“I know words. I have the best words.” – Оранжевый Оверлорд
I’ve always been a very intelligent person.
I know, I know… People who like to talk about how smart they are generally are pretty stupid, especially if they mention their “high” IQ.
IQ is a poor way to measure intelligence. There are many different kinds of intelligences, with none really inherently “better” or “worse” than any of the others, but IQ overwhelmingly favors verbal intelligence. Similarly, culturally we favor verbal intelligence, as well, even though it is neither the only nor the best measure of “intelligence”.
I had a very good friend in high school and college who was never considered to be particularly bright because of his relatively low verbal intelligence. He now has a PhD and has had a very successful career doing research that I won’t even attempt to describe because I have literally no understanding of it. If intelligence were to be measured based on aptitude in his field, he is not only intelligent, but more intelligent than most people on the planet. He would also be undeniably far more intelligent than I could ever hope to be. But I have always had a very high verbal intelligence—far greater than his—and so I was always considered to be “smart”, from kindergarten to college and beyond, whereas he wasn’t.
Verbal intelligence is all about reasoning and storytelling using language. It features quick recall verbal memory. High verbal intelligence indicates a high aptitude in reading and writing, as well as logic and the ability to form verbal arguments. I’m the son of a teacher and a lawyer. Of course I excelled in those areas. How could I not?
An interesting aside on my verbal intelligence and its limitations: When I was up for a BFA review in college one of my committee members gave me this useful and demoralizing feedback. She said, and this is a direct quote that I will never forget, “At this time your words are more interesting than your art. Your art needs to be more interesting than your words.” As an artist those are words that I now try to live by.
So why do I bring all of this “intelligence” stuff up?
Because I am, per the way that my intelligence has always been measured, no longer as “smart” as I used to be. Bipolar has taken that away from me.
When considering symptoms of bipolar, mood symptoms always, obviously, take center stage. Mania and depression are the two “poles” of bipolar. Manic symptoms like excessive energy, poor impulse control, racing thoughts, and psychosis are widely known and understood. Depressive symptoms like increased sleep, decreased energy, lethargy, hopelessness, and suicidal ideation are equally widely known and understood. Cognitive issues, however are not a part of the pop lexicon of bipolar.
But cognitive issues are the symptoms that are kicking my ass right now.
This post has been challenging for me to write. I’m having difficulty finding the right words to use. They seem to be floating all around my head, teasing me, and every time I start to grab ahold of the one that I need it vanishes, flittering away to tease me some more from a safe distance, where I can’t get ahold of it to use it.
My train of thought is perpetually derailing. Compositionally I’m having difficulty building transitions and carrying a consistent, cohesive narrative. Sentences, paragraphs, fully developed thoughts, or even half baked ones, are all elusive. And as I start to construct something somewhat meaningful the whole thing falls apart again. Attempting to write at the moment is a sisyphean endeavor.
At home I am forgetting things. I have forgotten whole conversations—important ones. My partner and I have argued of late based on this. If I don’t remember saying or doing something, or if I don’t remember her saying or doing something, then it creates issues. It frustrates me to no end and, in so doing, has a tremendous negative impact on my mood. I get more irritable and agitated. I even start to feel a little paranoid.
If I can’t remember something how can I know for sure that it happened? I have to trust her on it, and that is not always easy to do. It isn’t that she isn’t trustworthy—she is. It’s just that everyone favors their own perspective and recollection of events over those of others. That’s normal. But I can’t trust mine right now, and yet I still favor them.
I have also, alarmingly, gotten lost a couple of times recently. I’ve lived in Lexington for 38 years. I know where things are. Heck, I pretty much know where everything is. I can stand in almost any part of the city and point in the correct direction to go to any other portion of the city. My brain works as both compass and map this way.
And yet that brain, that compass and that map, is failing me. I got lost taking my youngest daughter to her class at the Living Arts and Science Center one day last week. I got my bearings back, but there was a terrifying couple of minutes where I simply had no idea where I was or where I was going. And I’ve been going to the Living Arts and Science for over 30 years—since I was a kid. It’s at the corner of MLK and 4th. It hasn’t moved. Ever. And yet I lost it for a few minutes. I can’t tell you how terrifying that experience was.
Cognitive decline is somewhat common in bipolar. It is estimated that cognitive decline occurs in roughly 15% of people with bipolar disorder. There are many reasons for bipolar cognitive decline. To start with, mood episodes literally destroy the brain. They have been shown to shrink grey matter in the brain. Mood episodes also include an overactive amygdala that takes resources away from other parts of the brain, like the prefrontal cortex, which controls things like short-term memory and working memory. If there is less neural activity in the prefrontal cortex then of course memory will be impacted.
Meds like mood stabilizers and antipsychotics alter the way the brain works. That is literally their entire function. In doing so they inhibit neural activity. The specific way they do so this not fully understood, but it can and does include inhibiting neural activity in the frontal lobes and the prefrontal cortex. This also can have a negative impact on memory and cognitive function.
So I am experiencing (hopefully temporary) cognitive decline due either to a recent mood episode, the meds that I take to control mood symptoms, or both. There isn’t much that can be done to change it either way.
I’m trying to work around my current cognitive issues. When I experience this kind of cognitive decline I start to stutter some. There is nothing wrong with stuttering, but it embarrasses me. It probably shouldn’t, but it does. So I intentionally slow down my speech and try to be very deliberate with my words. That masks the stutter for the most part, although it doesn’t solve the problem of me “losing” words. Those words stay gone for entire conversations. Slowing down my speech has no impact on that. My quick recall verbal memory is simply gone in that moment.
I am not driving myself places as often as I normally would. I generally have one of my older kids or my partner with me in the car when I go places, too. And I also have the dog with me most of the time. He’s not much help navigating but he is great at keeping me from panicking if I start to have issues. And if all else fails I could suck it up and use the GPS on my phone to help me navigate. I’m too proud to do that right now but another couple of times getting lost will almost certainly change my disposition on the matter.
I have added an app on my phone that helps me keep track of when I need to take my meds and whether or not I have taken them. It gives me alerts when it’s time to take each pill, and then I have to put in that I took it after I’ve taken it. If I’m not sure whether or not I’ve taken something I have an easily accessible record of that on my phone.
I hate all of this. I really do. I hate the need for it and I hate the practice of it. And the worst part is that it may never get better. I have experienced these symptoms before and they’ve always improved over time, but there are never any guarantees. I am working to try to accept the fact that this may very well be the new normal.
I’ve given myself some accommodations to help me navigate life after cognitive decline, but that doesn’t mean I have to like it. I just have to accept it, which I believe I am doing.
It is frustrating as all get out, but it really is the best that I can do.