Sex And Mental Health Management

Can sex help you manage a mental health condition? Cherith Fuller explains how it works for her.

My mind had been whirring all day; I couldn’t quiet or slow it. Thoughts raced through my head at lightning speed, some positive, but mostly negative – about myself, friends, strangers on the street, inanimate objects. When I’m manic, my mind is a thunderstorm. I can’t control it, so I try to ride it out. Hopefully, it won’t last too long. Fingers and toes all crossed.

My self-care: sleep, water, journaling, regular exercise, therapy, medication, and sex. A lot of sex.

James was coming over that night, and I thought about cancelling, but I knew that, even though being around people was difficult, having sex would help my situation. I didn’t want to talk to anyone, but we wouldn’t be doing much talking anyway. I needed to be near someone, not in a needy, cloying way: I wanted someone close to me to remind me that I was still there, still present, still myself.

How I developed a healthy relationship with sex and bipolar

I haven’t always had a healthy relationship with sex. In the past I’ve used it for… well… a lot of different things. Some of which I didn’t even understand. What was I looking for in some of those encounters? One thing’s for sure, I know I’m not the only person with a mental health condition who’s started out that way.

“I’ve seen sex as a magic cure in the past. I find searching for cures is as much a symptom of bipolar as anything, as it can become manic,” says Amanda, 40, who’s had a diagnosis of bipolar II (like me) for five years. “Mania means I can justify anything – even to myself.” And I too have justified a lot of things, people, situations I’ve gotten myself into.

But sex nowadays is therapeutic for me. It’s not therapy of course – therapy is therapy. But sex – whether partnered or solo – is a time when I can feel present in my own body. One of the negative effects of mania/hypomania is that I have a hard time staying present. I’m constantly looking one, two, three steps into the future. I’m constantly going going going, moving so fast no one can keep up with me. While this makes me an incredibly productive member of society, it makes it hard for me to sit and just be. But when I’m with another person, I’m able to let the rest of the world go, quiet my mind, and stay in the moment with them, and even myself.

The benefits of casual sex

Sometimes – especially when I’m very busy managing my mental health – I find intimacy difficult and draining. Relationships are hard. I stress about telling new partners that I’m bipolar (if we even get that far). I’m pretty miserly, preferring to be alone rather than in the company of someone I feel lukewarm about.

But when you’re having sex with someone, there is no barrier between the two of you. Practicing intimacy with someone/multiple people is invaluable. Even though I prefer being alone, I know that opening myself up on occasion is what keeps me sane, keeps me human. No one is an island, and the more often you remind yourself of that fact, the better off you’ll be.

Those bonds of intimacy, no matter how fleeting, help me practice trust with another. Like many people, I have had difficult relationships, sometimes even abusive ones. I’ve been judged and mischaracterized for my diagnosis. Trust doesn’t come easy. But when you strip away your outer layer, both literally and figuratively, you must trust the other person with your body and your emotions and even your mind. I might barely know the person, but I am literally naked with them, and I am (at least partially) putting my body and pleasure in their hands, as they are putting theirs in mine.

I can ask for what I want and say what I don’t

This doesn’t mean I don’t have agency. It’s taken a long time, but I can ask for what I want and make it clear what I don’t. I wasn’t always very good at asking for what I needed with regards to anything – my mental health, my sexual happiness, my general wellbeing. I’ve found that all of them are tied to one another.

I used to let sex happen to me. It wasn’t something that I participated in, that I was an equal member of.

But once I started taking care of and advocating for one area of my needs, the others were quick to follow. Once I started taking care of my mental health and asking for what I required in that regard, it became much easier to talk to my partners about what would fulfill me sexually. Once I accepted how much I loved having sex, I was able to pay closer attention to my body and take better care of it. Taking care of my body takes care of my mind.

Sex can be part of self-care for mental health management

Sometimes I still use sex as a band-aid, but I’m much better at identifying that before it goes too far. Progress, not perfection. Knowing how to advocate for my desires in bed is a sign that I have agency over not only my body, but also my mind and my moods.

If you are worried that you might have a mood disorder, seek the advice of a medical professional. And whether you have a mental health diagnosis or not, if your sexual behaviours cause you harm or distress or interfere in your day to day functioning, you should seek help.

But if you know you have a mental health condition, and are getting the right medical help, there are also other things you can do in conjunction. Self-care is a huge part of managing mental health, and sex can most definitely be a part of that.

Amanda agrees. “I track my behaviour to see what makes me happy and have a few highly trusted friends who will always be honest with me if they have any concerns,” she says. “Sex can be a useful tool with managing mental health but as with all tools, have the right safety mechanisms (and safe words!) in place first.”