Expert: Ivan Goldberg, M.D. - 7/5/2008

Question
I am bipolar, diagnosed about 3 years ago but probably have been for much longer. I have had difficulties with sexuality, as in being promiscuous, online chats, fantasies, pornography, and recently,affairs with rather unknown men etc. Last time it happened my marriage almost ended and I vowed to get help so it didn't. However, I was doing good and now I have started to fall into the same trap again with online chats, pornography, and fantasies. My therapist has been out of town and I did not feel comfortable using her replacement so I did not and I have not seen my psychiatrist in a few months because I just felt that he would increase my dosages of medications which I did not want. I have not felt sexual in a very long time and have enjoyed feeling sexual but it has gone too far and now my husband has found out again so now my marriage is in shambles again. What can I do to prevent this from continuing to happen again and again? It is not often talked about in bipolar circles, at least not in the ones I have been in. Please help me.

Answer
Hi Julie . . .

Excuse my bluntness but children do what is comfortable while adults try to do what is right. It would be the right thing for you to see the replacement therapist while your therapist is unavailable.

Also, hypersexuality and bad judgment are characteristics of inadequately treated hypomania or mania. i think you should see your psychiatrist and have your medications adjusted so you become more euthymic.

Best regards . . .

Ivan
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