Bipolar Blackouts

A bipolar blackout or bipolar brain fog is a term used to describe a situation where a bipolar person fails to remember certain events or periods. This may be during manic, hypomanic, or depressive episodes and it is evident that the illness has a bidirectional relationship with bipolar disorder [1]. 

These blackouts are not like the temporary memory loss one experiences and can last for hours, days, or even more and the person may not remember what they did during the blackout period. This can be particularly distressing and disorienting, which affects daily life and interpersonal relationships.

Does Bipolar Disorder Affect Memory

Cognitive impairment, transient or long-term, can be a major concern in bipolar disorder and impacts different types of memory and cognitive abilities. It is possible to have difficulties with remembering some past events, recent actions, or even forming new memories. This can happen during the mood episodes or maybe even when the patient is in a relatively stable phase.

Types of Memory Affected

Different types of memory can be impacted by bipolar disorder:

Short-term Memory: Otherwise referred to as the executive working memory, this is the capacity to temporarily store and manipulate data. Bipolar disorder can cause difficulties in memory, for example, a patient may forget what has been said to him or her a few minutes ago or forget what he or she was supposed to do.

Long-term Memory: This is the storage and retrieval of information over extended intervals of time. Bipolar memory loss impacts the long-term memory in major part meaning that one is likely to forget events or experiences that occurred in the past few days, weeks, or months.

Declarative Memory: This entails information that can be deliberately retrieved from memory, like people’s names, dates, and occurrences. Epileptic blackouts are characterized by deficits in working memory, and people cannot remember specific events or facts about themselves.

Procedural Memory: This is a type of memory that is acquired in performing certain tasks that do not require a person to think through them, for instance, cycling or typing. Bipolar disorder has a lesser effect on procedural memory but severe episodes may impair it.

What Areas Of the Brain Are Involved

The following brain regions are crucial in understanding the mechanisms behind bipolar blackouts and memory loss:

Hippocampus: This area is vital for creating new memories and transferring information from short-term memory to long-term memory. Research has also indicated that bipolar disorder patients tend to have a small hippocampus, which may explain why they have problems with memory consolidation and recall [1].

Prefrontal Cortex: This region is involved in the higher cognitive functions like planning, decision-making, and regulation of social behavior. It also contributes to the working memory. It has also been found that mood episodes can affect cognitive functions such as control and memory in the prefrontal cortex.

Amygdala: The amygdala is involved in the experience of emotions and is associated with the storage of emotional memories. In bipolar disorder, the amygdala may be hyper or hyporeactive and may alter how emotional experience is stored and retrieved.

Basal Ganglia: This group of nuclei is involved in motor control and several cognitive functions such as procedural learning and memory. It was discovered that basal ganglia are involved in the expression of the motor and cognitive manifestations of bipolar disorder.

How Memory Loss Occurs

Memory loss in bipolar disorder can occur through several mechanisms:

Neurochemical Imbalance: Bipolar disorder is characterized by an abnormality in the levels of neurotransmitters such as serotonin, dopamine, and norepinephrine. These chemicals are used in the body to regulate moods and also in cognitive functions such as memory. Neural communication can be affected by imbalances in the transmitter chemicals which in turn affects the brain’s capacity to handle and store information.

Structural Brain Changes: As discussed earlier, structural changes in some parts of the brain including the hippocampus and the prefrontal cortex can interfere with memory storage and recall. Such alterations could be due to prolonged stress, multiple episodes of mood disturbances, or genetic factors linked to bipolar disorder.

Cognitive Overload: In the manic state, the brain is flooded with too much stimulation, and during the depressive state, there is insufficient stimulation. Such cognitive overload can interfere with normal memory functioning and thus, there will be some gaps in memory [1].

Sleep Disturbances: Sleep disturbance is common in bipolar disorder individuals and it is well established that sleep disruption interferes with memory processes. Lack of or disrupted sleep hampers the ability of the brain to consolidate memories and recall them.