Bipolar: Fact or Fiction?

Do individuals with bipolar disorder often confuse fact with fantasy, and believe the latter is, in fact, an actual occurrence? In other words, if an event did not actually happen, can the bipolar individual create her own reality and believe it to be true?

We all do some version of what is called "confabulation," and to varying degrees. Confabulation is term referring the phenomenon of misremembering, or creating a context for memory that fills in data—often skewed and erroneous data, into a memory. Memories are not videotaped information stored in our psyches—they are active, sculpted, and nourished bits of data, accompanied by emotions and sensations (remember Proust's madeleine). We first encode, then store in long term, then retrieve memories. We forget more than we remember, and in order to make sense of past experiences, we unwittingly may create a series of events that did not occur. False memories are an example of this in the extreme.

Your question is about bipolar disorder specifically, and so far, the data suggest that those with this condition may have some effect on verbal recall (remembering what was said and what words were used) and in general learning. In a study examining word recall, those with BPD performed less well than those without, but their other cognitive faculties remained intact. This suggests that a mild disruption in verbal recall occurs, but that other aspects of functioning were normal. The memory that is "encoded" may be erroneous. Interestingly, the emotional swings associated with BPD did not hinder the encoding aspect of memory. Those with BPD seemed to "recall" words that were not presented to memory, suggesting that a small amount of confabulation might be happening.

Medication and their effects need to be ruled out since a side-effect of some medication on some people could be difficulty in concentrating.

Does this have any noticeable impact in daily living? We still cannot say, as much more research is required to limn the brain areas of recall with those causing bipolar disorders. The thing to remember: We all confabulate to some degree—so let's be flexible about what we're so sure happened—or didn't!