Bipolar Disorder What to Know About Executive Functioning in Bipolar Disorder By Arlin Cuncic, MA Arlin Cuncic, MA Arlin Cuncic, MA, is the author of "Therapy in Focus: What to Expect from CBT for Social Anxiety Disorder" and "7 Weeks to Reduce Anxiety." She has a Master's degree in psychology. Learn about our editorial process Updated on February 01, 2023 Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Daniel B. Block, MD Medically reviewed by Daniel B. Block, MD LinkedIn Twitter Daniel B. Block, MD, is an award-winning, board-certified psychiatrist who operates a private practice in Pennsylvania. Learn about our Medical Review Board Print FG Trade / Getty Images Table of Contents View All Table of Contents Do People With Bipolar Disorder Have Executive Dysfunction? Causes of Executive Dysfunction in Bipolar Disorder Impact of Executive Dysfunction What Impairs Executive Functioning in Bipolar Disorder? How to Manage Executive Dysfunction Coping With Executive Dysfunction Executive functioning is a set of cognitive skills that help regulate thoughts, emotions, and behavior. These skills allows people to plan ahead, stay organized, and make decisions. People with bipolar disorder often have difficulty with executive functioning.This can lead to problems with managing day-to-day activities, making decisions, and staying on track with goals. The good news is that there are strategies that can help improve executive functioning. These include developing a routine, breaking down tasks into smaller steps, and using visual aids to help stay organized. If you’re struggling with executive functioning, talk to your doctor or a therapist. Can Bipolar Disorder Cause Brain Damage? Do People With Bipolar Disorder Have Executive Dysfunction? Most people with bipolar disorder have some degree of executive dysfunction. This means that they have difficulty with planning, organizing, and completing tasks. The severity of executive dysfunction varies from person to person. For some people, it may be a mild problem that only causes occasional difficulties. For others, executive dysfunction can be a major obstacle that makes it hard to function in daily life. Causes of Executive Dysfunction in Bipolar Disorder There is not one single cause of executive dysfunction in bipolar disorder. Rather, it is thought to be caused by a combination of factors. These include the following: Biological factors: Executive dysfunction may be partially due to changes in the brain that occur as a result of bipolar disorder. Psychological factors: Psychological factors, such as stress and anxiety, can also contribute to executive dysfunction. This is because stress and anxiety can make it more difficult to focus and pay attention, which are important components of executive function. Medication side effects: Some medications used to treat bipolar disorder, such as antipsychotics can cause executive dysfunction as a side effect. Impact of Executive Dysfunction Executive dysfunction can cause a number of difficulties for people with bipolar disorder. For example, it may make it hard to do the following: Keep track of appointments and medication schedules Pay bills on time Return phone calls and emails in a timely manner Meet work deadlines Stay organized and tidy Finish a task that has been started These difficulties can make it hard to function in daily life and may contribute to problems at home, work, and school. Additionally, executive dysfunction can make it difficult to stick to treatment plans for bipolar disorder. This is because treatment plans often require people to complete complex tasks, such as taking medication regularly or attending therapy appointments. When executive dysfunction is present, these tasks may be more difficult to complete, which can make symptoms worse. What Impairs Executive Functioning in Bipolar Disorder? There are a number of things that can impair executive functioning in bipolar disorder. These include the following: Mania: During a manic episode, people may experience racing thoughts and a decreased need for sleep. This can lead to difficulty with goal management. Depression: During a depressive episode, people may experience low energy, fatigue, and difficulty concentrating. This can affect executive function, memory, and attention. Psychosis: Psychotic symptoms, such as hallucinations and delusions, which can make it hard to think clearly or focus on tasks. Medications: Some medications used to treat bipolar disorder, such as antipsychotics, can cause side effects that impair executive functioning. Substance abuse: Substance abuse can lead to impaired judgment, impulsivity, and difficulty concentrating. How to Manage Executive Dysfunction There is no single way to manage executive dysfunction in bipolar disorder. Rather, management will vary depending on the individual and the severity of symptoms. Possible treatments include the following: Identifying and avoiding triggers: Triggers are things that can make symptoms worse. Avoiding triggers can help prevent a worsening of symptoms. Cognitive behavioral therapy: Cognitive-behavioral therapy (CBT) is a type of therapy that can help people learn how to better manage their thoughts and behaviors. CBT has been found to be particularly helpful for treating executive dysfunction. Medication: Medication can be used to treat the underlying causes of executive dysfunction. For example, antipsychotics may be prescribed to treat psychosis, while antidepressants may be prescribed to treat depression. Life skills training: Life skills training can teach people with bipolar disorder practical skills, such as time management and organization. This type of training can be helpful in managing the symptoms of executive dysfunction. Vocational rehabilitation: Vocational rehabilitation can help people with bipolar disorder who are struggling to maintain employment due to executive dysfunction. Services may include job coaching, job placement, and on-the-job support. Coping With Executive Dysfunction If you have bipolar disorder and are struggling with executive dysfunction, there are a few things you can do to help yourself. These include the following: Finding a support system: Having supportive family and friends can be helpful in managing the symptoms of executive dysfunction. Staying on track with treatment: It is important to stick to your treatment plan even when it feels difficult. This may require getting extra support from your treatment team or finding creative ways to stay on track. Practicing self-care: Taking care of yourself is important for managing the symptoms of bipolar disorder and executive dysfunction. This includes eating a healthy diet, getting regular exercise, and getting enough sleep. Managing stress: Stress can trigger a manic or depressive episode.Learning how to manage stress can help prevent these episodes from happening. Practicing relaxation techniques: Relaxation techniques, such as deep breathing and meditation, can help reduce stress and promote feelings of calmness. Seeking professional help: If you are struggling to manage your symptoms, professional helpmay be necessary. This can include therapy, medication management, or vocational rehabilitation. How to Help a Loved One With Bipolar Disorder A Word From Verywell In summary, executive dysfunction is a common symptom of bipolar disorder that can cause significant difficulties in day-to-day functioning. There are a number of things that can contribute to executive dysfunction in bipolar disorder, including mania, depression, psychosis, and medication side effects. There are also a number of things that can be done to help people with executive dysfunction, such as therapy, medication management, life skills training, and vocational rehabilitation. If you are struggling to manage your symptoms, seek mental health help. 13 Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. 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The Role of Stress in Bipolar Disorder. Curr Top Behav Neurosci. 2021;48:21-39. doi:10.1007/7854_2020_151 By Arlin Cuncic, MA Arlin Cuncic, MA, is the author of "Therapy in Focus: What to Expect from CBT for Social Anxiety Disorder" and "7 Weeks to Reduce Anxiety." She has a Master's degree in psychology. See Our Editorial Process Meet Our Review Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit Speak to a Therapist Online Advertiser Disclosure × The offers that appear in this table are from partnerships from which Verywell Mind receives compensation.