I tried to find the clinical term for “brain fog” to sound more professional, but Google couldn’t figure out exactly what I meant by “clinical term”. I’m sure you know what I mean though, like you can’t understand what’s happening past the end of your nose. Like a daydream without the actual dream part. Everything just goes temporarily out of focus and your brain RAM dumps pieces of information you actually need. For example, when I called my doctor the other day about my brain fog, I momentarily forgot my phone number. I recovered quickly but in the instances that moments like these happen, it’s terrifying and frustrating. I’m not old enough to experience this, except that I am because my brain fog doesn’t have anything to do with age.
Bipolar disorder can actually come with mild cognitive impairment. That’s the medical term for the all-encompassing symptoms, not just the space out. When most people think of bipolar symptoms, they focus on the ups and downs, the manic risk-taking, the anxiety or the depression. Those are the main symptoms, so that’s fair. Along those same lines, cognitive impairment is usually associated with dementia and alzheimer’s. Side note: One can have dementia without having alzheimer’s but dementia is the main criteria for alzheimer’s. You probably know or have at least encountered someone with some level of cognitive impairment as there are approximately 16 million people in the U.S. who live with it. Symptom levels vary greatly, especially depending on the cause. Alzheimer’s is the most common cause at 62% percent of cases, but if you look at the lowest cause, it’s 3%. That’s where we fall in- “other.” At least we have that, right? Bipolar disorder isn’t even common enough to have it’s own category! However, about 40-60% of bipolar patients have mild cognitive impairment as a symptom, so it’s important to talk about.
I’ve already described the general feeling of MCI, but now it’s time for the actual symptoms. The symptoms are what can be termed “negative symptoms.” Negative in this case does not mean “bad,” it means “lacking.” Most of the symptoms of cognitive impairment are negative, thus the “impairment” part. (Sometimes all the technical jargon comes together and makes a lot of sense. I appreciate that.) With that, here are traits that are lacking in cases of cognitive impairment:
- Speed of thought
- Decision making
There are a few different types of memory that are affected: fact recall, like spacing out on my phone number or forgetting a person’s name; appointments and where you wrote down those appointments because you know you won’t remember them; situational memories like what happened on your last birthday; and visual memory, for example, becoming lost in someplace that should be familiar. Forgetting where you parked your car can also count as spatial or visual memory, but that might be too common to count as mild cognitive impairment.
Lack of attention is exactly what it sounds like. Multi-tasking is not an option. Well, the brain doesn’t really multi-task anyway, but that’s not what we’re talking about. Attention shifts back and forth. It can be hard to concentrate on things like someone speaking to you, working or reading. We’ve all had the moment of reading a book when we realize we’ve been staring at the same page for who knows how long but haven’t read a single word. It’s like that. I’ve talked about the inability to focus when experiencing anxiety with bipolar disorder, but this is a different kind of loss-of-focus that can be just as frustrating, especially with decreased speed of thought.
Decision-making and inhibition can go hand-in-hand. There are at least two possible scenarios. Decision making can be overwhelming on its own. When inhibition is also decreased, the two can wreak havoc. For example, making the decision not to take medication.
Like most things, there is good news and bad news for all of this.
- Good news: symptom severity is usually mild and does not necessarily increase over time
- Bad news: symptom severity can still vary for an individual and is present even when other bipolar symptoms are not (a euthymic state)
- Good news: It’s treatable with medication
- Bad news: It can be a side-effect or a withdrawal symptom of medication
It’s important to talk to your doctor and therapist to make sure your symptoms are being managed as well as possible. This may mean trying a different classes of medication, which can be a long, arduous process. It will continue to be frustrating, but there is always the possibility of better results. Just keep trying and don’t forget you’re not alone.