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Little has been published on mania-induced hypersexuality and many psychiatrists skirt the issue on this sensitive subject. The limited studies of people with bipolar disorder conclude that hypersexuality occurs in 57 percent of all patients with mania (ranging from 25 to 80 percent). Ultimately, when sex crosses the line from pleasure to compulsion, it can become a destructive problem for many. Here’s what you need to know:
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Lack of definition
It is listed in the DSM-5 as part of the diagnostic criteria for bipolar disorder, as one of the primary symptoms. There are increased incidences of risky sexual behavior with people who have bipolar manic episodes. However, due to ongoing changes to diagnostic criteria, there remains no formal definition of hypersexuality itself as a disorder. The diagnostic criteria for mania include “excessive involvement in pleasurable activities that have a high potential for painful consequences.”
Understanding the symptoms
People with hypersexuality stemming from bipolar mania typically have a dysfunctional preoccupation with sex. They may experience the following symptoms: think about sex constantly, have one-night stands, have multiple sex partners, be more interested in pornography, notice a difference in their sexual behaviors and engage in other reckless behaviors like driving too fast, gambling or spending beyond one’s limit.
What hypersexuality is not…
As blogger Gabe Howard explains: “Hypersexuality doesn’t mean having a lot of sex. “It isn’t spring break; it isn’t your honeymoon. There is a world of difference between having a lot of sex and having many partners or sexual experimentation. The primary difference is motivation.”
A destructive symptom
It is a pervasive and damaging symptom that has wrecked marriages and caused life-threatening health problems. Olympic runner Suzy Favor Hamilton’s manic-induced hypersexuality symptoms found her reputation in jeapordy when it was publicly revealed she was engaged in escort prostitution. Luckily Hamilton was able to seek help from medical professionals and from her family.
Women vs men
At least one study found that hypersexuality appears to play a larger role in women’s lives than in men’s. – women with bipolar tend to be far more sexually provocative and seductive than their male counterparts.. twice as many women as men reported sexual intensity as “very much increased” during hypomania. The women in her study also rated sexual intensity as the most important and enjoyable part of mania.
Adolescent behavior
Barbara Geller, MD, professor of psychiatry at the Washington University in St. Louis. The author of a groundbreaking study about hypersexuality behavior in children with bipolar, she has helped overturn widespread assumptions through her research. flirtatious, sexual behavior was a common symptom in 30 percent of young, prepubescent children with mania and in 60 percent of the adolescents.
Understanding the fixation
Just as someone coping with mania might not stop at $50 when his credit card allows him to spend $5,000, he may also devote hours each day staring at Internet porn or searching for partners. It’s the excess that gets him into trouble. In his book Electroboy, Andy Behrman said the fixation “becomes your secret little world … you escape to this world of fantasy, your mind I racing, and this is the direction your mind is racing to.”
An addiction
Louis J. Cozolino, PhD, a professor of psychology at Pepperdine University, says to think of hypersexuality as an addiction because the compulsion and obsession can feel much the same as what’s felt by drug addicts and alcoholics. “As an addict you never get enough of a drug …. with bipolar disorder you have people who are more vulnerable to using sex as an addiction because they use it for soothing.”
Telltale signs
Some signs include a person is taking risks, missing school or work, and/or shirking responsibilities because sex has become more important than personal responsibility. This may be a warning sign one is “unable to act with an eye toward future consequences of their behavior.”
Psychiatrists should ask…
Many psychiatrists refer to hypersexuality almost as an afterthought—if at all—when forming a diagnosis; however, it can be the most challenging parts of bipolar disorder. All psychiatrists should first ask, ‘has your physical energy increased? Has your sexual energy increased?’ This should be followed by a question about impulsive new relationships and impulsive sex during the mood swings.”
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