Bipolar - motivation - brain fog - meds

[Pibolar]

Hi, I’ve finally found a med that helps my moods and energy levels. However, I’m seriously struggling with my motivation and have what I can only describe as brain fog…. Struggling to get my head wrapped round even simple tasks and organising myself.

has anyones med helped them with this or is it just something I have to find a way round, and how?

Thanks.

What medication are you taking? Unfortunately 'brain fog' does seem to be common problem with all the main meds for BD. I'm on lithium and I've found reducing the dose has helped somewhat.

Using lists and simple systems to help remember things. Exercise in the morning and lowering sugar in my diet to avoid afternoon energy slumps is another thing. In my experience psychiatrists will either blame this symptom on the illness and/or don't really engage with it as a problem. The focus is on compliance. Cognitive remediation therapy is something researchers have been looking at - exercises to help improve cognitive function.

Hi, thanks for replying. I’m taking 1.5 risperidone.

I try using lists etc. It kind of works for a short while, then it all falls apart again. I think i need to put more effort in maintaining it, not easy when i also have ADHD. I’m in the process of starting again, every time the schools go back i set a new routine with new lists. That’s interesting what you say about the psychiatrists, still, might be worth a mention.

Maybe you could ask psych about getting some OT input? Or maybe just being very direct and asking for advice re cognitive issues + amotivation when taking APs. I sympathise - it is demoralising.

The only other thing I would say is try to make changes gradually and start to 'stack' good habits as you gain momentum. Don't overload yourself or be too rigid especially at the start. Things will fail but don't beat yourself up. Embrace the trial and error! Building in time for things you enjoy is so important as well. For tasks sometimes gamifying things can help - maybe a time goal. Or just listening to music/podcasts while you do it.

Good luck!

@BeatenbySassafras thank you for your advice and words of encouragement, it’s a big help at a time like this.

what’s OT?

Occupational therapy. Worth arguing your case for especially if you have ADHD diagnosis too.

For me this is part of my depression when it gets bad I have a real struggle with cognitive function. Finding words is a struggle, I can't remember names and faces and decisions are impossible. I had a really bad episode in 2020-2021 and it took until August 2022 to recover and then it took a other year for my cognition to be back to normal. Word and name recall were the last bits to return. I was on lamotrigine, lithium, quetiapine and mirtazapine. I stopped the lamotrigine at the beginning of 2023 so I don't know if that helped with the brain fog but I didn't stop the lithium and mirtazapine until late 2023 early 2024 when I was feeling more normal again so for me I think it's more about the lingering effects of the depression rather than the meds. Getting back the clarity of mind was one of the signs that I felt more able to reduce the meds.

I have had various therapies over the years. One that didn't help at the time but I think had the possibility to be helpful was behavioural activation therapy which is similar to CBT but where CBT improves the thoughts and that allows you to do more with behavioural activation you do more and it helps improve your mood.

I have also had support worker at times and a mentor through dsa when at uni and they helped with planning my week and adjusting activities to my mood to incrementally build on what I could manage and also not over do it one day to end up bed bound the next day. I learnt a lot about pacing myself with them which made a difference. Having more predictable energy levels and competencies improved my moods.