While bipolar disorder is generally considered a mood disorder, symptoms can also include disorders of thought—particularly during manic episodes. People in a manic state may have difficulty filtering out meaningful versus non-meaningful input and may thus respond to their environment in surprising ways. When this happens, ordinary sensory input, such as the sound of traffic or blinking lights, may become severely distracting. As a result, people experiencing mania focus attention on nonessential information. During manic episodes, it is not unusual for bipolar people to experience “racing thoughts” and “flight of ideas.” These two associated symptoms involve extremely rapid thought processes that sometimes leap from topic to topic at incredible speed. Racing thoughts and flight of ideas are also common symptoms of schizophrenia and some cases of ADHD.
Causes of Flight of Ideas
Flight of ideas is not a condition. Instead, it is a symptom of bipolar mania. Other factors that can play a role in flight of ideas include:
Psychosis, which can occur with bipolar disorder, schizophrenia, or neurological conditions, including Parkinson’s disease and Alzheimer’s disease Schizophrenia Substances such as marijuana, which can cause psychosis and worsen the course of schizophrenia
Other Types of Thought Disorders
In addition to flight of ideas, other types of thought disorders can occur in bipolar disorder and other conditions. Some of these include:
Tangential thinking: This involves having connected thoughts but straying far from the original topic and never coming back to the original idea or point. Racing thoughts: Such thoughts occur rapidly, feel uncontrollable, and are highly distracting. This symptom can occur with bipolar disorder and attention-deficit hyperactivity disorder (ADHD), anxiety, and obsessive-compulsive disorder. Thought blocking: This symptom involves a sudden halt in speech because a person forgets what they were talking about as if the idea has been blocked or removed from their mind. Loose thinking: This type of thinking involves having thoughts that are not connected and do not follow a logical train of thought. Circumstantial thinking: In this type of thought disorder, people will follow a series of connected ideas, straying far from the original topic before eventually returning to the original idea.
Treatment
There is no specific treatment for flight of ideas, but treating the underlying condition can help with this symptom. The treatment that may help depends on the condition that an individual has been diagnosed with. Racing thoughts and flights of ideas may be relatively mild or quite severe. When the symptoms are mild, it may be possible to use simple calming techniques such as:
Meditation: Meditation is a proven technique for self-calming Deep breathing exercises: The physical act of deep breathing can often calm both mind and body Guided visualization: Tapes are available to help refocus racing thoughts to calmer thoughts Distraction: Watching television or otherwise distracting one’s mind from the racing thoughts Adequate sleep: There is an important connection between sleep and mental health Stress management: Reducing stress and using coping strategies may be helpful Understanding triggers: Recognizing triggers can help people avoid them or manage them more effectively
Treatments for mania or psychosis may involve:
Medications include mood stabilizers, antipsychotics, anxiolytics, antidepressants, or sleep medicationsPsychotherapy, including cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT), and group therapyElectroconvulsive therapySupport groups
Other times, the racing thoughts are so disorganized and chaotic that even a close friend or relative will find them confusing. For example: “I am hungry. Does my dog need to go for a walk? I wonder what the weather will be tomorrow. What is the purpose of life? I should learn to play canasta. My mom should lose some weight. Wait, I forgot to pick my kids up from school.” Typically, racing thoughts focus on a particular topic, often related to a stress-inducing event; for example: “My big test is tomorrow, but I don’t know the information. I could know the information if I studied more but studying also makes me feel more stressed. If I’m more stressed I’ll likely do poorly on the test but if I don’t study I’ll also do poorly and either way, I’m in trouble because this test is half my grade and if I fail I’ll fail the class which means summer school and …”
Elevated moodImpaired judgmentChanges in thought patternsMood changesChanges in activity and energySpeech disruptions
