Similarly, on the depressed end of the mood spectrum, we read descriptions of low energy, low self-esteem , feelings of sadness, loss or emptiness, suicidal ideation, pervasive pessimism , low motivation , and all the other experiences we associate with feeling depressed. A key conclusion supported by numerous research articles is there appears to be a positive correlation between the presence of cognitive deficit and higher acuity bipolar symptoms. This means that those with histories of more acute bipolar mood symptoms are more likely to experience aspects of cognitive deficit.
There are also important findings that point to the reality that individuals whose symptoms have been well-managed over the years will be less likely to experience cognitive impairment. A salient question is whether the manifestations of cognitive deficit symptoms are mood-phase-specific or do they represent some degree of impairment that persists and is independent of cycles of mania , hypomania and depression.
Most would agree that cognition is adversely impacted when one is acutely depressed. Recall of written or spoken words can also become compromised.
Consider the depressed student whose trying to complete a reading assignment the night before class. The same can apply to retention of material that was conveyed during a class lecture. Hypomania and mania also generate a broad range of cognitive alterations. Racing thought is a common experience during mood elevation, and the consequence of accelerated thought can again manifest as faulty memory and impaired focus. The experience is that of excessive mental activity and the consequence becomes manifest through behavioral responses that are poorly planned, prioritized and executed.
A different dilemma that sometimes comes along with mood elevation is the experience of becoming too focused. An example would be the individual who becomes locked on to an idea, a plan, or a project and continues with sustained focus far beyond what would likely occur in mid-range or even depressed mood.
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This sometimes yields an amazing burst of sustained focus and productivity in a short span of time. This should come as no surprise. In fact, it would be more surprising if mood intensity had little to no bearing upon cognition. There seems to be a fairly broad consensus in the research literature that for some with bipolar disorder, the presence of cognitive deficit is not just a reflection of mood intensity, but an enduring element of the illness itself.
The specific cognitive difficulties that present for an individual can be present during mid-range mood or even during sustained periods of remission. This is where the discussion potentially evokes anxiety for those with the disorder. My best answer at this point is — Maybe. The salient piece is that those with a history of more acute instability are more likely to encounter some enduring cognitive difficulties whereas those on the lower end of the acuity continuum are less likely to struggle with sustained deficits.
And with all of this, there is no guarantee either way. No doubt we will find examples of individuals with bipolar disorder whose experience is inconsistent with the trends being addressed in this blog.
First, how do you know if you do have any enduring cognitive deficit? This is normal for most who live with bipolar disorder. Frankly, these are tough differential diagnostic calls to make and doing so would require consultation from a neuropsychologist who is expert at assessing both. The next issue to consider is whether any symptoms of cognitive deficit may possibly be related to the medications you are prescribed.
This too is difficult to sort out, as different people react to medications differently. Many who take one of the atypical antipsychotic medications often experience some cognitive dulling from the medication. That said, I also want to strongly caution readers that taking antipsychotic medication on a daily basis does not mean that cognitive deficit symptoms are inevitable. Ultimately, these matters should be raised and explored with your prescribing psychiatrist.
The same issues are applicable to the use of lithium as well as most of the other more commonly used mood stabilizers anti-seizure medications. Determining if your medications may be responsible for changes in your cognition should begin with an in-depth discussion of the issues with your prescribing physician. If he or she does not know the material with sufficient depth, it would be worthwhile to get a second opinion particularly from a psychiatric professional that specializes in the treatment of bipolar disorder.
Undergoing a thorough neuropsychological assessment may help you to concretely identify whether you do have any enduring areas of deficit related to your bipolar disorder. Another consideration in this discussion entails where you are with the course of your disorder.
That can be a good thing if it further promotes your resolve to make healthy lifestyle choices that can mitigate the destabilizing influences of your bipolar illness. The crucial implication here is that the sooner you can be successful with healthy lifestyle management the better are your chances of having a positive stabilizing impact upon your disorder. What are your options? Deficits brought on from abnormal brain activity mania, acute depression, rapid cycling, etc.
Instead the brain learns to adapt and compensate such that the injury is no longer evident through functional impairment.
But, when the brain dysfunction occurs repeatedly over time, the extent of damage may not be adequately ameliorated through adaptation and compensation. This is where acceptance becomes crucial.
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I know this sounds trite as well as much easier said than done. But the truth is there are some aspects of decline that we really do have to figure out how to live with and accept — all of us, bipolar or not. Is this different for the thirty-something individual with bipolar disorder who recognizes cognitive decline from the point when he or she first entered college? Yes and no. Most of us typically do get better with acceptance and adaptation as we age.
The process of acceptance and adaptation has already begun earlier in the lifecycle than is the case for the majority of the population. Forgetfulness or planning difficulties can be lessened by the use of good scheduling apps, to-do apps and even more sophisticated project management apps. When writing and struggling to find the elusive but perfectly fitting word, you can allow a good thesaurus app to become your friend.
Now, do you really want to have to rely on technology to compensate for internal deficits? Even if, further on down the road. The difficult aspect of this kind of downshift is being able to make the adjustment while not perceiving it as failure. Cognitive deficit stemming from bipolar disorder is no more your fault than impairment brought about by brain trauma. Last, I encourage that you not lose sight of the fact that scientific based aspects of bipolar treatment are ongoing and evolving.
Research is currently being conducted on cognitive remediation approaches for bipolar disorder. Newer intervention strategies are always in the research pipeline. The role of maturation across the lifespan provides us with more potential for growth and healthy adaptation than most would ever imagine.back2test.barrica94.cl/xicib-yamaha-cw50.php
Ramblings of a Manic Depressive - Ed Franklin - Google книги
Russ Federman, Ph. I am interested in the issue of impaired risk assessment. My relative, 32, cannot judge risk,always assumes a positive outcome and builds her life on optimistic assumptions. Can any form of cognitive therapy help? These so far, have been hopelessly useless. Doing very well otherwise, not prone to mood swings at all, always a bit on the manic side only but only in speech. Her topics are always connected to some future success and grandiose plans. Only occasionally capable of critical self-reflection. Any hope? Not knowing your relative, beyond what you've written, it's difficult to comment on hope for her improvement.
That really has a lot to do with her own motivation. Based on the little you did write, I wonder if she may struggle with narcissistic dynamics in addition to the underlying bipolar disorder? I say that because if her mood is relatively stabilized, then what's driving the grandiose striving. She may always be trying to hit the home run as a means of avoiding her own felt inadequacy. If that is the case, then her insight and self-awareness could improve, but she'll need to be sufficiently motivated towards that end.
In the absence of strong motivation then long-term change may occur the hard way - through repeated misjudgments and poor outcomes. Wow Just read whole load of writing to do with bipolar disorder, And it was interesting , and readable, but if you were. My answer would b fuck kno's??? Blank now But I will never stop trying to help my self. CBT I have everyweek For depression, anxiety, low and height moods , with s topping of OCD but single OCD , Do u think future is something to look forward to!
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