Bipolar disorder episodes can affect your ability to think, concentrate, and recall information.
Mental health conditions don’t just affect your emotions. They can affect the way you think.
If you have bipolar disorder, you might notice that your thinking patterns change during manic (or hypomanic) and depressive episodes.
During a manic episode, you might experience high levels of mental energy and racing thoughts. On the other hand, during a depressive episode, your thinking might slow down.
Both types of bipolar disorder episodes can impair your ability to focus, recall facts, and make decisions.
Appropriate treatment might help you manage your episodes better, which can reduce bipolar disorder’s effects on your thinking patterns, memory, and ability to concentrate.
Bipolar disorder can affect the way you think and reason, particularly during a manic, hypomanic, or depressive episode.
Manic episodes involve high energy levels, racing thoughts, and impulsivity. During a depressive episode, your thoughts might be slower. You might find it harder to concentrate.
The type of bipolar disorder you have determines how it can affect your thinking. There are four types of bipolar disorder:
- bipolar I disorder
- bipolar II disorder
- cyclothymic disorder (cyclothymia)
- other specified and unspecified bipolar and related disorders
Bipolar I disorder and bipolar II disorder are the most common types. The main difference between them is the severity of manic episodes: People with bipolar I disorder experience mania. People with bipolar II disorder experience hypomania. Hypomania is less severe and shorter in duration than mania.
Another difference is the depressive episodes. People with bipolar II disorder experience episodes of major depression. People with bipolar I disorder don’t always experience depressive episodes.
Common thought patterns during a manic episode
During a manic episode, you might feel highly energized, restless, and euphoric (that is, extremely happy). Manic episodes can last for a week or longer. They can also affect your thought patterns.
Manic episodes might cause you to experience:
- racing thoughts, where you think quickly and aren’t able to “shut off” your thoughts
- high mental energy, which means you might be able to think a great deal, possibly leading to more creativity and new ideas
- difficulty concentrating or remembering things
- impulsivity, where you make irrational decisions or act without thinking, possibly leading to harmful behaviors, like reckless driving, impulsive shopping, or condomless sex
If you have bipolar II disorder, you’ll experience hypomania. Hypomania is similar to mania but doesn’t last as long and is less intense.
Hypomanic episodes may also cause racing thoughts, impulsivity, and difficulty concentrating, but not always to the extent of manic episodes.
Common thought patterns during a depressive episode
Depressive episodes in bipolar disorder are characterized by more than just an extremely low mood. It can affect your thinking, too.
During a depressive episode, you might experience:
- low mental energy
- difficulty concentrating
- difficulty making decisions
- poor memory
- thoughts about death and suicide
Many people experience cognitive distortions during depression. Cognitive distortions are errors in thinking or judgment.
In depression, cognitive distortions may lead you to think more negatively, compounding feelings of hopelessness, sadness, or worthlessness.
- All-or-nothing thinking: Also known as “black-and-white thinking,” you might feel that everything is terrible because it’s not perfect, or that you’re worthless because you made a mistake.
- Catastrophizing: This is where you assume the worst-case scenario will play out, even if there’s little chance it will. For example, you might think, “If I make a mistake at work, I’ll get fired immediately and become homeless.”
- Disqualifying the positives: This cognitive distortion involves ignoring the good and focusing exclusively on the bad.
- Emotional reasoning: This is where you draw conclusions based on your feelings, not facts. For example, “I feel unloved, so it must mean nobody loves me” or “I feel useless, so I must really be useless.”
- Mind reading: This involves assuming you know what people are thinking.
- Overgeneralization: This is where one experience dictates your beliefs about all similar experiences. For example, “I haven’t been happy lately, therefore I’ll never be happy again” or “My antidepressants don’t seem to work, therefore nothing will work. I’ll just give up trying to feel better.”
- Personalization: You assume you’re personally to blame for anything that goes wrong. For example, your friends argue and you feel guilty for not mediating, or your partner seems upset about something and you assume they’re angry at you.
Talk therapy can help you identify the cognitive distortions you tend to do. With the help of a therapist, you can identify strategies for addressing these cognitive distortions so you can think more clearly or logically.
Yes, bipolar disorder seems to negatively affect memory.
A small 2017 study found that people with bipolar disorder may experience impairments in delayed memory during manic episodes. A
Additionally, a 2018 review found that people with bipolar disorder, particularly those with severe symptoms, had worse prospective memory. Prospective memory is the ability to remember what you planned or intended to do at the right time so you can do what you planned.
A 2016 study found that, while bipolar disorder can negatively affect memory, verbal memory is particularly reduced in people with bipolar disorder who also have a substance use disorder (SUD).
There’s a link between bipolar disorder and substance use: People with bipolar disorder are more likely to misuse substances and develop SUDs than the larger population.
Bipolar disorder and psychosis
Some people with bipolar disorder experience psychosis, particularly during severe manic episodes. Episodes of psychosis can lead to auditory or visual hallucinations, delusions, and paranoid thinking.
During an episode of psychosis, you might think or act irrationally. Your ability to reason is compromised. You might believe in things despite all evidence to the contrary. You may also have difficulty caring for your basic needs, like eating or showering.
Psychosis also impairs memory because it involves parts of the brain involved in storing and recalling information.
After an episode of psychosis, you might find it challenging to remember what happened during the episode. You may also remember things that didn’t actually happen, according to research.
A 2016 study involved people with bipolar disorder who had psychosis. It found that those with poor working memory were more likely to experience auditory verbal hallucinations. This is where someone hears voices even though there is no speaker.
However, the link between bipolar disorder, memory, and psychosis needs to be studied further before it’s fully understood.
Psychosis is a medical emergency. If you think you or a loved one is experiencing psychosis, get immediate medical help.
Bipolar disorder can affect your thinking ability. Your memory and ability to concentrate might be especially compromised during a manic or depressive episode.
If you have or suspect you have bipolar disorder, know that there are numerous treatment options. Therapy, medications, and certain self-care strategies can help you improve your quality of life.