Bipolar disorder is a serious mental illness. The condition tends often involves sudden episodes of illness separated by remissions. The symptomatic phases involve mania or depression.
It can also affect the ability to think, including memory. Whether this is due to treatment or the condition itself remains unclear.
Contents of this article:
What is bipolar disorder?
Bipolar may involve sudden episodes of mania or depression.
Bipolar disorders generally last for life. They tend to emerge sometime between the teenage years and the 30s.
The condition involves depression and mania. These tend to alternate in cycles. The cycles and symptoms vary. One person may have more depressive symptoms, while another has mainly manic episodes.
What are manic episodes?
For an episode of mania to be diagnosed, it needs to last for at least a week, or shorter if the patient is hospitalized and treated. It involves a high or irritable mood and an increase in goal-directed activity.
There must also be three or more other symptoms from among the following:
- High self-esteem or grandiose feelings
- Less sleep
- Talking far more than usual, with a rapid flow of speech
- Racing thoughts
- Being easily distracted and regularly moving from one focus of attention to another
- Risk-taking behaviors such as going on shopping sprees
The mania can also be psychotic, meaning that patients can have delusional ideas and sometimes hallucinations. They may see, hear, or smell things that do not exist.
Hypomania involves the same symptoms but in a milder form. It lasts for a shorter time.
What are depressive episodes?
When someone with bipolar disorder is depressed, the depression takes on a severe form that resembles major or clinical depression.
The person is likely to experience a range of depressive symptoms, including very low mood for most of the day, loss of interest in activities, and a loss of pleasure. The depressive episode must last for at least two weeks.
Causes and risk factors
It is not known what causes bipolar disorder exactly, but a number of factors are thought to play a role. These include genetic, biochemical, and external influences.
There is a strong pattern of heredity, suggesting a genetic element that runs in families.
A brain chemical disorder may be involved, and possible environmental triggers, such as stress. Drug use, including alcohol, may make the condition worse.
Bipolar disorder: Effects on ability to think
Cognitive ability refers to a person's ability to think and reason. Research shows that people with bipolar disorder face some cognitive challenges.
Examples include difficulties with:
- Working memory
- Verbal learning and memory
- Recall and recognition
Working memory is a type of short-term memory that allows us to store information for a short time while carrying out a mental task. It helps with learning.
It is used, for example, in mental arithmetic. It plays a role in processing different types of information, including audio, visual, and spatial data. It is important for concentration.
Short-term memory problems affect daily functioning. They can be subtle, and they may affect a person's ability to take in new information that is needed to complete complex tasks.
They may also make it harder to fit in socially.
While bipolar disorder is widely understood in terms of mania and depression, its effects on thought may have more impact on daily life, and especially working life.
Poor memory and difficulty concentrating can make it hard for a person with bipolar disorder to work and learn. These problems can persist between bipolar episodes.
How does electroconvulsive therapy affect memory?
ECT may be used to treat bipolar but some studies suggest it may have negative side effects.
Some people have electroconvulsive therapy (ECT) as a treatment for bipolar disorder. This treatment may lead to memory loss.
ECT may be used in cases of severe depression that does not respond to other treatment and to treat mania.
During ECT, an electric current is passed through the brain. This causes a seizure, or epileptic fit.
In the past, scientists have found that ECT may help people with epilepsy and depression to feel less depressed. The reason for this remains unclear.
ECT is given over several weeks. Individuals vary in the number of treatments that they will require in order to feel better.
Some evidence has linked ECT to memory problems.
Some people have reported memory loss for a short time immediately before and after the treatment. Some say that their long-term memory is affected.
The more a person undergoes ECT, the more likely it seems that they will have memory problems. It is not clear whether the problems are related to ECT, another treatment, or bipolar disorder itself.
Possible effects of lithium on memory
Lithium is a well-established medication for treating bipolar disorder. It has adverse effects, but the benefits usually far outweigh the risks.
Some reports suggest that lithium can affect thinking and memory.
It appears to have a subtle effect on verbal memory, making it harder to recall and use words. This could affect a person's ability to retell stories.
Conversely, lithium appears to protect against the memory disorder, Alzheimer's disease.
Living with cognitive problems
Some research has suggested that people who have more episodes of illness are likely to have more cognitive problems than others.
Early diagnosis and good medical management of bipolar disorder may help to minimize the effects on memory and thinking.
However, most treatments focus on stabilizing mood rather than cognitive issues. This means that some people whose mood swings are treated may still have some problems with thinking.
Understanding the effect that the disorder has on thinking, and realizing that bipolar disorder is not only about mood swings, may make it easier for patients and their families to cope with the challenges.