The rapid, frequent shifts in conversation topics could be a symptom of mania or hypomania. Another speech-related symptom that might be observed in such individuals is pressured speech, wherein the patient feels the pressure to keep talking. The frequent shifts in conversation topics and rapid, copious speech can make it very difficult for others to understand or follow what the patient is saying.
✦ Content (subject that is being thought about)
✦ Flow (manner in which thoughts are linked together)
✦ Stream of thought (amount and speed of the thought pattern)
In case of disturbances in the stream of thought, there are changes in the amount and the speed of thinking. Also known as the formal thought disorder, the disorder of the form of thought can be identified by analyzing the patient’s speech and writing. Disorganized thinking could appear in the form of symptoms such as:
✦ Flight of ideas (fragmented ideas; frequent shifts in conversation topics)
✦ Loosening of associations (minimal logical connection between thoughts)
✦ Clang associations (combining unrelated words due to similarity in sounds)
✦ Distractible speech (change in subject in response to a stimulus)
✦ Word salad (unintelligible, nonsensical speech that is just a jumble of words)
✦ Tangentiality (digressing from the topic, and never returning to the question and providing the information requested)
In the following sections, we would be focusing on flight of ideas.
✦ Easily distracted
He/she might talk nonstop. While the affected individual might feel excited, those around him/her should be able to identify the symptoms of hypomania. Unlike an episode of mania that is characterized by psychosis, a hypomanic episode is not as severe. Moreover, it is not characterized by delusions or hallucinations. Racing thoughts might also be observed in individuals affected by schizophrenia and Attention-deficit Hyperactivity Disorder (ADHD).
An individual exhibiting this symptom seems to be rapidly jumping from one topic to another during a conversation. The sudden and frequent changes in the topic makes it difficult for the other person to understand what the other person is talking about. The train of thought breaks several times, as before one train of thought could get completed, the affected individual suddenly shifts to another topic. Though there might be some link between the ideas, the link is due to verbal distractions in the form of puns, rhymes, or clang associations. The term ‘clang association’ refers to words or phrases that are connected by sound instead of meaning. The logical sequence of ideas might be kept through distracting cues in the environment.
✦ My mother is very sweet, but she is always getting angry at me. I never get angry because I love everyone, but only my dog loves me. Dogs are man’s best friend. Friends can become enemies. That man is the enemy of the nation.
✦ The sky is blue. I love blue eyes. My eyes are watering. There’s water everywhere.
✦ I love the color blue. I am feeling blue. I can feel my heartbeat. I beat Sam in a game of scrabble.
✦ I love my home. Home is where the heart is. My heart is beating very fast.
✦ I want good food. That restaurant offers tasty food. How many restaurants are there in your city? My city is the best.
✦ I like red color. My red-colored dress is lying on the bed. It’s time to go to bed.
In the aforementioned examples, each sentence is connected to the preceding sentence by clang associations (sound of words rather than meaning). However, the topic changes with every sentence, and the thought in none of these sentences is elaborated.
Flight of ideas might also be accompanied by pressured speech, which in turn refers to the increased rate of speech. The affected person talks rapidly, as he/she feels the pressure to continue talking. It is almost like speech without punctuation.
✦ I went to the market. I should read that book.
✦ When did you buy this dress? It’s a lovely evening.
✦ I should go for a walk. I feel like having a chocolate.
✦ I need to study for the examination. That movie has received very good reviews.
In the aforementioned examples, there’s no connection between the thoughts or statements. Loose connections, as well as flight of ideas could be indicative of a thought disorder or psychiatric illnesses such as schizophrenia. This is the reason why verbatim examples are often recorded by psychiatrists for analyzing a patient’s condition.
On a concluding note, flight of ideas is not really a condition in itself, but it can be a symptom of serious mental health problems. It can be observed in individuals going through the manic or hypomanic phase of bipolar disorder. During this phase, the affected individual has racing thoughts or pressured speech, with constant influx of thoughts that can affect that person’s ability to effectively interact with others or even sleep or relax. Therefore, medical assistance must be sought immediately if one exhibits the aforementioned symptoms.