Bipolar Disorder Living With Racing Thoughts and Bipolar Disorder Erratic, shifting thoughts can be a sign of mania By Marcia Purse Marcia Purse Marcia Purse is a mental health writer and bipolar disorder advocate who brings strong research skills and personal experiences to her writing. Learn about our editorial process Updated on July 24, 2024 Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Amy Morin, LCSW Medically reviewed by Amy Morin, LCSW Amy Morin, LCSW, is a psychotherapist and international bestselling author. Her books, including "13 Things Mentally Strong People Don't Do," have been translated into more than 40 languages. Her TEDx talk, "The Secret of Becoming Mentally Strong," is one of the most viewed talks of all time. Learn about our Medical Review Board Print Verywell / Brianna Gilmartin Table of Contents View All Table of Contents Signs What It's Like Pre-Diagnosis Causes Treatment Coping Close Racing thoughts involve fast-moving, repetitive, and overwhelming thought patterns. They often involve multiple topics, move quickly from one idea to the next, and seem to come out of nowhere. Everyone occasionally experiences situations that cause their mind to race. Imagine that feeling amped up several notches and persisting without relief, and you'll 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. At a Glance Racing thoughts often happen during the manic or hypomanic phase of bipolar disorder. It can be an overwhelming experience where your mind jumps from one thought to the next. It's also common to experience other symptoms of mania, like pressured speech, restlessness, and grandiose thinking. However, racing thoughts can also be a sign of other conditions such as anxiety, OCD, or psychosis, so it's important to talk to a doctor to get an accurate diagnosis. Treatment depends on what's causing it, but may involve therapy, medications, and coping strategies to manage your symptoms. Press Play for Advice On Living With Bipolar Disorder This episode of The Verywell Mind Podcast, featuring actor Maurice Benard, shares for living with and managing bipolar disorder symptoms. Click below to listen now. Follow Now: Apple Podcasts / Spotify / Google Podcasts / Amazon Music Signs of Racing Thoughts Racing thoughts are more than just thinking fast. Instead, they are a rapid succession of thoughts that cannot be quieted and continue without any sign of restraint. Even when you try to control them, they just keep coming, one after another, with little ability to slow them down. 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. What Racing Thoughts Feel Like 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: Pressured speech Reduced need for sleep Persistently elevated or irritable mood Increased energy and restlessness Increased distractibility Grandiose thinking Risk-taking behavior Pre-Diagnosis 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. So, 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 full-blown bipolar disorder. What Causes of Racing Thoughts? Bipolar disorder is one potential cause, but racing thoughts and flight of ideas can occur with conditions including major depression and anxiety disorders. That's why talking to a doctor or mental health professional about what you are experiencing is so important. They can evaluate your symptoms and help determine the cause. Common causes of racing thoughts include: Anxiety Acute or chronic stress Attention-deficit hyperactivity disorder (ADHD) Bipolar disorder Certain prescription medications Depression Drug withdrawal Medical conditions, including multiple sclerosis and stroke Obsessive-compulsive disorder (OCD) Panic disorder Post-traumatic stress disorder (PTSD) Psychosis Substances such as methamphetamine, heroin, and cocaine Traumatic brain injury 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 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. Treatment for Racing Thoughts The treatment for racing thoughts depends on the underlying condition causing them. In many cases, recommended treatments may include therapy and medications. Therapy For racing thoughts that occur in bipolar disorder, therapy can help people learn to identify changes in mood and behavior. By learning how to identify things that might trigger manic or hypomanic episodes, people can better manage their condition. Cognitive-behavioral therapy (CBT) is a type of therapy that helps people understand and manage their thoughts. In CBT, people learn to identify their thoughts and develop new strategies to change or regulate them. Other types of therapy that may help treat bipolar disorder include dialectical behavior therapy (DBT) and family therapy. Medications Medications may also be helpful. The specific type of medication that your doctor prescribes will depend on your diagnosis but may include: Anti-anxiety medicationsAntidepressantsAntipsychoticsMood stabilizers If your racing thoughts are related to bipolar disorder, antipsychotics, such as Abilify (aripiprazole), Risperdal (risperidone, and Seroquel (quetiapine), or mood stabilizers, like Depakote (divalproex sodium) and Tegretol (carbamazepine), may be prescribed. How to Cope With Racing Thoughts In addition to seeking help from a mental health professional, there are also strategies you can use on your own to help manage racing thoughts. Some steps you can take include: Practice deep breathing: Deep breathing can help induce a relaxation response and calm feelings of stress and anxiety. Utilize mindfulness: Racing thoughts are often centered on worries about the future. Practicing mindfulness by focusing on the present moment can help calm these worrying thoughts. Distract yourself: When your mind is racing, try to distract yourself with something else. For example, you might try cooking a new recipe, listening to music, painting a picture or watching a movie. Get active: Exercise has many mental health benefits, including combatting feelings of anxiety and depression. You might need to experiment with several strategies to determine what works best. Talk to a doctor or mental health professional if you still struggle to manage your thoughts after trying some self-help techniques. If you or a loved one are struggling with anxiety, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area. For more mental health resources, see our National Helpline Database. 8 Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. 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Focus (Am Psychiatr Publ). 2021;19(2):184-189. doi:10.1176/appi.focus.20200045 Ma X, Yue ZQ, Gong ZQ, et al. The effect of diaphragmatic breathing on attention, negative affect and stress in healthy adults. Front Psychol. 2017;8:874. doi:10.3389/fpsyg.2017.00874 Aylett E, Small N, Bower P. Exercise in the treatment of clinical anxiety in general practice - a systematic review and meta-analysis. BMC Health Serv Res. 2018;18(1):559. doi:10.1186/s12913-018-3313-5 By Marcia Purse Marcia Purse is a mental health writer and bipolar disorder advocate who brings strong research skills and personal experiences to her writing. See Our Editorial Process Meet Our Review Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Helpful Report an Error Other Submit