new study is significant as it can help both healthcare professionals and people with bipolar disorder recognise hypersexuality as a symptom of their condition. Currently, it takes an average of 9.5 years to get a diagnosis of bipolar disorder after an individual first tells their doctor about symptoms.

“These findings are an important step forward in understanding the challenges faced by people living with bipolar,” Dr Dolman said. “This is crucial because once someone recognises that it’s a symptom, they can take steps to protect themselves should they become unwell again, and they can also begin to let go of any unresolved shame or blame.

“It’s also important because healthcare professionals need to recognise, talk about and offer treatment for this common symptom.

“Research suggests that more than half of people with bipolar don’t have a diagnosis. So, if you - or someone you know - can recognise this behaviour, it’s worth asking. ‘Could it be bipolar?’”

Simon Kitchen, CEO of Bipolar UK, added: “There is not a ‘one-size-fits-all’ approach when it comes to treating bipolar, but medication, support and self-management strategies are key protective factors.

“The message we want to get out to anyone who’s struggling with any of the symptoms – including hypersexual behaviour - is that, with the right treatment and support, it is possible to live a full and meaningful life with the condition.”

If you are living with bipolar disorder and need support, you can reach out to Bipolar UK. You can also access the charity’s resources, including its Mood Tracker app.

Read more about mental health:

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• Bipolar made me suicidal but now I’ve completely rebuilt my life (Yahoo Life UK, 7-min read)

• How erectile dysfunction impacts men's mental health, according to new research (Yahoo Life UK, 4-min read)