“Cognitive function” is the technical word for how the brain processes information. It affects many aspects of thought, perception and understanding. How well a person is functioning cognitively highly impacts well-being and overall functioning. In bipolar disorder, the focus is typically on mood episodes, but cognitive function plays a huge role in the illness and the day-to-day lives of the patients who live with it.
Not everyone with bipolar disorder experiences impaired cognitive function. The prevalence of cognitive impairment among bipolar disorder patients is not yet known, with estimates anywhere from 15% to 60%, though there is evidence that it is more prevalent in people who have experienced multiple manic episodes. Impairment can happen at different levels of severity throughout phases of mania and depression as well as between episodes. Those with bipolar I seem to have more problems than those with bipolar II.
There are several operations that are impacted by cognitive function, with five major categories.
Restlessness, inattention and racing thoughts are symptoms of bipolar disorder. Problems with attention frequently mimic those of Attention Deficit Hyperactivity Disorder. Around 20%-30% of people with bipolar disorder also have ADHD.
People with bipolar disorder often have problems with both short-term and long-term memory, which can worsen as they age. Research postulates that patients in phases of depression and mania, it can be difficult to encode memories because the mind is either moving too fast or otherwise preoccupied. Bipolar disorder can also affect language recall. So, people may have difficulty coming up with a particular word or phrase in the moment.
Sometimes in bipolar disorder, the brain seems to slow down, making people less able to think straight. This can cause problems with impulse control, planning and organizing thoughts. Poor impulse control is a hallmark of bipolar disorder, especially with manic episodes. These issues also exist during depression and between episodes. They may also cause patients to be noncompliant with treatment.
There is some evidence that bipolar disorder patients can have slower reaction timing. This may be related to the problems with clear thinking and thought organization. If the brain isn’t processing information quickly, the body can’t respond to that stimulation quickly. Because of this, some patients have slower reaction times as well as difficulties with dexterity.
All of the symptoms of bipolar disorder can cause difficulties for patients in social settings. People with bipolar disorder often experience problems with family, friends, romantic relationships and work environments. Cognitive impairment exacerbates these problems. Attention deficits can lead to poor performance at work or school. Not being able to think clearly or plan creates obstacles in any social situation. Patients may not even realize they are having these difficulties, making it impossible to explain their circumstances to others.
This is not to say that people with bipolar disorder are less intelligent. In fact, bipolar disorder is linked to both high intelligence and creativity. Some people just experience difficulties at times.
It’s important for patients to recognize that medications used to treat bipolar disorder can also cause problems with cognitive functioning. Antipsychotics can affect attention, concentration and learning. Lithium has been shown to both negatively impact cognitive function as well as have neuroprotective qualities. Lamotrigine seems to have the least effect either way.
Aside from cognitive impairment being an inherent part of bipolar disorder, it can also be exacerbated by other factors. Lack of sleep, high stress and even body weight can lead to cognitive impairment. If someone with bipolar disorder is experiencing problems with cognitive function, they should speak with their doctor to determine the cause.
Find ways to better cognitive function here: 5 Ways to Boost Cognitive Reserve
Image credit: Neil Conway