I recently wrote about the myth that you can be “too smart” to have bipolar disorder. I wrote about the prejudicial and false thought that if we were “smart enough” we wouldn’t have bipolar. This, of course, isn’t remotely true.
A couple of people requested more about bipolar disorder and intelligence.
But I’m sorry to say, the truth is, people with bipolar disorder are actually cognitively impaired compared to the average individual.
What is Intelligence?
One of the troubles with asking, “who is intelligent?” is that you need a definition for intelligence. Scientists want something specific, repeatable and reliable. The intelligent quotient (IQ) is not generally considered one of those things. So scientists measure “cognitive deficits.” In other words, they take a very specific component of brain function and measure it. Examples include vocabulary, memory, spatial reasoning and cognitive speed. “Intelligence” itself is a moving target and open to interpretation.
Cognitive Deficits in Bipolar Disorder
As bipolar disorder is a brain illness, it shouldn’t really come as a big surprise it affects more than just the parts of the brain involved in mood. Scientists have measured all sorts of cognitive dysfunction in bipolar disorder. Here is some of what they have found, both positive and negative:
- Cognitive dysfunction in verbal memory; dysfunction severity was linked to duration and severity of illness (Depressed, manic/hypomanic and bipolar is remission measured.)
- Bipolars on antipsychotic drugs showed lower IQ, memory and working memory scores. Duration of illness created greater memory impairment but did not affect IQ or working memory. Family history of affective disorders correlated to higher IQ. (Measured in bipolar I patients.)
- Visuospatial reasoning impairment seen in before manifestation of bipolar. Higher score in arithmetic reasoning was associated with a more than 12-fold greater risk in developing bipolar disorder.
- Large dysfunction noted in: working memory, executive control, fluency and verbal memory. Medium dysfunction noted in: concept shifting, executive control, mental speed, visual memory, and sustained attention. Small dysfunction noted in visuoperception. First degree relatives also had dysfunction in executive function and verbal memory in particular. (Meta-analysis of bipolar disorder in remission.)
- Dysfunction found in a few areas but most prominent in card sorting test, verbal memory, processing speed, sustained attention, executive function/working memory and verbal learning. (Odd increase in vocabulary function.) (Measured in bipolar disorder in remission.)
- Poor and excellent school performance both associated with increased risk of bipolar disorder. Achieving an A grade associated with increased risk for bipolar disorder, particularly in humanities and to a lesser extent in science subjects. The association between high scores and risk for bipolar disorder seems to be confined to males. A grades in Swedish (language) and music have particularly strong associations with risk for bipolar disorder.
And that doesn’t count all the neurobiological dysfunction found in neuroimaging studies. There’s quite a bit of that too. Did you know people with bipolar disorder don’t properly process facial expressions?
(For those of you curious, the story on creativity is different, but that will have to wait for another post.)
So Then, We’re Not Smart?
It depends on your definition. But look, we’re not more intelligent, we’re not less intelligent, we’re just different. Some parts of us, like memory and visual-spatial cognition, seem to be pretty universally impaired but that’s hardly the end of the world.
And psychotropic medication, particularly antipsychotics, gets in there and messes things up further for some people. Not particularly pleasant, but not overly surprising.
Life is not Even-Steven
People want to believe those with bipolar disorder are smarter because then it seems like we got a pretty present with the not-so-pretty present of bipolar disorder. I get it. It’s romanticized. It’s “fair.” It’s convenient.
It just doesn’t happen to be true.
IQ isn’t happiness. I’ll work with what I actually have to get what I want. That’s smart.