If you live with bipolar disorder, you may wonder whether the condition or your medications may have long-term effects on your brain. It’s possible.

Bipolar disorder is a mental health condition characterized by mood episodes.

These episodes may mean you experience symptoms of depression with mania or hypomania in a cyclic way. Each of these symptoms may impact the way you see yourself and others, and the way your brain processes experiences.

Not everyone experiences bipolar disorder in the same way, though. So the long-term effects of these mood episodes may vary.

The exact causes of bipolar disorder haven’t been established yet. Some research suggests, however, that bipolar disorder may be associated with changes in the brain related to inflammatory processes.

Other long-term effects of bipolar disorder may include a quicker cognitive decline.

Research from 2019 suggests bipolar disorder is associated with a greater difference between brain age and chronological age. In other words, brain age seems to be higher for people with bipolar disorder compared to people of the same age without the condition.

The study also indicates this difference may not be as significant if you’re treating bipolar disorder with lithium.

Research from 2022 using clinical data and MRI results, also indicates bipolar disorder with episodes of mania may be associated with a thinning of the frontal cortex and subcortex. These cortical areas are involved in high-level functions, such as decision-making, and primitive functions, such as emotional response.

Whether these differences in people with bipolar disorder are a cause or an effect of the condition is yet to be determined. More research is needed to validate these findings and to identify short-term and long-term effects of bipolar disorder.

In a 2021 overview of the physiological changes associated with the condition, experts discuss grey and white matter changes that have been observed in some people living with bipolar disorder.

Grey matter

The limbic system of the brain consists of grey-matter structures such as the hippocampus, hypothalamus, and the amygdala. The limbic system is instrumental in functions like processing memories, stress response, and controlling emotions.

Changes to the limbic network or structure can impact how brain cells communicate. The production of dopamine and serotonin, for example, could be altered. These changes could, in turn, have an effect on your mood and they could be at the core of mood episodes in bipolar disorder.

White matter

Experts have also suggested that an immune and inflammatory response in the brain’s white matter may be what prompts changes in grey matter. More research is needed to determine if this is the case.

The white matter of the brain exists beneath the grey matter cortex. It’s composed of innumerable nerve fibers that transmit electrical signals from one region of the brain to another. This allows different brain regions to communicate, by sending and receiving important messages.

Research suggests changes in the white matter of people with bipolar disorder may impact communication between brain regions associated with the regulation of emotions.

Bipolar disorder impacts the way you see yourself, others, and the world. It can also impact how you navigate everyday tasks from self-care to school and work. But symptoms can be managed and effects can be diminished with treatment.

Untreated bipolar disorder, on the other hand, may result in the following long-term effects:

  • relationship challenges
  • job instability
  • longer mood episodes
  • more frequent mood episodes
  • more intense symptoms of depression or mania
  • higher chance of substance use disorder
  • higher chance of hospitalizations
  • suicidal ideation or a higher chance of suicide attempts

All medications may cause side effects but it doesn’t mean they always do.

Bipolar disorder is often treated with medications such as:

  • antidepressants
  • antipsychotics
  • mood stabilizers

Taking these medications may sometimes result in long-term side effects. This doesn’t mean you will experience effects, but there’s a chance some people will.

These effects might depend on the type and brand of medication you take and how long you take medication for.

On the other hand, as they help you manage your symptoms, some medications for bipolar disorder may have protective effects.

For example, lithium, a mood stabilizer, is considered the gold standard pharmaceutical treatment for bipolar disorder.

While lithium may be associated with potential side effects on kidney and thyroid function, numerous studies suggest it may also help decrease the frequency of some symptoms of bipolar disorder like suicidal ideation.

Research from 2003, 2008, and 2019 suggests lithium may also provide long-term protective effects on the brain, which could lower the chance of cognitive decline and emotional dysregulation.

It’s highly advisable that you discuss possible effects of bipolar disorder medication with a health professional. They can provide specific information about the medication that would better work for you.

Antidepressant medications

Possible effects of taking antidepressant medications include:

  • weight gain
  • emotional numbness
  • feelings of being addicted to the medication
  • sexual disorders
  • increased frequency of mood episodes in people who tend to have four or more episodes per year


Antipsychotics are sometimes prescribed for bipolar disorder when mood episodes involve symptoms of psychosis.

Possible long-term effects of antipsychotics include:

Mood stabilizers

Mood stabilizers are commonly prescribed for bipolar disorder. Some of the possible long-term effects include:

If left untreated, symptoms of bipolar disorder may intensify and have a greater impact on your day-to-day life.

A 2016 literature review suggests early treatment for bipolar disorder may lead to more positive outcomes such as:

  • lower chance of symptom recurrence
  • longer time in between mood episodes
  • less intense symptoms during mood episodes
  • increased functionality and ability to manage daily life challenges

Research isn’t conclusive about the long-term effects of bipolar disorder on the brain. It does suggest, however, that a more rapid cognitive decline and more intense symptoms are possible when the condition goes untreated.

Bipolar disorder is a lifelong mental health condition, but symptoms can be managed and relief is often possible.

Consider reaching out for professional support and exploring treatment options with a specialized healthcare team.