I’ve been reading a little about the effect of bipolar on mental functioning, especially the effect of bipolar depression on cognition and the potential for dementia in bipolar patients as we age. The news doesn’t look promising at this time.
Cognitive impairment, in simple terms, means your brain is less able to function normally in terms of memory, attention span, and input processing. A study showed that bipolar patients do worse on standardized tests* than people without bipolar, and those cognitive deficits are worse when the subject has bipolar depression.
I used to be a borderline genius, but now I don’t feel as smart, especially related to listening skills and verbal thought processes. I have difficulty listening to people for more that a few moments, and I comprehend less of the conversation. I also find myself less able to respond quickly; I have to think a little bit before I speak, then sometimes my words come out jumbled. In addition, my short-term memory is getting worse, although many long-term memories are still very clear. A few times at work, I have completely blanked out when someone wants to discuss a project only a couple months old, and I can’t recall ever working on it. I may be overthinking this, but it seems like I can feel an increase in these problems in the past few years.
I’m concerned about the potential for these effects to become worse over time. I wondered if some of the people who have dementia became that way due to the effects of bipolar. A couple of articles seem to agree with that theory. Natasha Tracy writes that 19 percent of older bipolar patients had dementia, and it seems to occur earlier in life that people without bipolar.
Apparently there are few options to prevent the slide into early dementia. In another article, she quotes a PubMed paper that says “no pharmacotherapies substantially improve cognition in bipolar disorder, although preliminary findings suggest some potential value for adjunct stimulants such as modafinil [Provigil] and novel experimental agents.” However, another article says that lithium has “neuroprotective properties that may help preserve cognitive function in patients with bipolar disorder.”
I worry about the possibility of losing brain function as I get older. I’m not pretty, not rich, not physically active, not artistic, and not successful in social situations. My brain power is the only positive thing I have going for me. It is my source of income in an intellectual job, and it is the source of my writing and reading hobbies. It allows me to enjoy the music I love so much. It lets me tinker with computers and blog and research my next vacation.
My intellectual function is my reason for living. I don’t want to be a mental vegetable. I don’t want to sit and stare at the wall for hours, then in a moment of clarity think about everything I have lost. The thought of all the memories, all the thought, all the pleasures of an intellectual existence being lost in a fog … it makes me fear for my future. I hope I am overreacting.
Dementia Risk for Bipolar Patients
Depression and bipolar disorder linked to an increased risk of developing dementia
Can Bipolar Disorder Cause Dementia?
* These tests include assessments of attention, motor speed, working memory, verbal memory, reasoning and problem solving, verbal fluency, affective interference, and emotion inhibition.
**Updated from my original post in 2015.