What Are Racing Thoughts in Bipolar Disorder?

Repetitive, unquieted thoughts may signal a manic episode

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Within in the context of bipolar disorder, racing thought are not just "thinking fast." Rather, they are thoughts that won't be quieted and can continue in the background 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.

In some bipolar individuals, the thoughts can zip through their heads so quickly and repetitively that it's becomes nearly impossible to sleep or carry a fluid conversation.

Racing thoughts can often revolve around rhythms, almost like a broken record without sound. It might include a bar of music, a snippet of conversation, a sentence in a book, or dialogue from a movie that gets repeated again and again in one's mind. In some cases, the racing thoughts are accompanied by (or in tune with) the rhythm of a beating heart or a drumming in the persons' ears.

Racing thoughts can be a symptom of mania or hypomania and should not be confused with "hearing voices" (a symptom associated with schizophrenia and other types of psychotic disorders).

Racing Thoughts in Bipolar Disorder

For some people, racing thoughts is the first sign that he or she is entering a manic state. It can be — but is not always — an outwardly debilitating experience. Some people described 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 stop the constant looping of thoughts can prove unnerving. 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 in Diagnosing Bipolar Disorder

Racing thoughts can also for the first sign of an undiagnosed bipolar disorder.

A 2013 study from the University of Buffalo looked at more than 40,000 individuals who had previously reported symptoms of elation or irritability. Of these, most were found to have racing thoughts and other signs consistent with bipolar disorder. This was an especially important finding given that many of these individuals had been prescribed antidepressants to treat their condition — the very drugs that can trigger a manic episode.

Another set of researchers from the Hofstra Northwell School of Medicine evaluated symptoms in 52 teens who had been diagnosed with bipolar I disorder. More than 60 percent considered racing thoughts as one of the primary symptoms that led them to a bipolar diagnosis.

Racing Thoughts in Depression

Racing thoughts can also occur, less commonly, with depression. Researchers have characterized racing thoughts in depression as being more "crowded" and "jagged" and less fluid than those in manic or hypomanic episodes.

One 2005 study from the University of California, San Diego surveyed 271 people with major depressive disorder and found that 56 percent reported racing thoughts as a symptom. These individuals shared other characteristics, as well:

  • Most were diagnosed at a younger age.
  • Their depressive episodes were more severe.
  • Their disorder was more psychotic in nature.
  • They tended to have a family history of bipolar disorder.

In the end, while racing thoughts can be a symptom of mental illness, they are not specific to any particular illness. They can occur during panic attacks, anxiety attacks, when intoxicated, or during a manic or hypomanic episode.

Speak with your doctor if racing thoughts are interfering your ability to work, sleep, concentrate, or interact with others. There may be treatments that can help.

Sources:

Benazi, F. "Unipolar depression with racing thoughts: a bipolar spectrum disorder?" Psychiatry and Clinical Neurosciences. 2005; 59(5):570-5.

Correll, C.; Hauser, M.; Penzner, J.; et al. "Type and duration of subsyndromal symptoms in youth with bipolar I disorder prior to their first manic episode." Bipolar Disorders. 2014; 16(5):478-92.

Homish, G.; Marshall, D.; Dubovsky, S.; et al. "Predictors of later bipolar disorder in patients with subthreshold symptoms." Journal of Affective Disorders. 2013; 144(1-2):129-33.

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