My pdoc once told me to think of my lithium treatment as practicing for Alzheimer's. Personally I think it's both. I have read on the subject alot online trying to figure it out, it seems like research suggests it is both the meds and the illness itself at play.

Each episode I have, my cognitive skills seem to deteriorate bit by bit and never fully return. I have a lot of psychotic symptoms as well. I personally think this disorder itself is plays a big role. I wish there was more answers and research into this.