Bipolar Disorder: Does It Lead to Personality Change?

This is a question that I am frequently asked and it requires a much more detailed answer than I am offering here. I will revisit this topic later, but for now I will summarise what the research tells us.

The take home message is that Bipolar disorder does not cause a permanent 'transformation' of a person's core personality, but the extreme mood episodes it triggers can make a person act in ways that are completely foreign to their usual self. 

How Bipolar Affects Personality

While core personality remains relatively stable, researchers highlight several ways the disorder interacts with how a person is: 

• Episodic Shifts: During hypomanic/manic episodes, a person who is normally reserved may become extremely extroverted, or impulsive. Conversely, depressive episodes can cause withdrawal and a loss of confidence in someone who is typically high-achieving and high-functioning. Feelings of guilt and shame can be overwhelming in the wake of mood shifts; this can affect how a person sees themselves.

• Common Traits: Studies show that people with bipolar disorder often score higher in Neuroticism (emotional sensitivity) and Novelty Seeking (curiosity/impulsivity) compared to those without the condition.

• Character Changes Over Time: For some, repeated episodes can lead to a 'new normal.' This might include a loss of interest in former activities or a more permanent shift in how they view the world and their place in it. This is not the same as a change in personality.

  
  

• Misinterpretations: Family and friends may feel like the person has 'disappeared' during severe episodes, but most people return to their baseline self once stabilised through treatment. 

Bipolar vs. Personality Disorders

It is important to distinguish Bipolar Disorder from Personality Disorders (like Borderline or Narcissistic Personality Disorder): 

• Bipolar Disorder is a mood disorder where symptoms occur in episodes (weeks or months) with (often long) periods of stability in between.

  
  

• Personality Disorders involve enduring patterns of behaviour and thought that are consistent over many years. 

Other Considerations

Whilst the research shows that medication does not change a person's core personality, it does have other effects/side-effects that need to be taken into consideration. Again, this is a topic that requires a far longer article.

Electroconvulsive therapy (ECT) does not typically alter a person's core personality, but it often induces significant, positive behavioural changes by relieving severe depression, allowing individuals to return to their baseline personality. However, during treatment a person's behaviour and memory may be affected and this needs to be taken into account.

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