When people hear “bipolar disorder” they generally think of mood fluctuations and the symptoms that go along with depression, hypomania and mania. All of that is more than plenty for a person and loved ones to endure. But there’s another symptom that many battle during those mood fluctuations, and every single day in between. Cognitive Impairment. Not only can it make life frustrating and difficult, it can get in the way of both enjoyable activities and meaningful work. It can be isolating and, in my experience, lead to feelings of failure.
A Doctor’s Description
Russ Federman Ph.D. accurately describes it in a Psychology Today article: “difficulties with linguistic working memory (word retrieval), difficulties with planning, prioritizing and organizing of behavior (executive functioning), problems with retention of what’s been read or listened to, as well as the experience of mildly dulled or slowed thought processes.”
How It Affects My Everyday Life
I often feel like I’m running into the same brick wall over and over again. I feel like I’m trying SO hard and going nowhere. Everything takes me at least twice as long to complete as it does someone who doesn’t have a mental illness. My husband sometimes takes over tasks because he can’t bare to watch me waste so much time on things of such an ordinary nature.
What’s most frustrating is when I attempt to do something I love and am passionate about. Something that requires thought, organization and planning. Like blogging. My past life experiences reinforce my feelings of knowing I’m capable. It’s like I have this huge boulder blocking my way. And I’m no match for it, yet I continue trying to figure out ways around it, over it and under it. From time-to-time it causes me to get down on myself. I ask if I’m kidding myself for thinking I can accomplish anything at all. Then, the worst feeling of all comes over me – failure. And failure’s not a feeling I cope well with. But I feel a bit better after becoming aware of the studies referenced directly below.
Studies show that individuals with bipolar disorder maintain their IQ levels once their illness begins.
One of my biggest fantasies in life is to simply be organized. I go through spurts when I “lose my words,” what the doctor calls “word retrieval.” My memory is awful. I currently have 19 Facebook friend requests from people who I obviously know – we have over 20 mutual friends, but I cannot remember them to save my life. I wonder how many people I walk right by when I’m out in public simply because I’ve forgotten what they look like or who they are all together. I’m sure this only adds to the typical introvert misconception of me being a snob or a b*@!h. Is it really a misconception though? 😉
WHAT STUDIES SAY
Despite normal, or even above normal cognition prior to the first episode of mania, there’s a decline in cognitive capacity that’s steepest after the first episode of mania.
Researchers agree that cognitive impairment is present during symptom remission, with deficits intensifying during mood episodes. Both depression and mania negatively impact memory, focus, thinking and planning. However, the level of impairment varies from person-to-person and numerous studies show impairment to be more intense in individuals who’ve had a higher acuity in bipolar symptoms.
According to an article in the American Journal of Therapeutics, currently there are no FDA–approved medications specifically designated for the management of cognitive deficits in bipolar disorder. Though some have been tested, with mixed results. “Non-pharmacological interventions, such as cognitive remediation and non-invasive brain stimulation techniques, seem promising, but their role has not yet been properly explored among bipolar patients.”
But new research is always being completed. For example, researchers at Karolinska Institute, and the Sahlgrenska Academy at Gothenburg University in Sweden have identified a gene variant linked to specific psychotic symptoms and cognitive impairment in people with bipolar disorder.
Studies indicate that, for some, cognitive impairment will be a lasting symptom of their bipolar disorder. For some. There are many variables. Talk to your doctor if you have concerns.
IS IT EVEN COGNITIVE IMPAIRMENT?
As usual, there are other things that can look the part. For example, ADD (Attention Deficit Disorder) has overlapping symptoms. So you’d definitely want to rule that out before settling on cognitive impairment. And under your doctor’s supervision, you may want to take a look at some of your medications’ side effects.
WHAT CAN WE DO?
- Discuss concerns with your doctor.
- Get enough sleep, 7-1/2 – 9 hours nightly for adults. You may enjoy Bipolar Disorder & Sleep (w/free download).
- Accept yourself and your disorder, wherever you are on your journey. You may enjoy Self-Compassion: It’s Okay
- Stay up-to-date on research.
- Eat a well-balanced diet and eat regularly, including drinking plenty of water everyday.
- Try out some mind-sharpening games. There are many free smartphone apps available.
“Studies show that individuals with bipolar maintain their IQ levels once their illness begins.”
Cognitive impairment does not equate stupidity. On your most frustrating days please remember that you are still the same brilliant person you were before your disorder made life more difficult. In fact, you’re even more so now! Why? Because you fight back! You keep moving forward despite your disorder and all that it throws your way, in addition to the stress of everyday life. You’re THE BEAST, not bipolar disorder. We need to put things into proper perspective. We’re winning this fight. Every day.
Do you battle cognitive impairment? How do you manage?
- Cognitive Impairment in Bipolar Disorder by Russ Federman Ph.D., A.B.P.P. -via PsychologyToday.com
- Karolinska Institute. Possible mechanism for specific symptoms in bipolar disorder discovered. ScienceDaily, 15 December 2015
- Neuroprotection in the aftermath of first episode mania, M Berk, R Daglas, M Yucel, SM Cotton -via Wiley Online Library
- The Management of Cognitive Impairment in Bipolar Disorder: Current Status and Perspectives, Sanches, Marsal MD, PhD*; Bauer, Isabelle E. PhD; Galvez, Juan F. MD; Zunta-Soares, Giovana B. MD; Soares, Jair C. MD, PhD -via American Journal of Therapeutics: November/December 2015 – Volume 22 – Issue 6 – p 477–486