No, I mean in terms of my memory, which has worsened terribly over the years, my intelligence which seems to be slipping, just all sorts of cognitive things. It scares me. I know part of it is that I'm not actively in school being challenged to think. And part of it is a mental laziness left over from being able to coast through most tasks. But...this may be part of it too:
1: Bipolar Disord. 2004 Jun;6(3):224-32.
Cognitive impairment in euthymic bipolar patients: implications for clinical and functional outcome.
Martinez-Aran A, Vieta E, Colom F, Torrent C, Sanchez-Moreno J, Reinares M,
Benabarre A, Goikolea JM, Brugue E, Daban C, Salamero M.
Bipolar Disorders Program, Clinical Institute of Psychiatry and Psychology, Hospital Clinic, Barcelona Stanley Medical Research Institute Center, University of Barcelona, IDIBAPS, Spain.
OBJECTIVE: Cognitive impairment in bipolar disorder may be a stable characteristic of the illness, although discrepancies have emerged with regard to what dysfunctions remain during remission periods. The aim of this study was to ascertain whether euthymic bipolar patients would show impairment in verbal learning and memory and in executive functions compared with healthy controls.
Secondly, to establish if there was a relationship between clinical data and neuropsychological performance. METHODS: Forty euthymic bipolar patients were compared with 30 healthy controls through a battery of neuropsychological tests assessing estimated premorbid IQ, attention, verbal learning and memory, and frontal executive functioning. The effect of subsyndromal symptomatology was controlled. RESULTS: Remitted bipolar patients performed worse than controls in several measures of memory and executive function, after controlling for the effect of subclinical symptomatology, age and premorbid IQ. Verbal memory impairment was related to global assessment of function scores, as well as to a longer duration of illness, a higher number of manic episodes, and prior psychotic symptoms. CONCLUSIONS: Results provide evidence of neuropsychological impairment in euthymic bipolar patients, after controlling for the effect of subsyndromal depressive symptoms, suggesting verbal memory and executive dysfunctions. Cognitive impairment seems to be related to a worse clinical course and poor functional outcome.
PMID: 15117401 [PubMed - indexed for MEDLINE]
Related Links
Cognitive function across manic or hypomanic, depressed, and euthymic states in bipolar disorder. [Am J Psychiatry. 2004] PINT:14754775
Do cognitive complaints in ethnic bipolar patients reflect objective cognitive impairment? [psychotherapy psychosomatic. 2005] PINT:16088267
Neurocognitive function in unmedicated manic and medicated ethnic pediatric bipolar patients. [Am J Psychiatry. 2006] PINT:16449483
Neuropsychological function in ethnic patients with bipolar disorder. [Br J Psychiatry. 1999] PINT:10645326
Cognitive impairment in ethnic bipolar patients with and without prior alcohol dependence. A preliminary study. [Arch Gen Psychiatry. 1998]
PINT:9435759
And these are just a few of many, many articles in the medical literature about cognitive complaints in people with the various types of bipolar disorder. Euthymia refers to normal mood, that is, a bipolar person is in remission, being neither depressed nor manic. The other two states can make the cognitive issues even worse. The same group of researchers has also looked at comparing bipolar I and bipolar II patients in remission with controls and found that bipolar I is effected in a more pronounced way. Also, from what I can tell just browsing through a few articles, the more manic or depressive episodes, the length of the illness, and the presence of psychotic episodes all exacerbate cognitive dysfunction. It only seems to get worse the older you get, too.
I feel like I'm being screwed by my brain chemistry. At least there is medication, and I'm on it, so I'm not quite out there. But it bothers me that I seem to be slipping in terms of being able to think. Add in variations in blood sugar and it's like living in a fog. :(
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