This blog is based on the following article: Bauer IE, et al., Inflammatory mediators of cognitive impairment in bipolar disorder, Journal of Psychiatric Research (2014)
Have you ever felt like you are a little slow or you can’t remember everything as well as you used to? It’s easy to blame the meds, especially the benzodiazepines (in short it’s mostly calming and sleeping pills) Because of the fogginess they create. But research has found that people with BD suffer from more than just fogginess. The disorder itself can lead to verbal and memory deficits, poor sustained attention and reduced executing functioning even during euthymia (when you’re feeling normal). Can you relate to this? Do you sometimes feel like you just can’t get anything done or you’ve lost your glasses for the millionth time? Now you know what is contributing to this cognitive regress.
The fact that it persists right through all phases of bipolar points to the fact that these cognitive deficits are not solely caused my mood disturbances but other factors as well. Some of the possible causes under current research is inflammation, oxidative stress (an imbalance in the reactive oxygen species in Biosystems which cause disruptions in cellular communication) and cellular degeneration.
It has been found that BD is characterized by high peripheral levels of proinflammatory agents like interleukins etc. This can be linked to elevated neuroinflammation (inflammation of nervous tissue). BD has also been associated with a decrease in BDNF (brain-derived neurotrophic factor) levels. Neurotrophins like BDNF are essential for synaptic functioning and neuron survival.
There is evidence to suggest that multiple mood episodes can lead to neuronal death, this cycle is called “neuroprogression”. It can make a person more vulnerable to psychological stress and cognitive impairment over the course of the disease. In short every time you have an episode it worsens the cognitive impairment. There are still a lot of unanswered questions about the exact mechanisms involved in neuroprogression, with more information comes more opportunities for alternative treatment options for BD.
So what now? At the moment it is a waiting game before we can start addressing the cognitive impairment caused by BD. As the research is trickling in, a fuller more coherent picture is being formed of what exactly is going on in our heads. For the moment all we can do is develop habits that improve cognitive functioning. A few things that are being investigated is taking Omega 3 supplements, keeping our brains active by cognitively engaging activities like solving math problems, playing memory games, chess, the list goes on. Then there is also the role of exercise which deserves a whole blog of its own.
I hope that this blog did not upset you, but give you an answer to the question; why can’t I do everything I used to be able to do before BD smacked me in the face? What I want to prove with the review of this article is that people are working on the problem, so hold on, all is not lost, someday you will rock Sudoku again like in the old days.