Challenging the Bipolar-Sex Conventional Wisdom

I just added a new article to mcmanweb, The Whole Bipolar Sex Thing, which had its genesis in a series of posts on HealthCentral. Following is an extract ...

The conventional wisdom is that (hypo)mania increases our sexual drive - often to the point of excess - while depression has the opposite effect. Goodwin and Jamison in their 2007 "Manic-Depressive Illness" note that Aretaeus of Cappadocia in the second century AD observed "a period of lewdness and shamelessness exists in the highest type of [manic] delirium."

The authors cite a number of studies showing increased sexual interest and behavior during mania or hypomania, and the DSM makes it official by including "sexual indiscretions" in manic and hypomanic episodes. It also notes "decrease in sexual interests or drive" during depression.

Okay, time to challenge that notion. A 2006 NIH-funded study of a large teen population found that those who were depressed were far more likely to engage in risky behaviors such as drug use and sex. The study corroborates earlier findings.

One aspect of depression is a feeling of being "clinically dead but breathing," the very opposite of the "feeling alive" states of mind we experience in pure mania and hypomania. But something else also tends to be going on - intense psychic pain. If the clinically dead aspect of depression is about feeling too little, our psychic pain is about feeling too much. In this tortured state of mind we tend to be desperate for release, and seek it in a variety of ways - from attempting suicide to over-eating and over-sleeping to alcohol and drug abuse to "retail therapy" to the flood of feel-good hormones from a warm embrace.

The feeling may quickly wear off, but so what? People who have never experienced depression cannot possibly understand.

Thus both sides of the bipolar equation find us at risk, up as well as down. Yes, it is true that we are more likely to lose interest in sex when we are depressed, but this should not mask the fact that in certain instances the very opposite may occur, replete with the full menu of life-altering consequences. Psychic pain has that kind of effect on us.

Do Bipolars Make the Best Lovers?

Does hypersexuality in mania and hypomania actually translate to being better in bed? We have no evidence.

What is reasonable to assume is that our ups intensify all our experiences, whether listening to music, enjoying food, watching a sunset, or having sex. Even our downs can add layers of richness to our existence.

But is it possible for those close to us to experience our subjective realities? The answer appears appears to be yes. Our states of mind can be contagious. Wrote Kay Jamison of Virginia Woof, citing one of her social circle: "I always felt on leaving her that I had drunk two excellent glasses of champagne. She was a life-enhancer."

But the very intensity of our world can also be very frightening to others. Virginia Woolf may have lit up her Bloomsbury circle, but she also drove poor husband Leonard nuts. Likewise, the intensity factor has a way of drowning out the rest of our surroundings, including the people around us.

So - let's make a few wild guesses about what happens when we take our enhanced subjective realities to the bedroom. When things go right, it appears that the intensity we bring to the moment jumpstarts the "normal" partner's intensity, and next thing both partners are experiencing the type of cosmic union you read about in the poetry of Rumi.

Sample verse: "You are the sky my spirit circles in."

But maybe things get too intense for the comfort of our partner, perhaps to the point where he or she no longer feels safe. Maybe we are so into our own needs and desires that we lose sensitivity to those of our partner. We fail to pick up vital signals. We fail to make the necessary adjustments. Sex is mind-blowing enough without adding bipolar to it. Thus, if we are prepared to brag about how bipolars make the best lovers, we also need to accept the fact that there are times when we are probably the worst.

The "Bipolar-By-Proxy" Complication

Jumpstarting our partners may have the effect of turning them into "bipolar-by-proxy." This is wildly speculative, but let's run with it. If our partner is feeling the same kind of intensity we are feeling, with similar dopamine surges, then their capacity to make rational decisions may be as impaired as ours, perhaps more so. We at least have an experiential context to place our current state of intensity. Our partner may confuse this novel experience with love.

For the full article, check out The Whole Bipolar Sex Thing