Bipolar Disorder and Sexuality: A Preliminary Qualitative Study

Abstract BackgroundIndividuals with mental health disorders have a higher risk of sexual problems impacting intimate relations and quality of life. For individuals with bipolar disorder (BD) the mood shifts might to a particular degree affect their sexual function with possible hypersexual interest during manic episodes and with low sexual interest during depressive episodes. The diagnosis is often given in late adolescence, which may impact sexual identity and development. Only few studies have looked at BD and sexual life, with no qualitative research on the topic. We conducted a qualitative pilot study exploring sexuality in connection to mood swings in five participants with BD. ResultsThematic content analysis revealed five themes: 1) sexual drive and impulses, 2) sexual behavior, 3) thoughts and feelings in relation to sexual issues, 4) intimate relationships, and 5) sexuality and identity. During manic episodes the participants described having a higher sexual drive, leading for some to more sexual interactions. During depressed episodes, the sexual drive in the three female participants were low, however, in the two men, rather than a reduced sexual drive, a more self-destructive way of engaging in sex prevailed. The sexual outgoing behavior during manic phases was described as joyful, with no feelings of shame connected to it. However, the shifts in sexual drive connected to mood shifts affected the participants’ relationships negatively. Further, all of the participants described having an outgoing sexual behavior in their youth and before a diagnosis of BD. ConclusionsThe findings suggest that changes in sexual drive may act as a trigger or early warning symptoms of new episodes, pinpointing the clinical relevance of addressing sexual in individuals with BD. Further, all participants described having an outgoing sexual behavior in their youth before the onset of BD, which might be essential to consider if there is a clinical suspension of BD in an individual.