Understanding Bipolar Disorder Memory Loss

Bipolar disorder is a mental health condition characterized by intense mood swings that range from manic highs to depressive lows. These periodic episodes can cause disruptive shifts in a person’s personality, behavior, sleep, and emotional regulation. 

The mood disorder can potentially alter their decision-making faculties, ability to think clearly, and memory retention. As such, some people with bipolar disorder may experience bipolar memory loss during the heights of their mania. 

Symptoms and Memory Loss

Everyone goes through ups and downs, but people with bipolar disorder experience extreme mood changes that oscillate between a euphoric adrenaline-fueled frenzy to an intense depressive crash.

If needed, these turbulent behaviors can lead to hospitalization. 

The understanding of bipolar disorder can be complex and disorienting for those who have the condition. Common symptomsfor depressive and manic episodes include:

• Racing thoughts
• Impaired judgment
• High, elevated mood
• Hyper-sexuality
• Difficulty focusing
• Fuzzy thinking 
• Feelings of loss of control of one’s own mind
• Decreased need for sleep
• Cyclical depression 
• Grandiose, risky thinking
• Rapid and tangential speech (a flight of ideas)
• Reckless decision-making (quitting a job, restlessness, poor sleep, spending money) 
• Swells of energy from high productivity to crashes
• Abnormal changes in activity, behavior, and patterns

After the episode wanes off, there’s typically a recovery period (mental, physical, emotional) dealing with the aftermath which can feel draining on top of the mental illness. 

Memory-related effects from bipolar disorder have been termed as a “brain fog” or a “bipolar blackout” where the person remains conscious but they’re unable to recall the memories during their high and low periods due to the rapid volatility of their mood swings.

At its most severe, it can manifest into suicidal ideation and psychosis where they lose contact with reality, and delusions may occur.

Types of Memory 

Researchers have suggested there is evidence of lasting cognitive impairments regarding sustained attention and memory although variables can be influenced by the individual response, pharmacological treatment, familial risk factors, clinical features, seasonality, and age of onset. 

As a result, some people may face problems with memory functioning as a whole. Memories are the ability to encode, store, and access information as needed.

There are different types of memory:

• Sensory memory, which is a brief storage of memory for a short period of time-based on the five senses
• Short-term memory, which holds a limited amount of information in an accessible state temporarily
• Long-term memory, which is a vast store of knowledge and a record of prior events

In each of these types of memories, research shows some people with bipolar disorder reported cognitive dysfunction related to executive functioning, verbal and visuospatial episodic memory, working memory, verbal learning, information processing speed, sustained attention, and sensorimotor performance. 

Effects 

Several studies have reported various neuropathological findings in bipolar disorder. In a 2020 review of 81 data studies, researchers compiled together MRI imaging results from people with bipolar disorder. These MRI images revealed small, but robust, differences in the volumes of brain structures in:

• The hippocampus, which is in charge of learning and creating new memories
• The thalamus, which relays sensory and motor signals, as well as regulation of consciousness and alertness
• The prefrontal cortex, which is the part of the brain responsible for skills such as emotional regulation, problem-solving, sexual behaviors, judgment
• The anterior cingulate cortex, a brain region critical for integrating cognitive and emotional functions in support of adaptive, goal-directed behavior 

Along with the above brain reductions, another 2021 studyof 1,232 participants noted faster ventricular enlargements for people with bipolar disorder, with abnormal accelerated cortical thinning in the frontal cortex for those who experienced persistent manic episodes. Cortical thinning is a type of mental atrophy associated with aging and linked to disorders such as dementia and Alzheimer’s. 

The neurocognitive decreases are notable since the research suggests the brain’s executive functioning and its capacity for memory formation can be particularly vulnerable to the mania and depression experienced during bipolar episodes. 

The recurrent frequency and severity of these periods can trigger a cascading effect of cognitive memory loss since the impacted areas around the prefrontal cortex organize one’s personality, the ability to feel empathy, plan things. It also controls their primary motor functions. 

Treatment and Management

Bipolar disorder memory loss can be managed with certain interventions to stave off the frequency of the episodes and balance out overall mood and well-being. Since stress can set off an episode, it’s essential to maintain healthy habits to support a stable quality of life. Often, bipolar disorder is best managed with professional help and guidance which can include: 

• Drug treatments that involve agents such as antidepressants, anticonvulsants, atypical antipsychotics, mood stabilizers, and pharmacological intervention can come with varying side effects and risks 
• Psychotherapy to help identify and change thinking and behavior patterns, specific therapies like talk therapy, dialectical behavioral therapy (DBT), cognitive-behavioral therapy (CBT), family-focused therapy (FFT), group therapy
• Attending outpatient or day treatment programs for counseling can help keep symptoms at bay. These are often recommended by a doctor or psychiatrist 
• Ketamine clinical therapy is a newer, promising treatment. A 2020 study has reported that a low dose of ketamine infusions produced quick and consistent results across cognition, sleep, mood level, and stability across 77% of patients.
• Alternative treatments include herbal supplements such as St. John’s Wort or Ashwagandha, (an Ayurvedic Indian ginseng with potential neuro-protective effects on the hippocampus). Please speak with a healthcare professional before taking any new supplements. 

Outlook for Memory

Bipolar disorder is intricate and how the illness may affect a person’s life will vary. Memory impairment might not affect everyone managing the condition, but the strongest predictor of memory problems is if manic depressive episodes are frequent, extreme, and often progress into mania, psychosis, and hospital care.

How to Minimize Memory Loss

To limit bipolar memory loss, it’s helpful to reduce the recurrence of manic depressive episodes and achieve more mental clarity with short- and long-term memory through:

• Lifestyle changes (e.g., consistent bedtimes and mealtimes)
• Creating structure with daily routines and repetitive actions 
• Regular sleep and healthy nutrition habits
• Aerobic exercise to help with mental health 
• Elimination or reduction of alcohol
• Simplifying life and slowly adding in obligations and additional activities over time
• Writing out to-do lists to help organize personal and professional tasks
• Using a calendar to manage appointments, reminders, and cues 
• Ongoing psychotherapy treatment for emotional regulation
• Understanding your triggers so that you can seek help before an episode occurs