By Marcia Purse July 25, 2019
Everyone occasionally experiences situations that cause their mind to race. Imagine that feeling amped up several notches and persisting without relief and you have an idea of what it’s like to experience racing thoughts. This symptom often signals a hypomanic or manic episode in people living with bipolar disorder, although there are other possible causes.
Racing thoughts are more than just thinking fast. Rather, they are a rapid succession of thoughts that cannot be quieted and continue without restraint. They can progressively take over a person’s functional consciousness and gallop out of control to a point where daily life can be affected. This symptom can become so severe that it interferes with the ability to sleep.
When talking with someone experiencing racing thoughts, it’s usually readily apparent because they not only speak at a rapid clip but also quickly jump from one topic to another. This outward manifestation of racing thoughts is called flight of ideas. Thus, racing thoughts and flight of ideas are two sides of the same coin.
Racing thoughts might revolve around rhythms, almost like a broken record without sound. They might include a bar of music, a snippet of a conversation, a sentence in a book, or dialogue from a movie that repeats in one’s mind. Importantly, racing thoughts do not involve hearing voices, a symptom associated with schizophrenia and other types of psychotic disorders.
Racing Thoughts in Bipolar Hypomania and Mania
Racing thoughts are often one of the first symptoms to develop when someone with bipolar disorder is entering a hypomanic or manic episode. It can be—but is not always—a debilitating experience. Some people describe it as having excessive thoughts that move quickly, but with a sense of fluidity and pleasantness.
In others, however, the experience can be jarring. Concentration can become increasingly difficult, and the inability to quiet the relentless onslaught of thoughts can prove unnerving and disruptive. It is not unusual to hear of people who need to play word games for an hour or two just to settle their thoughts enough to sleep.
Racing thoughts and flight of ideas in the context of a hypomanic or manic episode are accompanied by other signs and symptoms that might include:
Racing Thoughts That Predate Bipolar Disorder
People who experience hypomania—as opposed to full-blown mania—are typically able to maintain their daily functioning and, as such, often go undiagnosed until their first depressive episode occurs. Thus, racing thoughts and flight of ideas may predate a person being diagnosed with bipolar disorder, typically type II.
Additionally, racing thoughts and flight of ideas that occur without the requisite number of accompanying symptoms to meet the criteria for a diagnosis of hypomania or mania may identify a person at risk for eventually developing bipolar disorder. This is sometimes referred to as a subthreshold bipolar disorder.
Racing thoughts and flight of ideas accompanied by an elevated or irritable mood appear to increase an individual’s risk for eventually developing the full-blown bipolar disorder, as reported in a study published in 2013 in the Journal of Affective Disorders.
Racing thoughts and flight of ideas can occur with conditions other than bipolar disorder, including major depression and anxiety disorders. Certain drugs can also cause racing thoughts, such as methamphetamine and cocaine. Withdrawal from these drugs as well as opiates and heroin can also cause racing thoughts.
While racing thoughts can be a symptom of a mental disorder, they are not specific to a particular illness. The accompanying signs, symptoms, mood, and behaviors help distinguish among the various possible causes of this symptom.
Talk with your doctor if you experience racing thoughts, especially if they interfere with your ability to work, sleep, concentrate, or interact with others. Once the cause of your symptoms is identified, you can receive appropriate treatment.
by David Clark
So you be aware that there is currently a Royal Commission into Mental Health in Victoria. More information about the Royal Commission is available on their website at https://rcvmhs.vic.gov.au/ including the Terms of Reference, the issues the Royal Commission is tasked with investigating, timelines for their work and also transcripts of all the witness statements made during the recent hearings. If you have a spare few minutes, I strongly recommend you have a peek at the website; it’s well designed, easy to navigate and contains some fascinating details about what’s happening in mental health in Victoria.
For anyone aware, there are already guidelines for treatment of mood disorders, published by the Royal Australian and New Zealand College of Psychiatrists, available at the link below:
The issue is that no-one seems to follow their guidelines. Attending sessions of the Royal Commission to hear psychiatrists, CEOs, Chairs of Boards talk about mental health was quite an experience and revealed much of the source of the problem around mental health. There is a wealth of documents and reports around mental health published and available online from Federal Government, State Government, The National Mental Health Commission, Mental Health Victoria and various other mental health service providers and none of them talk to each other – they all standalone in their own reality.
The issue for me as someone who’s been dealing with a bipolar diagnosis since 2011 has been the lack of information about my diagnosis, my journey of healing and recovery and the lack of anything really from my psychiatrist to help me deal with my errant brain.
I now understand why the problem exists.
And thankfully through reading memoirs of those diagnosed with bipolar, reading more general books about bipolar, reading books around the relationship between bipolar and childhood trauma (which relates to my life story) and the science underpinning inter-generational trauma, I’ve focused on healing and recovery to the point now that, with the agreement of my psychiatrist, I am now off all medication and allowing my brain to heal. I do not and am not suggesting this for anyone else – this is my own personal journey and my own personal experience with bipolar. As someone only diagnosed at the age of 43, I have a different perspective perhaps from others on the journey of dealing with their bipolar brain – everyone is different and that’s been the gift of reading the memoirs of those diagnosed – to appreciate the complexities of what is and sense what could be as the journey of healing and recovery unfolds.
The National Press Club recently held a mental health forum which was followed this week with Greg Hunt, the Federal Minister for Health announcing a Long Term Mental Health Plan – see the link below for more detail:
So mental health is on the agenda of both Federal and State Governments. It’s been on the ABC many evenings and it’s been in the Herald Sun and The Age along with the Australian occasionally. Whilst it’s good that mental health is now being talked about, my concern is that the voices of lived experience are lost in the noise of progress. We have a chance to make our voices heard, to reach our to our Federal and State MPs and advocate on behalf of ourselves and others on the journey of healing and recovery. As many say, this is a once in a lifetime opportunity to help those grappling with their mental health.
Let’s get this right first, let’s put our voices and our experience of mental health at the heart of the future for mental health in Victorian and in Australia and deliver a fit for purpose approach to mental health for all!
David Clark runs a meetup group in Melbourne for those diagnosed with a mood disorder, more information can be accessed here: https://www.meetup.com/The-Melbourne-Bipolar-Disorder-Mood-Disorder-Meetup-Group/