*Throughout the article, reference is made to 'he' or 'she' when talking about a person who is bipolar. It can be either, and using one term or the other is merely for the sake of convenience. These suggestions are meant for anyone, male or female, who is suffering from bipolar and his (or her) family and friends.

This topic is not a popular one, but it is one I can't stress enough. Individuals with bipolar disorder have a very high incidence of STD's contracted because of sexual promiscuity during manic phases. Period. End of discussion.

It has nothing to do with feelings about fidelity or the meaning of marital vows or the way they see men or women or anything else. The simple fact is that during a powerful mania 'high,' a bipolar sufferer lives on the mantra, 'If it feels good, do it.'

They have no perception of consequences and can't think ahead farther than the moment. They feel invincible and can't imagine catching a transmittable disease, if they think about it at all.

So they may sleep with people they barely know, and they catch sexually transmitted diseases. Let's be clear on this - you have to talk about this with your bipolar spouse! I suggest that anyone who is bipolar in a relationship have a complete set of tests for all STD's, including AIDS, Herpes and Gonorrhea.

Some of these diseases have little or no outward symptoms but can cause serious, permanent damage to the reproductive system and eventually lead to sterility, complications or even death. Get checked, please!

If there is an STD, both partners must practice safe sex, which is entirely possible in a marriage. If the STD is something like Herpes, which lives on in the body in a dormant state permanently, flaring up periodically, you will need to talk to a doctor about your options. Some STD's can be treated effectively with a round of antibiotics.

If your husband (or wife) has a manic episode, however, and has unaccounted for time when you suspect they may have been having an intimate relationship with someone, both of you must get retested to make sure there are no new STD's. Many bipolar sufferers act out their mania through brief sexual encounters when they go on a 'bender' of spending, partying and risky living.

Keep in mind that these encounters are seldom affairs in the traditional sense of the word; that is, it is not about feelings like love or respect. These encounters are about immediate physical gratification and the lack of impulse control that is a hallmark of mania. It takes just one evening with a prostitute or a one-night stand with the boss to contract a disease that can last a lifetime.

Make it a condition of treatment that if your spouse goes through a manic phase that involves risky behavior and unaccounted for time away from his normal routine, he or she will get tested for STDs. During this time frame, you will not have unprotected sex. This is not a trust issue, this is about the reality of bipolar disorder and its consequences, which can be life or death.