In episode 280, I received a question from a listener who had recently been diagnosed with Bipolar 2 Disorder and had been struggling with low libido and extended lapses in intimacy within their marriage. In this post, I dive into the factors that may be the cause of such issues and take a look at what you can do to overcome them.
I was recently diagnosed with Bipolar 2 Disorder. I have begun medication and am feeling much better. Up until now I have been severely depressed for about 5 months.
Onto my question:
My wife and I have been together for 11 years, married for 8. We got together at 18 years old. Throughout nearly the entirety of our relationship I have struggled to provide intimately. There will occasionally be weeks where things are great between us but it always goes away. My wife is very hurt by this because she feels that I don’t find her attractive and that is why I don’t have sex with her. I love her dearly but our relationship has had more valleys than peaks. Even though I feel better on medication I still don’t feel that I have that sexual drive she desperately needs. She has said she has never felt this low before. I also stopped watching porn and masturbating for a month with no improvement.
Could Bipolar 2 explain these extended lapses in intimacy? I have been to an endocrinologist previously and my testosterone level is not to blame.
Sorry it’s a long question but I wanted to get all of the important things in there.
Thank you for the question. I think there are a few things to unpack here. Let’s first talk about some of the general reasons that someone might have difficulty with low libido or a significant libido mismatch:
First, everyone has a different natural baseline. Some people are asexual and have very little interest in sex to begin with. Others naturally have a very high libido and interest in sex to the point that it’s very central to their experience. Both of these and anything in between is okay. However, if you and your partner have very different natural baselines, this can definitely be the source of some difficulty in the relationship. That doesn’t mean it can’t work out, but it’s something that will require attention and consideration. It is also common to have a decreased sexual interest in your partner if you are not happy with them or the situation. I think this is one that a lot of people underestimate. They expect to be sexually interested in their partner and want to have sex often without considering the context of the quality of the relationship. If you have resentments, poor communication, or unresolved issues with one another, this can manifest in decreased interest. You mentioned that your testosterone level is normal. Awesome for you to go to an endocrinologist and get checked out. Physical issues are another common source of diminished sexual interest. Medications, especially long-term ones, are another source to consider.
Understanding the reason why
So, let’s talk more about your particular situation.
You asked the question of whether bipolar 2 could explain these lapses in intimacy. It definitely could play a role. In bipolar 2, you don’t have the more obvious manic episodes that you see in bipolar 1, but you definitely still have cycles. Both the up cycles of hypomania and the down cycles of depression fit with what you said. You said that you have weeks where everything is basically great. Could these be coinciding with when you are up? A lot of people with bipolar 2, especially when it’s somewhat controlled find that there are definitely aspects of being hypomanic that are nice and attractive. Having an increased libido and desire could be one of those.
On the flip side, with depression, whether in the context of bipolar or not, you frequently see a decrease in sexual desire. You can also have a decreased interest and sense of pleasure in all things. If you think about the way depression impacts other parts of life, it’s not too hard to see how you can have a situation like this sexually. For example, someone with depression might find no pleasure at all from watching movies or playing a sport they typically love. They have no desire to do this thing that they intellectually understand they really enjoy. That might be how it is with your wife – you know that you love her, you are attracted to her, and you intellectually DO want her, but the depression prevents you from really internalizing those feelings or having the urge to do anything about them. A similar effect can happen to anyone when they are under a great deal of stress. Similarly, we might also want to consider some deeper issues like your own self-esteem and self-concept. This is a bigger thing than we can get into here, but if you are constantly hating on yourself, it’s going to be hard to feel desirable yourself or that you are someone worth having sex with. It can also make you feel so mixed up when you literally have a person telling you they want you, but you feel like literal human garbage and can’t find it in yourself to participate.
Now, let’s consider the relationship. You made the statement that your relationship has had more valleys than peaks. This could also be a big part of it. You might need to take a real honest look at the quality of the relationship here. If you are in a relationship that is full of conflict or resentments, this could absolutely decrease the intimacy you feel toward the other person, even if things are “fine” from the outside. The intimacy part is another thing to consider, do you feel intimately connected to her in ways other than sex? Are you drawn to touch, flirt, compliment, and genuinely connect? If not, this may not be limited to the sexual realm. I don’t want to spook you, but I do want you to try to zoom out and take a critical look at yourself. I want you to ask yourself hard questions like are you uninterested in sex or are you specifically uninterested in sex with her? I’m not claiming to know the answer to this question, but it feels important to ask.
You said that you have started meds. I’m not sure how long you have been on them. Meds for bipolar can be very impactful and are often necessary. They help to reduce the symptoms of bipolar including the highs and lows. However, they can also cause some decreased libido and even sexual dysfunction, such as anorgasmia for some people. If the issue pre-dates the medications, it’s probably not that, but just be aware that they can impact these issues.
Moving forward: What are your options?
So those are some things to consider as possible contributors to the situation. What can we do about this?
Definitely continuing the communication. I think that’s super important. Especially if you are shutting down a bit and just feeling guilty rather than expressing your feelings or the factors at play. If there are issues like I’ve mentioned such as the bipolar symptoms causing issues, that might be important for her to understand. If she has no perspective on what you are going through, she is going to be much more likely to internalize and personalize your lack of sexual desire. There may also be things to work on in the relationship. Does any of this have to do with trust? Are there unresolved issues that you have a hard time not separating out from the intimate parts of your relationship? Communication, as well as professional assistance, can help with these things as well.
Sex therapy is most certainly an option. This is well within the wheelhouse of professional sex therapists. This, or some permutation of this, would be an extremely common problem for them to treat. By the same token, if you are not in personal therapy, that might be something to consider. This is for you to decide, but if there are personal things that are impacting the sexual situation, therapy would be a safe place to start addressing them. For example, if there are traumas from the past that could be creeping in or parts of your identity that are unfulfilled, these could absolutely interfere with sexual desire.
The last thing I will say is back to the communication part. You are both allowed to have needs and you both are allowed to want your needs to be met. There are creative ways to make that happen. Everything from initiating sex even though you don’t want to or even scheduling it to discussing things like consensual nonmonogamy or the use of sex workers if you live in an area where that is possible. I would be cautious about jumping straight to these last things without looking at all into the others, but they are also valid ways of dealing with this situation. You are allowed to have a lower libido and if that is just the way you are, that’s totally okay. She’s also allowed to be the opposite way and you guys are allowed to get creative in how you figure that out together.
You can listen to this on Episode 280 of the podcast!
Thank you for the great question!
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