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Hours lost to masturbating; the impromptu orgies; the damage caused to marriages by extra-marital affairs or the risk of seeking out more and more extreme sexual activities in order to try and “scratch an itch which can never be scratched”, as one web user puts it. Those with a more liberal approach to sexuality in general seem to cope better, probably because they don’t worry so much about being considered promiscuous.But the notion of feeling out of control is what really seems to gnaw at sufferers’ self-esteem, as well as affecting their relationships.I’d always known he struggled with high and low moods.

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In both cases, ‘up states’ are usually followed by down or depressive periods, although the balance of up to down varies from each individual.

Most can manage their disorder through medication and therapy.

Like anyone with clinical depression, libido often evaporates as the mood plummets.

As Tina puts it: “Sex never really impacts my mood; my mood impacts sex.

Individuals learn to watch out for triggers that may send them spinning into an exaggerated mood state.

Yet, sex for those who are bipolar can prove a real minefield.

Hypersexuality, a frequent urge for sexual activity, has long been touted as a symptom of bipolar, which is said to become apparent as individual descends into into a manic or hypomanic state.

However, it’s now the subject of much debate amongst both medical professionals and those with the condition.

In my past relationship, I was called a ‘let-down’ if I didn’t have sex, which made me scared of saying no.

With my current partner, if I’m really low I will push him away, not letting him touch or kiss me.” Yet if someone in a depressed bipolar state, or the common mixed state – where features of hypomania combine with those of depression - starts to self-medicate with sex, the result is rarely positive.

“From writing, to making phone calls, working to working out or having sex all night, it just depends on the individual.” Along with that energy burst and increased pleasure-seeking, comes the added complication of impaired judgement.