I suspect you already have figured this out, but if your lifestyle and activities are leading to distress then you may benefit from conseling or therapy . You describe increasing levels of your activity that are becoming necessary- which clearly will put you or a partner in danger - I am sure you have heard of situations here S and M turns into life threatening situations. You recognize that this is no longer fulfilling and that you have intimacy issues... While I am no psychoanalyst, I suspect there may be some underlying issues that you may benefit from 'working through'.
Just please try to get help before things go too far and someone gets seriously hurt. On a certain level a little 'rough' sex play by itself is not wrong but it sounds like you have gone way beyond that, to a point where you need help.
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I have reviewed your post here and also your other post here on JustAnswer.
It seems to me the key question you are asking is if your desire for S&M might be making you sick in some other way; causing your other mental health issues. The simple answer to that is no.
It is far more likely the other way around. Your bipolar disease is allowing these desires to be expressed in action.
S&M activity is NOT in itself a mental health issue; it only becomes such to the extent it is "ego-dystonic" ie when it conflicts with your general values enough to greatly disturb you.
Many people engage in S&M behavior without it being in any way a mental illness for those individuals.
You should discuss these issues with your therapist in order for them to help you as much as possible with your mental health issues.
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Please see my email response.
I can assure you that most psychiatrists have heard similar situations before and you have no reason to be afraid he/she will not be able to professioanlly handle it.
I really think you need some counseling about this problem.