Cognitive Impairment and other Taboo Symptoms in Bipolar Psych Docs do not want to discuss

Cognitive Impairment

There is a darker side of bipolar which includes cognitive impairment as well as other symptoms. These symptoms, which are discussed below are labeled “taboo to talk about”. There may be other indications that are also taboo, but I wanted to focus on the three below since I have so much experience with them. 

Psychiatrists do not want to discuss all symptoms of bipolar.

Psychiatrists know these indicators exist, although there is a mystique about them. Instead of psychiatrists discussing it with their patients, these symptoms are usually swept under the rug.  The scary thing is that many doctors do not believe these symptoms can be acquainted with bipolar.  Let’s take a look at the first symptom.

Cognitive Impairment

Cognitive impairment is when one of your brain’s functions are damaged.  The function could be reasoning, a higher order of thinking, learning new things, concentrating, making decisions that affect everyday life, or maybe memory loss.  A brain function may be harmed by an illness like bipolar, medicines like sedatives, problems with hormones, problems with blood sodium, or substance abuse.  The brain functions could also be injured by prescribed medications we use.

There are medicines that can have an impact on cognitive function.

There is a prescription on the market that is used by psychiatrists for bipolar called Topomax (also known as Topiramate).  It was originally FDA approved as an anticonvulsant (seizures) and for preventing migraines. 

I have cognitive impairment due to Topomax as well as the illness. This impairment has manifested itself through memory lapses, forgetting appointments, being unable to remember information such as after reading an article or brain fog. Cognitive impairment was one of the reasons I got so stressed out at my paralegal jobs. I could not remember something I did 15 minutes ago. This was problematic since the attorneys I worked for often asked for updates on their cases.

Dealing with cognitive impairment can cause a lot of stress.

Coping with Cognitive Impairment

This is a hard one.  When I started to lose my memory, it was devastating.  It really turned my world upside down.  For a writer, it is important to write grammatically correct. Although, one of the parts of my memory that began to fail was remembering grammar rules.

Be sure to tell your psychiatrist about this impairment if you are experiencing it.  You should tell your primary care physician, too.  The only thing that I know that may help reverse the damage (and is on the cheap) is the brain games for people to improve their memory loss.  I have tried some brain puzzles, but I didn’t stick with them.  Thankfully, my memory has come back a smidge.  It ebbs and flows.  Try not to get frustrated with yourself.

Bipolar Psychosis

I was diagnosed with bipolar disorder 1 with psychotic features, mixed episodes, and ultra-rapid cycling. This means that I can have delusions and hallucinations. I had my first delusion when I was about 6 or 7 in my bedroom. Not shortly after that, I hallucinated a mouse in the hallway. Plus, I have had hallucinations in all five senses, too.

When I had hallucinations in all five senses, my psychiatrist at the time tried to pass it off that I had some neurological issues going on. I took some tests and there was nothing found. Then I discovered research on the five senses in bipolars that said it could in fact happen.

There was a time when I lived in my husband’s house after we got married and before we sold it. I had paranoid delusions that someone was down in the basement ready to shoot and kill me. I did not want to go down into the basement at night for one reason there were no blinds or curtains! Where I live now, the paranoid delusions are still there but are different.

It sounds hilarious or like my brain is stuck as if I were still a child. The truth is, it is VERY real to me. My heartbeat quickens, my cheeks get hot, my palms get sweaty, and my heart pounds in my head like a drum. I hate it!

Hallucinations are not cool. They can be disturbing. There is a point in my bipolar cycle that I hear music all the time or it is someone talking.

For someone like me who has bipolar 1, there is a 70% chance of a full-on psychosis when manic. The experience can be bizarre and is similar to schizophrenia.

Coping with Psychosis as a Bipolar

Let me say this first: experiencing psychosis as a bipolar can be too much to take in.  As a friend, it will go a long way if you just listen.  Give a hug without wanting anything back.  Just spend some time with your friends.  It’s important to spend time together because the individual with psychosis needs to know they are still human.  You do not necessarily have to say anything to your friend.  Let’s face it, who can pop up with something to say right after their friend had a delusion or hallucination.

Dysphoric Manic Episode

This is a symptom of bipolar which can be dangerous, aggressive, and violent. It may also include physical assault and weapons. This is the sort of thing when “Miss Timid” in the office with her hair pulled up in a bun and her clothes neatly pressed, turns super aggressive.  You never saw that one coming!

I can take the hallucinations. But the dysphoric manic episode? I hate them.

There is one fallout with dysphoric manic episodes that greatly affects families. The family suffers in silence since they are too scared to tell anyone what is going on in the house behind closed doors.

I have experienced dysphoric manic episodes many times. All of a sudden, I have road rage and tail the person who has ticked me off until they move over or change directions. I know it isn’t safe, yet it makes me feel in control and feel better.  Consequences?  What are those?


When I was living alone in my twenties, I got mad quite a bit. I jumped from one relationship to the next.  The men I dated were crap (and that is putting it mildly).  I would get so mad that I wanted to punch a hole in the wall and ignore the phone for hours on end when family and friends tried to call.  When I got mad, I wanted to drive my car into the ground and not stop until the car exploded. I also wanted to throw my T.V. out the window.

How to Cope with Dysphoric Manic Episodes

One thing that helps me cope with dysphoric manic episodes, is to pray. I go to Jesus and let Him know what I am mad about and why. In my prayer, I ask for peace and guidance.  To cope with the out-of-control anger, I might even listen to relaxing music. This usually takes the pounding out of my ears and chest and leaves me feeling a bit calmer.  I might even talk with my husband, just to get it out in the open.  He might only listen.  He might give warnings concerning the situation.  Or the best one, he will make me laugh!

Praying has gotten me out of a lot of trouble.

Taboo Topics Conclusion

This is not an exhaustive list.  The three indicators were ones that I am very familiar with and can speak openly about and as an expert.  Do you have any other bipolar symptoms that nobody, including your doctor, want to talk about?  Please email me at or share your answer in the Comments section.  

Call to Action

Do these symptoms sound like you or a friend you know? Why is it important for us in the mental health field to shed light on these taboo symptoms of bipolar? Please leave a comment below or send me an email at

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