Why Memory Impairment Happens in Bipolar Disorder — and How to Manage It

a casette tape unravelled in front of a brain silhouette memory impairment with bipolar.Catherine MacBride/Stocksy; Everyday HealthMemory issues can be a frustrating and overwhelming challenge for many with bipolar disorder. They're part of the cognitive impairment that affects as many as 40 to 60 percent of people with the condition. What's more, this impairment can occur in any mood state in bipolar disorder, including stable mood states, not just during hypomanic, manic, depressive, or mixed episodes.

"The resulting inattention and short-term memory impairment can interfere with just about every aspect of a person's daily life," says Zishan Khan, MD, a psychiatrist with Mindpath Health in Dallas, who treats people with bipolar disorder and related mood disorders.

Even if you're already experiencing the effects of memory impairment, don't despair. It turns out there are a few simple steps you can take to address it, and in doing so improve other aspects of life with bipolar disorder.

Bipolar disorder is characterized by manic and depressive episodes. Being diagnosed could mean you are at risk for these related mental health conditions.

"Brain imaging shows numerous differences between those with bipolar disorder and those without, including reductions in the hippocampus, [a part of the brain involved in] learning and forming new memories," says Christina Lee, MD, a psychiatrist at Kaiser Permanente in White Marsh, Maryland, who treats people with bipolar disorder and related conditions.

Memory problems also tend to occur or worsen during mood episodes, says Dr. Khan. For instance, during a depressive episode, "people often find it hard to concentrate, and as a result, they can't encode and store new information as easily because of weakened connectivity between neurons," he says.

Other factors that can play a role in memory loss, says Dr. Lee, are:

Co-occurring conditions, such as anxiety or alcohol use disorder (AUD) Anxiety can lead to confusion, forgetfulness, and difficulty concentrating, while AUD is associated with cognitive and memory loss.

Medications Brain fog and memory problems are potential side effects of certain bipolar medications, such as lithium.

Genetics Memory problems may run in some families.

Both short-term memory loss (forgetting things you've recently seen, heard, or done) and long-term memory loss (forgetting things you've stored long term) can pose particular difficulties for people with bipolar disorder.

For example, short-term memory loss may make it hard to recall what you said or did that affected loved ones during a recent mood episode, says Khan. In turn, that "not knowing" may negatively affect those relationships.

Long-term memory loss may, for example, affect employment, Khan says, by making it difficult to function effectively at work because you can't remember how to perform certain tasks associated with the role or roles you play.

Research has also identified cognitive issues – including memory problems – as a reason people with bipolar disorder are less likely to be employed than the general population.

On the bright side, there are ways you can manage memory issues associated with bipolar disorder and lessen their effects on your life.

While medication is crucial for most people with bipolar disorder, it can come with unwanted side effects, including memory problems.

If you feel as if the side effects of your medications are interfering with your ability to think clearly and concentrate, don't hesitate to tell your doctor. "Not only can certain medications used to treat bipolar disorder further worsen memory impairment or lead to confusion and cloudiness in thought, but the more side effects and discomfort a person experiences from taking medication, the less likely they are to be consistent with their regimen," Khan says.

Your doctor may adjust the dose to lessen your side effects, or they may switch you to another drug with potentially fewer side effects.

One of the first things people diagnosed with bipolar disorder are typically told is that sticking to a consistent routine is an important way to keep mood episodes at bay. The part that you may not know is that making exercise a part of that routine will improve your memory on its own, but will also help indirectly by improving mood and sleep quality.

Accumulating evidence suggests that any exercise is likely to improve memory function, according to a research review. That's great news. But even better news is that regular exercise can also reduce symptoms of depression, anxiety, and mania in bipolar disorder, according to a different research review of randomized controlled trials.

How much exercise is enough? It's recommended that you get at least 150 minutes of moderate-intensity physical activity each week, which can look like a 30-minute session five days per week. Activities like walking, jogging, biking, or dancing all count toward this goal.

Along with regular exercise, getting adequate sleep, eating well, and practicing stress-reducing techniques like mindfulness meditation should be key parts of your mood and memory stabilizing routine, says Lee.

At least 40 percent of people with bipolar I or bipolar II disorder will also have a substance use disorder, such as AUD, at some point in their lives, according to research. That number jumps to almost 60 percent among people who've been hospitalized for a manic or mixed mood episode.

There are several reasons that overlap is so strong. One factor is that people turn to alcohol and recreational drugs to cope with bipolar symptoms like anxiety and depression.

But those substances can actually exacerbate memory impairment in both the short and long terms. What's more, they can reduce the effectiveness of prescription medications you're taking to manage your bipolar symptoms. Substance use also increases the risk of mood swings, violent behavior, and suicide.

Cognitive impairment, including issues with memory, is common among people with bipolar disorder.

Its severity can be influenced by co-occurring conditions, medications, and genetics.

Short- and long-term memory loss and other memory issues can negatively affect your life.

But there are ways to manage the difficulty that memory impairment may bring, such as adjusting medications, exercising regularly, and avoiding substance use.

Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.

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Qi C et al. Effect of Mood Stabilizers on Cognition in Bipolar Disorder: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Journal of Affective Disorders. December 15, 2025.

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Bonner-Reid FT et al. Comprehensive Review on Association of Bipolar Disorder and Substance Abuse: Dual Diagnosis and Treatment Approaches. Cureus. June 19, 2025.

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