In psychopathology we find a great variety of thought and speech disorders, which mainly affect patients with schizophrenia and bipolar disorder. In this article we will know one of them, the flight of ideas , a disorder that affects the speed of thought and speech.
We can differentiate two levels: thought (ideas) and speech (language). In this disorder, ideas slip away from each other without meaning, first in the person’s mind and later in his speech, when he verbalizes them.
Brain drain: characteristics
The flight of ideas is a disorder of thought, which affects the speed of thought and is characterized by an increase in the flow of ideas that appear in the mind , which makes the person who expresses it speak faster than usual, jumping from one idea to another constantly. This leap from one idea to another usually occurs before the first thought or idea has finished.
In addition, is considered the maximum degree of tachypsicity . Tachypsique is the pathological acceleration of psychic activity. Unlike this, the flight of ideas is more intense and aggressive.
In the flight of ideas the patient lacks a fixed direction when speaking; that is, the thought shoots up and jumps from one idea to another without direction or goal. Abrupt and illogical thematic changes occur.
Thus, as we have seen, the flight of ideas is composed of two main elements:
- Massive increase of the speed of thought .
- Systemic difficulty in reaching a conclusion.
The particularities common to all leaks of ideas are as follows.
1. Disorder and lack of purpose of intellectual processes
It happens that, even when the different ideas that the person has have some kind of relation, the whole of the cognition lacks sense and meaning .
2. Nonsensical associations that have no relation between them
Unrelated associations predominate. In addition, the thoughts generated can be very different from each other , even though they appear continuously in the person’s mind or speech.
3. Easy distractions and deviation from the topics
The subject with a flight of ideas is easily distracted and deviates from the subjects he is thinking about, influenced by the stimuli of the environment (external).
Thus, many of his ideas appear immediately as a result of the visualization of some image from the outside observed by the subject.
4. Highly visible
Leakage of ideas is easily observed through the patient’s verbal expression. This massive brainstorming that we have mentioned above is expressed immediately and unleashes the elaboration of incongruent discourses .
The flight of ideas is usually caused by an alteration in mood. In particular, a pathological euphoric state such as mania (in bipolar disorder type I) or hypomania (in bipolar disorder type II), is the main cause of the flight of ideas.
Thus, this alteration is typical of the bipolar disorders mentioned, but it can also appear in isolation (although it is not so common). It occurs especially in bipolar disorder type I, where at least one episode of mania appears or has appeared.
In an episode of mania, the mood is disturbed and there is an increase in goal-oriented activity, as well as increased energy, for 1 week (or less if hospitalization has been required).
The flight of ideas can also appear in patients with schizophrenia. Andreasen included it within his classification of thinking disorders in schizophrenia in 1979, when he developed the Thought Disorder Scale. However, when making the differential diagnosis, we must adequately differentiate the flight of ideas from the psychotic disorders themselves.
Sometimes, the flight of ideas appears together with delirious ideas , but then it is a different alteration, since the content of the thought in the flight of ideas is preserved (no delirium appears); only its presentation is altered (more accelerated than usual).
The flight of ideas is considered a serious disorder that has a very negative impact on the subject; thought is so accelerated that it loses its functionality completely.
Thus, the person experiences a massive brainstorming inside his mind, but these ideas appear to be overlapped by the generation of the subsequent idea; the person finally fails to attend to any particular idea . This is where his name comes from, from the “ideas that escape” from each other. The person elaborates a lot of thoughts and ideas, but none of them are productive.
On the other hand, thoughts disappear at the same speed as they have appeared. The subject jumps from one topic to another without any logical order or congruence. The result, finally, is that the discourse becomes totally incongruous and the subject is unable to focus the thought on any particular idea or aspect, even if it is simple.
In this way, tasks that require a minimum degree of concentration (for example, talking to someone, or even cooking) become really difficult, since the acceleration of their thinking prevents them from being able to concentrate.
The treatment for this kind of alterations depends on the general clinical picture in which it is framed, that is, the disorder that generates that and other alteations.
- Belloch, A.; Sandin, B. and Ramos, F. (2010). Manual of Psychopathology. Volume II. Madrid: McGraw-Hill.
- Vallejo, J. (2011). Introduction to psychopathology and psychiatry. (7th Ed.) Barcelona: Masson.
- American Psychiatric Association (2013). DSM-5. Diagnostic and statistical manual of mental disorders (5th Edition). Washington, DC: Author.