Bipolar disorder comes with a whole host of psychological issues. The mood swings are only part of it. Mania can cause euphoria and risk-taking to a dangerous degree or it can manifest as extreme irritation complete with lashing out at others. Depression induces horrible feelings of worthlessness or hopelessness and desperation with a serious risk of suicide. These are the most widely-known symptoms. Bipolar disorder comes with other, more subtle symptoms as well. They’re called “cognitive impairments.” Problems with memory, attention, thought-processing and decision making are incredibly common. These problems are also associated with another symptom of mental illness- dementia. So, does having bipolar disorder increase the risk of developing dementia? Unfortunately, the answer is yes.
The vast majority of people will lose cognitive function as we age. There are some that are able to avoid it, but they are a bit of a rarity. Forgetting names, appointments and recent events, losing track of your thoughts, losing your way in familiar environments, these are all things that become more frequent with age. Some will obviously be more affected than others. About 10-20% of people over 65 experience some level of cognitive impairment.
There are more than 36 million people in the world living with dementia. That number is expected to double within the next 20 years. It’s connected to a few diseases/disorders: alcoholism, vascular disease, stroke, brain tumor, head injury, Parkinson’s disease, Huntington’s disease and Alzheimer’s disease, to name the most common. Each of these carry their own risk of developing severe cognitive impairments. Some are permanent, some are not.
Bipolar disorder is now actually being linked to dementia. People with bipolar disorder are significantly more likely to be diagnosed with dementia in later life than the general population. Patients also develop the disease earlier in life with some developing symptoms in middle-age rather than beginning in their sixties, much less eighties. The risk also seems to grow the more episodes a person has, whether manic or depressive.
There isn’t a whole lot of information as to why the increased risk exists. The research linking the two only started to come out about 15 years ago, which may sound like a long time but is actually very short in the research world. So it will take more time to find what exactly is linking them. One thought is that the same brain structure abnormalities found in patients with bipolar disorder- decreased frontal lobe size and abnormal neural pathways- become risk factors in developing dementia. Basically, there’s not too far to jump.
It’s not all bad news, though. There is evidence to suggest that the same treatments used to stave off the symptoms of bipolar disorder may also be protecting against the development of dementia. Lithium in particular has the most evidence behind it. It has properties that both increase neuroprotective chemicals and decrease proteins that have been associated with the development of Alzheimer’s disease. Prolonged use of lithium seems to reduce the risk of developing dementia down to the same risk as the general population. Other bipolar disorder treatments like mood stabilizers, antipsychotics and antidepressants may also have neuroprotective effects against dementia, but there is little to no research on that yet.
Edited for clarification.
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