What should you know about bipolar and dementia?

Bipolar episodes can involve marked changes in energy, sleep, speech, activity, or judgement, while dementia is associated with progressive difficulty in memory and other thinking abilities. A person may have both, or a change may instead reflect medication effects, depression, infection, pain, or another health problem. New urinary incontinence, confusion, or memory problems should not be assigned to bipolar disorder without assessment.

Write down when the change began, whether it is steady or fluctuating, recent sleep, medicines, alcohol or substance use, and examples of altered decisions or daily tasks. Bring a trusted relative or carer who knows the person’s usual abilities, with consent. Do not stop mood medicines suddenly. A GP Consultation can coordinate physical checks and referrals, while a Mental Health Assessment can examine mood symptoms, thinking, and safety together.

Seek urgent help for sudden confusion, unsafe behaviour, threats of self-harm or harm to others, inability to care for basic needs, severe agitation, or symptoms after a head injury. Rapid change may signal a physical problem rather than dementia progression. Arrange a clinical review for persistent memory decline, repeated falls, medication concerns, or new difficulty managing money, food, medicines, or personal care.

Ask which symptoms suggest a mood episode, which suggest cognitive decline, what reversible causes should be checked, and how the care plan can support both the person and their carer.