Hypersexuality: The Taboo Symptom of Bipolar Disorder

What is hypersexuality?

The word “hypersexuality” suggests some state of increased sexual state – but what is it exactly? I am frustrated to discover that there is actually no single, formal definition, even within the scientific literature.

The Merriam-Webster dictionary says it is an adjective for displaying unusual or excessive concern with, or indulgence in, sexual activity. The Oxford dictionary doesn’t have hypersexuality listed at all. They have “supersexual” listed as a state beyond or outside the sphere of sexuality, as being highly sexual or sexed, and having a strong sexual appetite.

Psych Central uses the word synonymously with sexual addiction. They describe it as a dysfunctional preoccupation with sexual fantasy and the obsessive pursuit of casual sex, pornography, compulsive masturbation, romantic intensity and objectified partner sex for a period of at least six months. They elaborate by saying that this behaviour will persist despite negative consequences, intentions to change and actual attempts to stop. Now, this is sounding something more like what I experience personally, however I am unsure about the six month timeframe.

The DSM-5 simply describes it as “a stronger than usual urge to have sexual activity”. This definition does not do the experience of hypersexuality any justice whatsoever. In it’s chapter about Bipolar Disorder, the only reference to hypersexuality is hidden within the list of diagnostic criteria for mania and hypomania and says, “an increase in goal-directed activity (either socially, at work or school, or sexually) or psychomotor agitation”.

Although (hypo)mania-induced hypersexuality is common in bipolar there is a dearth of literature published about the topic, and the lack of a common definition makes sound scientific research difficult. Despite this, published research does show that there is an increased incidence of risky sexual behaviors in people with bipolar during (hypo)manic episodes compared to people with other psychiatric diagnoses (Kopeykina et al., 2016).

Hypersexual Disorder (separate from its relationship with bipolar) was also proposed as a new psychiatric disorder for the DSM-5, however it was not included. Nevertheless, research findings indicate that excesses of sexual behaviour can be accompanied by clinically significant personal distress, social dysfunction and medical conditions. Having experienced a lot of distress, dysfunction and sexually transmitted infections myself, this hits closer to home for me. Also, the proposed Hypersexual Disorder, can be thought of as a non-paraphilic sexual desire disorder with an impulsivity component (Kafka, 2010).

Until hypersexuality is clearly defined, it cannot be properly researched. Consequently, it cannot be adequately addressed by mental health professionals, treatments cannot be adequately targeted and there will be continued misinformation and stigma within society. Apart from my passion for scientific research, I care about this issue because hypersexuality is possibly the most dysfunctional component of my bipolar disorder. I care because so few people want to talk about hypersexuality and it remains lurking in the shadows of stigma and taboo. I hope to shed a little light on it.

My experiences of hypersexuality

Not everyone with bipolar experiences hypersexuality. But I do. I get hypersexual when I have an episode of hypomania. I often have periods of sub-threshold bipolar symptoms, but one of the sure signs of a full blown episode is when I experience hypersexuality.

It starts off with an increase in sexual desire. I start thinking about sex, a lot. This intensifies as thoughts of sex and anything of a sexual nature consume me. It becomes difficult to focus on almost everything else as my mind is scattered and incoherent, but I can somehow easily focus my attention on sex as my fixation magnifies into a near obsession. I see strangers in the street and have wild, vivid fantasies about them. My attraction towards people widens and I find myself lusting after both men and women whom I normally wouldn’t find attractive.

My thoughts and fantasies start manifesting into behaviours. Given the chance, I talk incessantly about sex. I feel sexier and become much more concerned with how I dress and wear my makeup. I’ll download dating apps and spend countless hours obsessively scrolling through profiles, feeling a sense of thrill and anticipation. With every match, my already inflated self-esteem swells and I ache with desire. I am hyperaware of my body and senses. Every touch and action is imbued with sensual and sexual overtones and my skin feels charged with electricity. The hypersexuality has now become a part of me and permeates every aspect of my being.

I start chatting to people online. I indiscriminately send explicit photos and videos to absolute strangers. In my hypomanic state, I am reckless and impulsive and feel invincible. My precious career and professional reputation become less important compared to the immediate gratification I single-mindedly and relentlessly pursue. My perception of risk is skewed and I don’t believe that anything negative will happen. I simply want to satisfy that urgent, implacable pulsing in my mind and between my legs.

In the past when I was single, I met up with many men. During a significant hypomanic episode, I had sex with more men within six months compared to the previous 12 years. I thrived on the entire process – attracting the attention of a man, flirting, upping the ante of communication to achieve an unbearable state of lust and yearning, arranging a meeting. Fucking. I became increasingly reckless, engaging in unsafe sex over and over again. Each conquest gave me a high and sense of reward, but it was never enough. I would fuck two men in a night, four in a week and I would have regular fuck buddies as well. I didn’t form attachments to any of them. Every man was simply there to feed my immense sexual cravings. Being hypersexual is to be insatiable.

I also become a lot more sexually curious and adventurous. My interest in kinky sex flares and I crave novelty and excitement. I get immensely interested and aroused by kinky scenarios and fantasies that I normally wouldn’t find so alluring. With my sense of grandiosity and recklessness peaking, I shamelessly indulge myself and others in acts that I would never have considered before. It is such immense fun. It is exhilarating.

I continue in this way until I feel that I am sex, personified.

And then, slowly, I become aware that the fun has tipped into dysfunction. I oscillate between feeling invigorated by all the fun and gratification, and feeling highly distressed by my inability to curb my sexual thoughts and behaviours. My work and study start to suffer. I lose track of time easily. I might decide to sext, watch porn or masturbate only to come out of my trance hours later, realising that I am late to work. One morning, whilst I was getting ready, I took some nude pictures and sent them to some men I was chatting to. This escalated into sexting, phone sex and masturbation, and before I realised, it was mid afternoon. I would even masturbate and take nude photos at work. The people closest to me grow tired of my endless chatter about men and sex. The hypersexuality eventually dominates my existence and threatens everything I hold dear.

Hypersexuality in a committed relationship

As I write this, I am in the process of recovering from a hypomanic episode with hypersexuality. This is the first time I have been in a committed relationship whilst being hypersexual. The unrelenting fixation on sex has been very challenging to manage. It has taken an inordinate amount of self control to curb my impulses and restrain myself. I think this is why hypersexuality has been more distressing for me this time around.

In the past, I have indulged and enjoyed myself. The distress was counteracted with pleasure and excitement. But I have suffered this time. There has been no outlet, no sexy rendezvous, no sexual exploration. I have been tormented by an invasion of fantasy and desire, a lust so expansive and visceral that it almost hurts. Besides expressing this in writing where I am most articulate, I am at a loss as to how to communicate these feelings to anyone, including my partner.

Nevertheless, I have somehow managed to stay faithful to my partner. I take this as a sign of my commitment to our relationship. But it hasn’t been easy. I talk to some people about hypersexuality, but I can’t divulge everything. How do you tell even your therapist that you spent two hours masturbating before seeing her and you can still feel a throbbing between your legs as you sit there trying to convey your distress in the most polite way possible? I wish there was someone I could speak to openly about this who could understand how it feels from their own firsthand experience. This is why I have written this blog post. To say all the things I could never look someone in the eye and say.

So, if you can relate or have a comment, please leave one below and lets start connecting and talking openly about hypersexuality!