### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
I have bipolar disorder and am having a bipolar manic episode. I haven t slept since night before last. What really scares me is the thought of early dementia. I am not normally a severely forgetful person, but the events of the past couple of days has me concerned. Maybe if I tell you the events of the past couple of days, you might be able to give me some kind of direction. One of the things happening a lot is that I will be in a conversation with someone and I stop mid sentence, and ask the person I m talking with what I said. More often than not over these days, I can t even remember the last word I actually said. Even so, I couldn t remember what I was going to say, much less what I already said. I m constantly misplacing things because I don t remember where I last had whatever I was missing. I turned 59 last March and I thing what really worries is that my mental health is on the rocks. I also live with PTSD, and generalized anxiety, and have been hearing voices, yeah you heard right, since the age of 10. Any suggestions that will help be less anxious would be greatly appreciated. I don t want to convince myself that I m a candidate for dementia. I m not someone who when they read about certain, believe it s what s definitely happening to me.

### output:

Hi, I don't think there is any clear indication of dementia by your account. Cognitive performance may be affected by other issues than dementia. Anxiety and depression are two sucChatDoctormon causes which create the false impression of memory impairment but in truth, it is because they affect concentration, not because there is true memory impairment. One other factor apart from anxiety might be the medication, as it may affect cognitive functions, so it might contribute as well. Therefore, dementia wouldn't be the first diagnosis coming to mind. You may have some neuropsychological tests (sort of questionnaires administered by doctors or psychologists) to test for dementia to make sure, but in the meantime, I see no reason for panic. As for sleeplessness, it is one of the most common manifestations of a manic episode, it is very common. Hope I have answered your query. Let me know if I can assist you further. 