In people who have recently learned of a diagnosis of bipolar disorder, sexual desire and experiences related to intimate life change along with mood. These are the conclusions of a group of researchers from Denmark who published their work in the Journal of Psychiatric Research.
Bipolar disorder is a mental illness in which mood, energy and activity fluctuate from deep depression to mania or hypomania (a state of elevated mood, impulsivity and unusually high energy). Even between pronounced episodes, the emotional background can be unstable.
Scientists led by Helle B. Krog of the sexology clinic at Copenhagen University Hospital observed 236 adults aged 18 to 68 who had been diagnosed with bipolar disorder no more than two years earlier. Participants were assessed three times over six months: at the start, after three months and after six months. At visits, doctors used standardized interviews to assess the severity of depressive and manic symptoms.
In addition, participants rated their mood daily in the Monsenso smartphone app, from negative to positive. This made it possible to track daily fluctuations in emotions outside clinical visits. At each in-person appointment, volunteers filled out questionnaires about sexual function and quality of life.
It turned out that higher scores on the depression scale were associated with lower sexual desire and greater sexual distress - the upset, anxiety and dissatisfaction a person experiences because of their intimate life. This association persisted after adjustment for age and sex. Women on average reported lower desire than men, and desire also declined with age.
Manic symptoms behaved differently: the stronger they were, the higher the sexual desire. At the same time, no link was found between mania and sexual distress - apparently, increased desire during such periods is not in itself perceived as distressing.
Another result: the more mood swung from day to day, the higher sexual distress turned out to be. That is, even outside pronounced depressive or manic episodes, emotional instability accompanies worse sexual well-being.
The authors emphasize that these are statistical associations, not proven cause-and-effect relationships. The study is observational, so it cannot be said that mood symptoms directly cause changes in the sexual sphere. More than 60% of the differences in desire and distress were explained by participants' individual characteristics, not only by clinical symptoms.
It was also found that better quality of life (measured using a standard World Health Organization method) is associated with lower sexual distress, but not with the level of desire.
The work has limitations. The study did not include patients taking certain common antidepressants known for sexual side effects. Many participants were in partial or full remission, so their sexual functioning may have been better than among people with bipolar disorder overall. In addition, people with more severe symptoms may have dropped out before the six-month mark - meaning the results more likely reflect the experience of those whose condition is relatively stable.
Researchers advise clinicians to regularly ask patients about sexual health. Such a conversation can help manage distress both during exacerbations and in calmer periods.