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There is little rigorous evidence on whether bipolar disorder permanently decreases IQ, and the exact mechanisms by which this happens. As with other neurological disorders, there are a lot of confounding factors: pathophysiologic processes of the disorder itself, suboptimal lifestyle choices, effects of medication, incorrect treatment, etc.It's also very hard to design controlled, reproducible studies on BP:For ethical reasons, you can't deprive a patient of treatment;We don't know what "bipolar disorder" is -- unlike a disease like malaria for which we can identify a causal agent, BP is just an umbrella term for a particular set of vague symptoms. Two people with similar manic symptoms might have very different causes. Also, a variety of disorders (including celiac disease) can mimic BP, and misdiagnoses are incredibly common.This said, the ravages of depression, which is a prominent symptom of BP, can cause temporary brain fog, loss of motivation, sluggishness, etc. Some people regain their cognitive abilities once the depression and mood shifts are under control, and can lead very productive lives.Also, some bipolar medication can cause drowsiness, disorientation, "brain fog", etc. These can translate into impairment on measures of cognitive ability. We think that mood stabilizers and antipsychotics work by (in layman's terms) "slowing down" erratic electrical signaling. Of course, it's hard to do this precisely, and sometimes there are less pleasant side effects. We still have much to learn about just how mood stabilizers work, but our "hunches" are supported by the fact that most bipolar medication is also used to treat epilepsy, a disorder in which seizures are caused partly by erratic electrical signaling in the neurological system.Here's a quote on BP from The Psychiatric Times:There is growing evidence that individuals with bipolar affective disorder have cognitive impairments, even during periods of symptom remission. While these impairments are typically less pronounced than those found in other psychiatric (eg, schizophrenia) or neurological (eg, Alzheimer dementia) illnesses, reduced neuropsychological ability appears to significantly affect psychosocial functioning in patients with bipolar disorder.Although it is unclear how common cognitive impairment is among individuals with bipolar disorder, a significant portion of patients complain of neuropsychological difficulties. Because formal neuropsychological deficits have been documented in asymptomatic patients who do not complain of cognitive difficulties, it is possible that neuropsychological impairments may be more widespread than clinical experience suggests. Indeed, we recently reported that 75% of asymptomatic patients scored more than one standard deviation below healthy controls on at least 4 cognitive measures, suggesting widespread, but relatively mild, neuropsychological dysfunction in patients with bipolar disorder.However, neuropsychological functioning is not a unitary process and consists of multiple, partially dissociable cognitive domains (eg, attention, processing speed, working or declarative memory, executive processing, language, intelligence quotient [IQ]). Currently, there is very little evidence of language or IQ deficits in patients with bipolar disorder. Rather, those euthymic patients with bipolar disorder who have cognitive difficulties tend to have attentional, executive, and declarative or long-term memory impairments.Neuropsychological impairments found in euthymic patients with bipolar disorder may be confounded by clinical variables such as the manifestation of subclinical symptoms or broader epiphenomena of an individual's illness history (eg, illness duration, number of hospitalizations, or medication use). While the importance of subclinical symptoms or illness sequelae is debated in the literature, a pragmatic approach suggests that since most patients who are in remission continue to have low-level cognitive symptoms, cognitive deficits should be considered when planning treatment strategies.If you're interested in more information, read the source article:Cognitive Impairment in Patients With Bipolar Disorder: Effect on Psychosocial Functioning

The advent of CT scanners and then MRIs in the early 1980s radically transformed Neurology, not to everyone’s delight. Lowell Lubic, a senior neurologist at the University of Pittsburgh, cautioned us Residents in the early 1980s to not be “Picture Doctors.” He frequently groused that the art of lesion localization based on the Neurologic History and Physical was being compromised by Residents rushing to the Radiology suite before thinking about the patient’s H&P. Alas, “progress” was inevitable.The OP’s belief that “there’s a fine line between traumatic brain injury and dementia” is a misperception. A History and Physical by a first year Neurology Resident should readily distinguish these conditions. In rare situations of combined pathologies, an MRI or Neuropsychological testing might be additionally needed. Even so, additional history from family and acquaintances would probably prove equally useful (and much cheaper).I suspect the confusion here is that both TBI and dementia disorders compromise cognitive function. However, the details differ in ways that are important to Neurologists, Neurosurgeons, Neuropsychologists, and Physiatrists, all of whom consider the conditions VERY different. Consequently, the premise of this question is incorrect.

There are many different types of psychologists, with the most common type of psychologist people think of being a 'Clinical Psychologist'. A Clinical Psychologist is someone who can assess, diagnose and treat psychological and mental health problems. These can include, but are not limited to, anxiety, depression, schizophrenia, post-traumatic stress disorder and so on.A neuropsychologist on the other hand is someone who can assess, diagnose and treat psychological disorders associated with brain-based conditions. For example, they can assess the cognitive, behavioural and emotional deficits resulting from a brain injury, stroke, dementia or a pattern of cognitive strengths and weakness in someone with a learning disorder or a disorder on the Autism Spectrum.A neuropsychologist uses a series of tests to assess various areas of cognition and behaviour, such as memory, attention, learning, processing speed and abstract reasoning. This information is linked back to brain structures, to provide information regarding the impact of any identified areas of difficulty on a person's day to day functioning.A neuropsychological assessment also differs from that conducted by an educational psychologist. An educational psychologist will assess a child's history, intellectual abilities, basic academic skills and conduct a screening psychological assessment. This type of assessment does not include tests to reliably capture cognitive difficulties associated with attention, memory or executive functioning weaknesses, as well as Autism Spectrum disorders or more subtle psychological/social difficulties.A neuropsychological evaluation includes detailed investigation of a child's developmental, medical, social and psychological history, as well as an extensive testing battery that examines intellectual, academic, attention, executive functioning, language, visuospatial, visuoconstructional, memory and fine motor skills. The results of a neuropsychological assessment are intended to identify not merely any intellectual or learning difficulties, but also any other cognitive or psychological difficulty that may be a contributing to a child's profile.