Hypersexuality in Mood Disorders: You’re My Little Secret

Author: Ivory Smith Causey

Janet* a first year college student has just found out that she is pregnant. She had inclination that she might be was not for sure. She has no idea who the father is nor can remember the name of one of the potential fathers. She is bewildered and very embarrassed as to how her perfectly seeming life is now out of control with an unplanned pregnancy.  She had been able to hide her what she called “freedom to express herself attitude” for years. Now she feel her life is being called a potential reality and talk show by others.

Trina* a very religous young woman married for 3 years trolls the internet for hook ups that are anonymous. The next day she is horrified of her actions and hopes no one finds out about these dangerous liaisons. She does not understand these actions despite them being opposite to her ethics and morals.

One would immediately characterize these people as lascivious, loose, and no ethics. However, people are being challenged with don’t ask, don’t tell, aspect of bipolar disorder mania known as hypsersexuality. Hypersexuality is not easy to talk about since most would assume just a high libido, or a person just likes to have a fun time, or even have “free” love.   It is easy for to discuss going on unchecked shopping sprees and decreased need sleep. Sex drive and sexual impulses during bipolar mania can lead to sexual behavior that is not typical for you when you are not experiencing mania.  It can include

  • greatly increased sexual activity, without a feeling of sexual satisfaction
  • sex with multiple partners, including strangers
  • continuous sexual affairs, despite the risk to relationships
  • inappropriate and risky behavior
  • preoccupation with sexual thoughts
  • increased use of pornography
  • cybersex and telephone sex, and visiting strip clubs, dance bars and so on

These individuals typically experience an element of distress and their behaviors may lead to many negative consequences, such as marital dysfunction, sexual transmitted disease, unintended pregnancies, and use of pornography at inappropriate places.

In the article, An Indian Study of Hypersexual Disorder in Patients with Anxiety and Mood Disorders  by Nair et al, there is a clinical need for mental health providers to recognize a distinct group of individuals who seek psychiatric consultations because of recurrent “out of control” sexual behaviors. The Diagnostic and Statistical Manual-5 proposed “hypersexual disorder” as a diagnostic category under sexual disorder, but it was later excluded.  However it is listed as the diagnostic criteria for bipolar.

It is noted that in depression and anxiety disorders, sexual desire is commonly decreased. However, interestingly patients with anxiety and depression may report hypersexuality. Loneliness, presence of interpersonal problems, and increased vulnerability to stress has also observed in association with hypersexual behavior. Two of the various theoretical models have been proposed to explain the phenomenon of hypersexuality include the addiction model and the obsessive –compulsive spectrum disorder. The addiction model is where sexual behavior can be a repetitive misuse as self-medication to manage mood states depression and anxiety. Subsequently this could lead to progression of sexual behaviors such as tolerance and risk taking, a “loss of control,” adverse psychosocial consequences, and a withdrawal state, as seen with other addictions.  It is also suggested that hypersexuality is an impulse control disorder. A person may feel an increased sense of tension or arousal before committing the act and then experience pleasure and gratification after.

Hypersexuality is a painful but real part of bipolar mania which has operated outside of my moral or ethics. It has destroyed committed relationships and left friendships with blurred boundaries. The flirtations made are intense and sometimes unwanted by others to the point of harassment. Hypersexuality has made me feel the ultimate confidence to flirt with anyone willing.

This was primarily caused by no med regulation and little to no therapy. My bipolar mania was out of control. However, being aware of triggers and changes in moods keeps hypersexuality under control. Sustained stress and perceptions of loneliness can be a trigger to begin hypersexual episodes. When life begins to appear to be an all you can eat buffet, I realize my thinking is in trouble. It is very strong when then the glass shatters and I get a dose of reality and mania relapse is relived through medication adjustments.

Today at 44 I realize some of the choices that I made in my 20s were a result of mania driven hypersexuality. I remember being terrified in the mid 90’s testing for HIV.  I truly would not have been surprised if I had contracted it but devastated. There was no thought to protection from HIV/AIDS at that time. I was driven by the intese high of the chase.

In a hypersexual manic state I have started up relationships and affairs only to have them fizzle in a few weeks to months. My imagination would run wild about relationships that wound never come to fruition. Most hypersexual mania situations tend to be delusions in that the person is not really that attracted to me as I am. Since I am in vulnerable situation I have exchanged gifts and favors for flirtations and sexual interludes. I have went through declarations that I was just polyamorous and this explains these behaviors not a bipolar mania episode.

Understanding the consequence of actions and protecting against unplanned pregnancy, sexually transmitted disease, and HIV, is important. This is especially important during periods of hypersexuality.  It is important to be upfront and honest with therapist in this area by exposing where triggers are starting. This keeps me from putting myself into situations that I would regret. Having accountability partners help to notice differences in behaviors, places gone and people that are being met.



Nair, Deepa, et al. “An Indian Study of Hypersexual Disorder in Patients with Anxiety and Mood Disorders.” Sexual Addiction & Compulsivity, vol. 20, no. 4, 2013, pp. 292–305., doi:10.1080/10720162.2013.814094.

My name is Ivory Smith Causey. I have a B.A. in sociology with a minor in women and gender studies from Georgia Southern University. I have a B.S. in nursing from Macon State College and is medical surgical certified. I am a registered nurse at Atrium-Navicent Health in Macon, Georgia. I work with finding ways to balance being a nurse but also realizing when I need nursing. I am a member of the American Holistic Nurses Association and hope to be certified in holistic nursing and become a health and wellness coach.


Translate »