Racing Thoughts - "what is really going on inside his thoughts?"
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Q:  Racing Thoughts - "what is really going on inside his thoughts?"

Dear Dr.Phelps:

My son describes the thoughts inside his head so intense that he has actually gone to the mirror to check to see if blood is coming out his nose because he states that he thinks there is "so much in there" that it feels as if surely blood must be coming out. Could you plese describes what is probably really going on inside his thoughts? Can racing thoughts make him feel this way? I would really appreciate your  input.

Thank you,

Dear Weary -- 
The "racing thoughts" of bipolar disorder are also sometimes described as "crowded thoughts".  But for "what is really going on inside his thoughts", I'd have to defer to people with bipolar disorder and their descriptions.  Here is an example: 

Mania, or depression, is like wearing a pair of magic glasses over your eyes. Everything you see, everything you perceive, everything from the real world outside must pass through these magic glasses to reach your inner self. In mania the magic glasses make everything appear much brighter than it really is. In depression they make everything appear much darker. Nothing can get through to you without being affected by the magic glasses. There is no escape. With bipolar affective disorder, everything gets affected.

The magic glasses are inside your head, firmly entrenched between external reality and how you perceive and interpret that reality. In addition to the magic glasses, your mind is also running a fantasy of some sort. You may believe yourself to have god-like qualities, to be superhuman, to be special in some way, certainly to be someone other than you really are. The magic glasses filter reality according to the fantasy you are running. External events will be interpreted to conform to the internal fantasy you are living in. You will respond to these events, not as they are, but as you interpret them to be with the magic glasses

That's from , a personal account with a strong sense of humor to ease the painful stuff.  

There are others out there with such accounts.  One famous one is Kay Jamison's An Unquiet Mind.  Here's an excerpt:  

 "There is a particular kind of pain, elation, loneliness, and terror involved in this kind of madness. When you're high it's tremendous. The ideas and feelings are fast and frequent like shooting stars, and you follow them until you find better and brighter ones. Shyness goes, the right words and gestures are suddenly there, the power to captivate others a felt certainty. There are interests found in uninteresting people. Sensuality is pervasive and the desire to seduce and be seduced irresistible. Feelings of ease, intensity, power, well-being, financial omnipotence, and euphoria pervade one's marrow. But, somewhere this changes. The fast ideas are too fast, and there are far too many, overwhelming confusion replaces clarity. Memory goes. Humor and absorption on friend's faces are replaced by fear and concern. Everything previously moving with the grain is now against.... you are irritable, angry, frightened, uncontrollable, and emerged totally in the blackest caves of the mind. You never knew those caves were there. It will never end, for madness carves its own reality.

It goes on and on, and finally there are only other's recollections of your behavior.... your bizarre, frantic, aimless behaviors..... for mania has at least some grace in partially obliterating memories. What then after the medications, psychiatrist, despair, depression, and overdose? All those incredible feelings to sort through. Who is being too polite to say what? Who knows what? What did I do? Why? And most hauntingly, when will it happen again? Then, too, are the bitter reminders..... medicine to take, resent, forget, take, resent, and forget, but always to take. Credit cards revoked, bounced checks to cover, explanations due at work, apologies to make, intermittent memories (what did I do?), friendships gone ordained, a ruined marriage. And always, when will it happen again? Which of my feelings are real? Which of the me's is me? The wild impulsive chaotic, energetic, and crazy one? Or the shy, withdrawn, disparate, suicidal, doomed, and tired one? Probably a bit of both, hopefully much that is neither. Virginia Woolf, in her dives and climbs, said it all, "How far do our feelings take their colour from the dive underground? I meant, what is the reality of any feeling?"

Most of my patients have found Jamison's book powerful and useful.  

Dr. Phelps

Published June, 2004


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