Bipolar disorder expresses itself in such a wide variety of ways that some bipolar people who have never had any sexual desire find their medication stimulates it, while others are on medication that dampens or kills their sex drive as a side effect. Having to sacrifice sex for sanity seems unfair, but that is a situation in which some bipolar people find themselves. On the other hand, adjusting medications may be a happier solution.
Hypersexuality, which is a problem for some bipolar people, is an intense, abnormal need for sexual gratification that may accompany a bipolar manic or hypomanic (mildly manic) state. The risks include having many sexual partners chosen at random, some of whom may be dangerous, and exposure to sexually transmitted diseases. Symptoms may also include thinking and talking about sex constantly and attraction to pornography. A manic episode of hypersexuality is potentially devastating for a couple.
Whether or not sexual addiction exists can be controversial, but a bipolar person whose desire for sex is out of control can find stopping is difficult or impossible without help. Psychiatrists trained in bipolar disorder provide both talk therapy and an adjustment of medications to help patients rein in out-of-control sexuality. Electroshock therapy for bipolar-1 people can sometimes eliminate or reduce sexual and other problems.
Good bipolar lovers are very good because of their intensity. Intensity can, however, be terrifying for some partners who are not bipolar. And a bipolar lover who is attempting to find relief from depression in sex is not going to be very good company out of bed. Bipolar people sometimes use sex to regulate dopamine in their brains, but the last thing a manic bipolar person needs is more dopamine making them more wired.
Bipolar depression that obliterates a sufferer's sexual desire can, like promiscuity, injure or destroy a long-term relationship. Again, adjustment of medications and talk therapy may provide relief.
Even bipolar people who are not experiencing extreme moods or any other serious dysfunction sometimes find it difficult to form a committed relationship. Lack of self-confidence and low self-esteem are possible contributing factors.
For bipolar people who have a partner, mood swings may be obstacles to creating a family. In fact, some people with bipolar-1 disorder (more severe than bipolar 2 or bipolar NOS, which means not otherwise specified) who marry choose not to have children, especially if their mood swings are frequent and intense, perhaps requiring periods in a locked psychiatric ward.
A bipolar lover or spouse, whatever the degree of their disorder, is not for everyone but can give life extra dimension for those who meet the challenge.