How to Identify Flight of Ideas in Bipolar Disorder and Schizophrenia

As a 2013 study noted, the concept of flight of ideas evolved over time.

Today, experts recognize it as one of a cluster of symptoms that may suggest a person is experiencing a mental health issue. However, you don’t necessarily have to have a mental health condition to experience flight of ideas. You could experience it during a bout of anxiety, for example.

But it’s common in people with certain mental health conditions like bipolar disorder and schizophrenia.

Specifically, someone with bipolar disorder who’s experiencing an episode of mania may exhibit signs of flight of ideas.

Mania is one of the two main types of mood episodes that a person with bipolar disorder can experience. The other is called a depressive episode.

Mania tends to show up as:

• excitability
• a tendency toward being excessively energetic
• jumpiness and irritability
• not needing to sleep more than a few hours

This is the opposite of a depressive episode.

Experts look for evidence of flight of ideas along with other signs that, when combined, suggest that you may have an underlying mental health condition.

In fact, the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) lists flights of ideas as one of the criteria for a manic episode in someone with bipolar disorder or a related disorder.

A few cues or signs to watch for:

• They’re much more talkative than usual.
• They’re very distractible.
• They’re experiencing flights of ideas.
• They function on just a few hours of sleep.
• They’re acting “wired” or “high.”
• They may not use discretion in their actions.
• They experience excessive confidence or grandiosity.

If someone’s experiencing several of those symptoms persistently, they may be having a manic episode.

Imagine that you strike up a conversation with another person. That person begins speaking quickly, taking the proverbial conversational ball and running with it.

You soon realize that the other person is rambling and changing topics faster than you can track. You may have trouble keeping up, and you probably can’t get a word in edgewise.

You’ve just witnessed a person showing signs of flight of ideas.

Flight of ideas can also show up in a person with schizophrenia during an episode of psychosis, along with some other signs of disorganized thoughts and speech.

The person may begin talking quickly, but all a listener hears is a jumble of words. The person may begin repeating words or phrases, or they may just talk and talk without ever seeming to get to the point.

Although it’s not the same, flight of ideas does bear some similarities to other phenomena that affect people with thought disorders, such as:

• Tangential speech: Also known as tangentiality, this describes the phenomenon in which a person constantly digresses to random, irrelevant ideas and topics. A person might start telling a story but loads the story down with so much irrelevant detail that they never get to the point or the conclusion. It often occurs in people with schizophrenia or when experiencing delirium.
• Loosening of associations: A person exhibiting loosening of associations will jump from one idea to another, with increasingly more fragmented connections between the thoughts. Also known as derailment, it’s often observable in people who have schizophrenia.
• Racing thoughts: Racing thoughts are a fast-moving series of thoughts that make their way through your mind and can be very distracting. Racing thoughts occur with a number of different conditions, including:
  • attention deficit hyperactivity disorder (ADHD)
  • anxiety
  • obsessive compulsive disorder (OCD)
  • a mania episode of bipolar disorder

Depending on the type they have, people with bipolar disorder may experience highs and lows. The highs are manic episodes. The lows are depressive episodes.

The cycles can happen very quickly, or they can be more spread out. In a manic episode, symptoms like flight of ideas may occur.

It’s crucial that people receive the correct diagnosis so they can receive the correct treatment.

Unfortunately, misdiagnosis can occur. For example, some people with bipolar disorder will be mistakenly diagnosed with schizophrenia if they also have symptoms of psychosis.

Treatment for bipolar disorder

Since bipolar disorder is a lifelong illness, people with this condition need ongoing treatment. The treatments can vary based on the type of bipolar disorder, plus any other conditions.

There are actually four subtypes of bipolar disorder. Plus, many people also experience other conditions at the same time, such as anxiety, post-traumatic stress disorder, or ADHD.

The most common treatments include psychotherapy, self-management strategies, and medication. Medications might include:

• mood stabilizers
• antipsychotic medications
• antidepressants

Treatment for schizophrenia

Medication and other strategies can help people with schizophrenia manage their condition and reduce their symptoms. Many people take antipsychotic medications to reduce their hallucinations and delusions.

Beyond that, mental health professionals also tend to suggest that people try some form of psychotherapy, such as cognitive behavioral therapy.

Some people also benefit from psychosocial treatments, such as participation in a peer support group or assertive community treatment.

If you know that you tend to experience flights of ideas during a manic episode, you may be able to prepare yourself.

One of the most important things that you can do is continue to take any medications that your doctor has prescribed for you.

You can also:

• Learn to identify triggers that might set off a manic episode, so you can work to avoid them.
• Ensure friends and loved ones recognize the signs of manic behavior, as it may be hard to recognize in yourself.
• Develop other strategies to help you cope, which may include exercise and meditation.
• Create a Recovery Action Wellness Plan that you can share with your loved ones, so they’ll be ready to help you if the need arises. The plan should include contact information for your physician and the rest of your healthcare team, and information about your condition and treatment.

Many people who are in the midst of a manic episode might not realize it. Or they might not want to do anything to stop the surge of energy, and don’t realize they might be putting themselves in danger.

Friends and family members in close contact with them might have to intervene.

That’s when that Recovery Action Wellness Plan can be helpful. Encourage your loved one to create a plan, and then make sure you have access to it so you can figure out how to get the right help for them.

If your loved one has schizophrenia and you notice signs of hallucinations, delusions, or other symptoms of psychosis, don’t wait to get help.

The context for flight of ideas matters. If you don’t have a mental health condition like bipolar disorder or schizophrenia, you may just be experiencing a bout of anxiety. You might be able to try some stress reduction techniques to help yourself calm down.

But if you have a family history of those conditions or have already been diagnosed, call your doctor if you start noticing signs of a manic episode or psychosis. Or you could alert a family member or friend to help you if they notice the signs, too.

All by itself, flights of ideas may not be a cause for concern.

When a person experiences flight of ideas and several other symptoms, it may signal a mental health condition. You can learn more by seeking help or a diagnosis.