Does ECT Treatment Cause Bipolar Memory Loss?

Bipolar disorder is a serious mental illness that causes mood swings, changes in behavior, and fluctuations in energy levels. People with bipolar disorder can also experience cognitive impairment, including deficits in short-term and long-term memory. Because of these symptoms, when treating bipolar disorder, it can be vital to consider the cognitive effects that certain approaches may produce. 

Electroconvulsive therapy (ECT) is a treatment method sometimes used to address mental health symptoms that haven’t responded to other treatment options. Modern electroconvulsive therapy tends to be far safer and much more humane than it has been in the past, but it can still carry some degree of risk, including the potential for mild to moderate memory loss. Speaking with your doctor or a mental health professional may help you decide if it’s the right option for you. In general, though, ECT acts as a last-resort treatment for bipolar disorder, major depressive disorder, and more. If you’re looking for a lower-risk option, therapy may be a helpful choice. You can work with a licensed mental health professional online or in person.

The cognitive effects of bipolar disorder

Bipolar disorder is a mood disorder characterized by mood swings, changes in cognition, and increased or decreased energy levels. Depending on the type of bipolar disorder an individual is living with, they may experience both depressive and manic episodes, which are periods of low and high mood, respectively. The symptoms of manic or depressive episodes can include not only mood changes but also significant cognitive impairments. 

Bipolar memory loss

The cognitive and memory issues associated with bipolar disorder include brain fog, difficulty focusing, and diminished memory functioning. Bipolar disorder is associated with certain alterations in the brain, which are also connected to deficits in short- and long-term memory. For example, research shows that people with bipolar disorder have abnormalities in the structure and function of the hippocampus, a region of the brain involved in the formation of new memories. The memory-related effects of these differences include impairments in verbal memory, a crucial facet of learning and cognitive function. While these deficits in brain function can be addressed through treatment, some modalities are believed to exacerbate them. 

What is electroconvulsive therapy (ECT)?

Electroconvulsive therapy, or ECT, is a medical treatment that can help people with certain mental health disorders find relief from their symptoms. ECT is often used to treat mental health conditions that have been resistant to other forms of treatment, including diagnoses like major depressive disorder, bipolar disorder, and even dementia. 

ECT is generally thought to work by creating changes in a person’s brain chemistry that may reverse their symptoms. In practice, ECT usually involves stimulating the brain while the patient is under anesthesia. Small electric currents may then be passed through the brain to intentionally cause a mild, brief seizure that typically lasts less than 60 seconds. 

For those who have been unable to find success through other forms of treatment, ECT can be a game-changer. Its ability to change the way the brain functions can be so powerful that it may produce noticeable results almost immediately. ECT has been subject to a good deal of stigma both in the past and present, largely because older versions of the treatment typically used higher doses of electricity and no anesthesia. The results often included memory loss, injury, and other severe side effects. 

Today’s ECT is generally much safer and relatively painless for those who pursue it. Still, it’s normally used as a last resort and only for those who can’t find relief elsewhere. Though side effects aren’t typically severe, there may be some risks that accompany ECT, so it might not be the right fit for everyone. For some, though, the consequences of being unable to treat depression, bipolar disorder, and other mental illnesses can be far greater than the potential risks of ECT.

ECT for mania and depression

ECT can be used to treat both mania and depression in patients with bipolar disorder. Severe symptoms that don’t respond well to other treatments are typically what lead a person to pursue ECT. Mania, for instance, may be intense enough to lead to hospitalization without proper treatment. Likewise, unaddressed depression, particularly when it accompanies a detachment from reality (psychosis), may lead to concerns like being unable to eat, completely isolating oneself from others, or experiencing thoughts of self-harm.*

*If you or a loved one are experiencing suicidal thoughts, reach out for help immediately. The National Suicide Prevention Lifeline can be reached at 1-800-273-8255 and is available to assist 24/7.

Side effects of ECT

Some side effects of ECT can be commonly observed in those who pursue the treatment. Below are some of the most common risks that patients may encounter:

• Confusion

• Vomiting

• Persistent headaches

• Stiffness or aches in the muscles

• Jaw pain

• Feeling disoriented

Potential for long-term cognitive impairment 

Research suggests that the cognitive dysfunction associated with bipolar disorder—memory loss and learning impairments, specifically—may be exacerbated by ECT. Though the risk of memory loss or other cognitive deficits may not be large in most cases, it still may be reason enough to take the time to thoroughly consider whether ECT is the right option for you. 

If you’re already prone to memory-related concerns, live with other conditions that might increase your likelihood of experiencing side effects, or have another reason to take pause, it may be best to consult a doctor. Making the decision that’s right for you can take some time and thought, but it’s perhaps one of the best things you can do to avoid unnecessary side effects. Research suggests that certain forms of ECT may be less likely to cause memory impairment than others. In a systematic review of 16 studies, researchers found that ultra-brief pulse ECT led to fewer cognitive effects than brief pulse ECT.  

Though several studies have linked electroconvulsive therapy to cognitive impairment, there is also evidence that ECT can improve certain types of memory in individuals with mood disorders. For example, one study found that participants experienced improvements in both depression scores and working memory following six sessions of ECT. 

Who can tolerate ECT?

As mentioned above, ECT is often used as a last resort when other methods of treatment do not work to treat psychological disorders. It is something that may treat people who cannot take medication, potentially including those who are pregnant. Unlike many prescription medications used to treat mental illnesses like bipolar disorder, ECT is generally considered to be safe for people who are pregnant. 

With that said, whether ECT is an ideal option may be contingent on the preferences, needs, and circumstances of the person experiencing the mental health disorder in question. Older individuals who may already be at an increased risk for dementia and memory loss, for instance, may find the risks associated with ECT to be greater than its potential rewards. The best way to know if ECT is safe for you may be to speak with a trusted doctor or mental health professional. 

Treatment for bipolar disorder: Medication and therapy 

If you’re considering ECT, it’s likely best to weigh all your options. It's typically not the only form of treatment for bipolar disorder. Patients—even those with strong, pervasive symptoms—may still respond to things like medication and psychotherapy. Common bipolar medications include mood stabilizers, antipsychotics, and antidepressants. Certain bipolar medications may be better for cognitive impairments, like bipolar brain fog or memory issues, than others. For example, research suggests that the anticonvulsant lamotrigine has a smaller impact on cognition than other medications. Always consult with a healthcare professional prior to starting or stopping any medication. 

Psychotherapy can help people with bipolar disorder receive emotional support, identify the sources of their symptoms, and address potential comorbid conditions. Cognitive behavioral therapy (CBT) is considered a particularly effective modality for bipolar disorder. Through CBT, participants can learn how negative thoughts may contribute to depressive or manic symptoms, while working through challenges like short- or long-term memory impairment. 

Healthy lifestyle changes for improved cognitive function

Additionally, healthy lifestyle changes—like getting adequate sleep and practicing stress-reducing techniques—may help you alleviate the cognitive symptoms of bipolar disorder and manage memory loss. For example, brain imaging studies have shown that physical activity can increase volume in areas of the brain responsible for memory formation. 

Additionally, a balanced diet can be an important component of your memory-stabilizing routine. There is evidence, for example, that increased consumption of omega-3 fatty acids may improve cognitive skills in individuals with bipolar disorder. It is also thought to increase volume in certain brain structures that are impacted by bipolar disorder, such as the anterior cingulate cortex, which is partially responsible for emotional functions. 

Benefits of online therapy

Regardless of how you approach your symptoms from a medical standpoint, one of the best ways to manage bipolar disorder may be by speaking with a mental health professional on a regular basis. Online therapy can be an excellent place to discuss topics pertaining to bipolar disorder, and you can use it to voice your concerns about memory loss and ECT.

By seeking out help from online therapists rather than in-person options, you may be able to save yourself time and money that may otherwise be spent on things like gas or childcare during appointments. There’s generally no need to leave your home to pursue treatment, which may mean you can find ways to incorporate therapy into your schedule with minimal stress. 

Effectiveness of online therapy for symptoms of bipolar disorder

Research suggests that online therapy can be just as beneficial as in-person options in terms of treating symptoms of bipolar disorder. Regardless of whether you pursue ECT or not, you may find that online therapy can give you the tools you deserve to successfully take charge of symptoms to the best of your ability.