Memory Loss in Bipolar Disorder: Why It Happens

Memory loss is a frustrating and overwhelming challenge for as many as 40 to 60 percent of people with bipolar disorder. That's according to a research article published in the August 2017 International Journal of Neuropsychopharmacology .

“The resulting inattention and short-term memory impairment can interfere with just about every aspect of a person’s daily life,” says Zishan Khan, MD, a psychiatrist with Mindpath Health in Frisco, Texas, who treats people with bipolar disorder and related mood disorders.

Even if you’re already experiencing its effects, don’t despair. It turns out there are a few simple steps you can take to address memory loss — and in doing so improve other aspects of life with bipolar disorder.

What Causes Memory Loss in Bipolar Disorder?

“Brain imaging shows numerous differences between those with bipolar disorder and those without, including reductions in the hippocampus, [a part of the brain involved in] learning and forming new memories,” explains Christina Lee, MD, a psychiatrist at Kaiser Permanente in White Marsh, Maryland, who treats people with bipolar disorder and related conditions.

Memory loss also tends to occur or worsen during mood episodes, says Dr. Khan. For instance, during a depressive episode, “people often find it hard to concentrate, and as a result, they can’t encode and store new information as easily because of weakened connectivity between neurons,” he explains.

Other factors that can play a role in memory loss, says Dr. Lee, are:

  • Co-occurring conditions such as anxiety or alcohol use disorder (AUD) According to Mayo Clinic experts, anxiety can lead to confusion, forgetfulness, and difficulty concentrating, while AUD is associated with cognitive and memory issues.
  • Medications Brain fog and memory problems are potential side effects of certain bipolar medications, such as lithium.
  • Genetics Memory loss may run in some families.

Possible Consequences of Memory Loss

Both short-term memory loss — forgetting things you’ve recently seen, heard, or done — and long-term memory loss — forgetting things you knew in the past — can pose particular difficulties for people with bipolar disorder.

For example, short-term memory loss may make it hard to recall what you said or did that affected loved ones during a recent mood episode, says Khan. In turn, that “not knowing” may negatively affect those relationships.

Long-term memory loss may, for example, affect employment, Khan notes, by making it difficult to function effectively at work because you can't remember how to perform certain tasks associated with the role or roles you play.

What’s more, a study published in March 2022 in the International Journal of Environmental Research and Public Health identified cognitive issues — including memory problems — as a significant reason people with bipolar disorder are less likely to be employed than the general population.

What People With Bipolar Disorder Can Do to Manage Memory Loss

On the bright side, there are ways you can manage memory loss associated with bipolar disorder and lessen its effects on your life.

1. Tell Your Doctors if You’re Experiencing Medication Side Effects

While medication is crucial for most people with bipolar disorder, it can come with unwanted side effects, including memory problems.

If you feel as if the side effects of your medications are interfering with your ability to think clearly and concentrate, don’t hesitate to tell your doctor. “Not only can certain medications used to treat bipolar disorder further worsen memory impairment or lead to confusion and cloudiness in thought, but the more side effects and discomfort a person experiences from taking medication, the less likely they are to be consistent with their regimen,” Khan says.

Your doctor may adjust the dose to lessen your side effects, or they may switch you to another drug with potentially fewer side effects.

2. Begin (or Resume) a Daily Exercise Routine

One of the first things people diagnosed with bipolar disorder are typically told is that sticking to a consistent routine is an important way to keep mood issues at bay. The part that you may not know is that making exercise a part of that routine will protect and improve your memory.

Accumulating evidence suggests that any exercise is likely to improve memory function, according to a review published in October 2021 in the Journal of Clinical Medicine. That’s great news. But even better news, according to the Anxiety and Depression Association of America (ADAA), is that regular exercise also reduces your risk of future mood episodes by helping to stabilize your mood and overall well-being. And, as noted before, keeping your mood stable is key to keeping your memory stable, too.

How much exercise is enough exercise? According to ADAA experts, people with bipolar disorder should aim to exercise for 30 minutes, three to five days a week. Activities like walking, jogging, biking, or dancing all count toward this goal.

Along with regular exercise, “getting adequate sleep, eating well, and practicing stress-reducing techniques such as mindfulness meditation” should be key parts of your mood and memory stabilizing routine, says Lee.

3. Steer Clear of Recreational Drugs and Alcohol

As many as 30 to 50 percent of people with bipolar I or bipolar II disorder also have a substance use disorder, such as AUD, according to the Substance Abuse and Mental Health Services Administration (SAMHSA).

There are many reasons why that overlap is so strong. One factor, Mayo Clinic experts suggest, is that people turn to alcohol and recreational drugs to cope with bipolar symptoms such as anxiety and depression.

But while those substances may seem to help temporarily, in the long run they actually exacerbate memory loss. What’s more, they can negatively interact with any prescription medications you’re taking to control your bipolar symptoms. This not only increases the risk of memory loss, but increases the risk of mood swings, violent behavior, and suicide.

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