Mood symptoms in bipolar disorder correlate with changes in sexual desire and distress

A recent six-month study has found that people newly diagnosed with bipolar disorder experience fluctuations in their sexual desire and distress that align closely with their mood shifts. Bipolar disorder is characterized by extreme mood swings, including depressive episodes marked by sadness and lethargy, and manic episodes featuring elevated mood and energy. Between these distinct episodes, individuals may also experience daily fluctuations in their emotional state, known as mood instability.

Doctors and therapists have long recognized that these mood swings can spill over into patients' sex lives, increasing the risk of sexual dysfunction. However, most previous research relied on single snapshots of patients' sexual functioning. This study aimed to better understand how specific mood symptoms interact with sexual desire and distress over a longer period.

Led by researcher Helle B. Krogh at Copenhagen University Hospital, the team conducted a longitudinal study involving 236 adults aged 18 to 68 who had been diagnosed with bipolar disorder within the past two years. Participants were evaluated at three points over six months: at the study's start, after three months, and after six months. They used standardized interviews and a smartphone app to assess depressive and manic symptoms, daily mood instability, and sexual functioning.

The findings showed a consistent pattern linking depression to sexual difficulties. Higher depression scores were associated with decreased sexual desire and increased sexual distress, even after adjusting for age and sex. Women reported lower sexual desire than men, and older age was linked to lower desire. In contrast, manic symptoms were associated with increased sexual desire, but not increased distress, suggesting that heightened sexual interest during manic episodes is not typically perceived as distressing by the individuals at the time.

Daily mood instability, as measured by the smartphone app, was linked to higher sexual distress, indicating that even outside full-blown depressive or manic episodes, daily emotional turbulence correlates with worse sexual well-being. Individual differences accounted for over 60% of the variation in sexual outcomes, highlighting that sexuality is highly individualized and influenced by personal, social, and situational factors beyond a psychiatric diagnosis.

Overall quality of life was associated with lower sexual distress, but not with sexual desire. The study had limitations, as it could only show associations and excluded patients on certain antidepressants known to cause sexual side effects.