Signs of Racing Thoughts

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. 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. 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.

Causes of Racing Thoughts

Racing thoughts and flight of ideas can occur with conditions other than bipolar disorder, including major depression and anxiety disorders. 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

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

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. 

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

Coping 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. For more mental health resources, see our National Helpline Database.