Cognitive Issues and Bipolar Disorder

Does bipolar disorder cause problems with memory, attention focus, speed of thinking and cognition?  Does depression cause dementia, or does it just feel like it?  Are memory problems and cognition issues caused by the medications that control mood episodes?  Is there anything one can do about troubles in thinking and memory related to mood issues?

“Suddenly becoming demented” is a complaint that we have found often leads to a diagnosis of a mood disorder.  True dementia comes on gradually and sufferers are often not aware of the slow buildup of impairment.  Mania, hypomania, and major depression, on the other hand, often cause problems in the brain, such as short-term memory loss and attention and focus problems.  In fact, research shows that recovery from the cognitive problems stemming from a mood episode can last as long as six to nine months, although three months may be closer to the average time needed.

People often worry that the slow-down in cognition, attention and memory may be caused by the medications they are taking to control mood imbalances, but we have generally found that the main problem is not taking enough time for the brain to heal after an episode of either mania or depression.  You may be under pressure (or pressuring yourself) to return to work once the apparent symptoms have tapered off, but our experience shows that the end of symptoms is only the beginning of the recovery period.  Healing takes time!

One possible approach to cognitive impairments is the use of “brain exercises” to hone perception, reaction time, attention and memory.  A fairly new resource is Brain HQ, a subscription service that offers a curriculum of brain training puzzles and activities that is beginning to show real effects on the everyday lives of users.  Users report improvements in their ability to remember phone numbers, directions, and other short-term tasks, as well as improvements in driving, balance, self confidence and other subjective and objective measures.

MoodSurfing has looked at “neuroplasticity” in the realm of mindfulness, and giving attention to positive elements of the environment while reducing attention to threats.  Gratitude is a real stimulant to a better life at many levels, while “learned helplessness” is a barrier to progress that can be overcome by careful attention to the slow progress of recovery.

The brain exercises of Brain HQ and similar programs are also a form of neuroplasticity that trains the “muscles” of the brain in performing simple tasks that can be applied to real life situations.  The program moves from simple tasks to harder ones, and can adjust itself, based on internal algorithms, to give the user an easier time when they are not doing well, and a more challenging workout on a “good day”.

The science of neuroplasticity is new and just beginning to show results in randomized controlled trials, but clinical experience, as is often the case is moving ahead of the science, finding that many people have experienced real help from these approaches.


Chowdhry, Amit. How Posit Science’s BrainHQ Helps People Sharpen Their Cognitive Abilities. Forbes; Mar. 6, 2018.

Aiken, Chris. Eight ways to improve cognition in bipolar disorder. Psychiatric Times; Jan 10, 2017.

Sanches, M., Bauer, I. E., Galvez, J. F., Zunta-Soares, G. B., & Soares, J. C. (2015). The management of cognitive impairment in bipolar disorder: current status and perspectives. American journal of therapeutics, 22(6), 477–486.