Q:  Sexual Activity Result of Bipolar Disorder?

My daughter is highly sexual, She is very sexually active.  She knows right from wrong but seems to feel driven to do these things.  We talk about it.  It has destroyed her school life.  She has switched schools 4 times becaus eof the rumors!!  Will Risperdal help with these symptoms?  She is currently on Depakote 1000 mills and celexa 20 mills.  She is 16 years old and weighs about 120.  she was diagnosed in January 2001.  what can we do?


Dear Debbie -- 
First question would be "are these behaviors symptoms of bipolar manic phases?"  Are there any other manic-side symptoms, like decreased sleep/increased energy/increased activity/irritability, etc. that accompany periods of increased sexual behavior?  If so, then that's the target -- i.e. the whole manic-side complex of symptoms -- , not just the sexual acting-out.  I'd look hard at that Celexa as potentially contributing to this problem, if that's what's going on.  

However, if the sexual behaviors occur when no other symptoms are present, that's a different story.  It would then sound more like "impulsive behavior" generally, and there are some psychotherapy approaches for that, focusing on improving impulse control generally.  Your daughter's psychiatrist could either do that psychotherapy or refer her for it. 

Finally, sometimes the sexual acting-out is a reaction to something going on in the family, and a psychotherapy that takes into account the whole family system may be more the thing that will help.  

I'm an adult psychiatrist, so this is not my strongest area; a child/adolescent psychiatrist would likely know of more ways to view this problem, and more treatment options, than I.  I hope you might be able to get such an opinion, a second one if necessary, from such a specialist.  

Dr. Phelps

Published March, 2001