What is it called when someone jumps from topic to topic?

You may also have racing thoughts and flight of ideas if you experience mania or hypomania. If you only experience them during a depressive, manic or mixed episode then you may be given a diagnosis of bipolar disorder.

See our pages on bipolar disorder for more information.

Along with tangentiality and flight of ideas, circumstantiality can often be a symptom of formal thought disorders such as schizophrenia or mood disorders with thought disturbances such as mania with psychosis.[1] Tangentiality refers to a disturbance in the thought process that causes the individual to relate excessive or irrelevant detail that never reaches the essential point of a conversation or the desired answer to a question. Flight of ideas refers to the expression of rapidly shifting thoughts that are loosely associated with one another. The listener may find this type of speech, in which the speaker “jumps” from one point to another, rendering their communication incoherent and nonsensical. Unlike in flight of ideas, circumstantiality contains tighter and more coherent associations that may be easier to follow or understand. Unlike tangential speakers, i.e., those who are circumstantial eventually arrive back at the main point of speech or the answer to a question.

For example, a physician may inquire about the highest level of education that a patient has obtained. A circumstantial patient may start and say they loved high school, then recount multiple lengthy tales of interesting academic and travel experiences from college before stating that they graduated with a bachelor’s degree. Similarly, a nurse may ask a manic and expansive patient about any allergies. The patient may begin by listing some of their allergies, then narrate a lengthy tale of how they went into anaphylactic shock after a bee sting in childhood, and discuss an interesting article they read recently in a magazine about the evolutionary origins of allergic reactions before finally arriving at the answer to the initial question.

Circumstantiality is commonly found in individuals with thought disorders, for example, brief psychotic disorder, schizoaffective disorder, or schizophrenia. It can also manifest in the pressured, grandiose, and disorganized speech of those with mood disorders with thought disturbances, such as bipolar I disorder with psychotic features.[2] It is also, more uncommonly, found in individuals with obsessive-compulsive disorder. In those diagnosed with psychotic disorders or thought disorders with psychosis, circumstantiality may be a direct and easily identified manifestation of the “disorganized speech” that is one of the five main diagnostic criteria for the disorder as defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM–5). In those diagnosed with obsessive-compulsive disorder, the circumstantial nature of speech may be more compulsive, in that individuals feel the need to include details in speech they consider to be relevant and feel compelled to present them in sequential order.[3]

According to an article by Levitas, children with an intellectual disability or developmental delay may also display signs of circumstantial thinking or speech that may present as the inclusion of irrelevant and concrete details. In these cases, clinicians must be careful not to misdiagnose these individuals with thought disorders. Instead, they must be evaluated in the context of their developmental delay or intellectual disability.

Circumstantiality can also be observed as part of the behavioral changes associated with some epilepsy syndromes, particularly in individuals with temporal lobe lesions. Some anecdotal studies have also documented circumstantial, rambling speech in a few patients with left complex partial seizures.[4] The term “Geschwind syndrome” has been informally suggested to describe a personality syndrome present in some patients with temporal lobe epilepsy characterized by circumstantial speech and thinking, excessive verbosity, heightened emotional responses, and altered sexuality.[5]

Flight of ideas is a symptom that involves rapid, erratic speech that switches quickly between thoughts and ideas. People who experience this symptom talk rapidly and jump from one topic to the next.

While bipolar disorder is generally considered a mood disorder, symptoms can also include disorders of thought—particularly during manic episodes. People in a manic state may have difficulty filtering out meaningful versus non-meaningful input and may thus respond to their environment in surprising ways.

When this happens, ordinary sensory input, such as the sound of traffic or blinking lights, may become severely distracting. As a result, people experiencing mania focus attention on nonessential information.

During manic episodes, it is not unusual for bipolar people to experience "racing thoughts" and "flight of ideas." These two associated symptoms involve extremely rapid thought processes that sometimes leap from topic to topic at incredible speed.

Racing thoughts and flight of ideas are also common symptoms of schizophrenia and some cases of ADHD.

Symptoms of Bipolar Disorder

Causes of Flight of Ideas

Flight of ideas is not a condition. Instead, it is a symptom of bipolar mania.

What Is Bipolar Mania?

Mania is a period of excessively elevated mood that causes extreme shifts in mood as well as significant increases in behavior and energy levels. It is a hallmark symptom of bipolar disorder.

Other factors that can play a role in flight of ideas include:

• Psychosis, which can occur with bipolar disorder, schizophrenia, or neurological conditions, including Parkinson's disease and Alzheimer's disease
• Schizophrenia
• Substances such as marijuana, which can cause psychosis and worsen the course of schizophrenia
  

Bipolar Disorder vs. ADHD

Other Types of Thought Disorders

In addition to flight of ideas, other types of thought disorders can occur in bipolar disorder and other conditions. Some of these include:

• Tangential thinking: This involves having connected thoughts but straying far from the original topic and never coming back to the original idea or point.
• Racing thoughts: Such thoughts occur rapidly, feel uncontrollable, and are highly distracting. This symptom can occur with bipolar disorder and attention-deficit hyperactivity disorder (ADHD), anxiety, and obsessive-compulsive disorder. 
• Thought blocking: This symptom involves a sudden halt in speech because a person forgets what they were talking about as if the idea has been blocked or removed from their mind.
• Loose thinking: This type of thinking involves having thoughts that are not connected and do not follow a logical train of thought.
• Circumstantial thinking: In this type of thought disorder, people will follow a series of connected ideas, straying far from the original topic before eventually returning to the original idea.
  

Pressured Speech in Bipolar Disorder

Treatment

There is no specific treatment for flight of ideas, but treating the underlying condition can help with this symptom. The treatment that may help depends on the condition that an individual has been diagnosed with.

Racing thoughts and flights of ideas may be relatively mild or quite severe. When the symptoms are mild, it may be possible to use simple calming techniques such as: 

• Meditation: Meditation is a proven technique for self-calming
• Deep breathing exercises: The physical act of deep breathing can often calm both mind and body
• Guided visualization: Tapes are available to help refocus racing thoughts to calmer thoughts
• Distraction: Watching television or otherwise distracting one's mind from the racing thoughts
• Adequate sleep: There is an important connection between sleep and mental health
• Stress management: Reducing stress and using coping strategies may be helpful
• Understanding triggers: Recognizing triggers can help people avoid them or manage them more effectively
  

When symptoms are very severe, however, the person experiencing the racing thoughts and flights of ideas will not be able to stop and focus on such exercises. In such cases, it is a good idea to consult a doctor who may be able to provide medication to lower anxiety and/or help manage a manic episode.

Treatments for mania or psychosis may involve:

• Medications include mood stabilizers, antipsychotics, anxiolytics, antidepressants, or sleep medications
• Psychotherapy, including cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT), and group therapy
• Electroconvulsive therapy
• Support groups

Helpful Online Bipolar Disorder Support Groups

Frequently Asked Questions

• What is an example of flight of ideas?

  While racing thoughts may or may not be expressed, flight of ideas involves continuous, rapid speech that changes focus from moment to moment based on association, distractions, or plays on words. Some of the time, it is possible to follow the person's leaps of logic (especially if you know the person well).

  Other times, the racing thoughts are so disorganized and chaotic that even a close friend or relative will find them confusing. For example:

  "I am hungry. Does my dog need to go for a walk? I wonder what the weather will be tomorrow. What is the purpose of life? I should learn to play canasta. My mom should lose some weight. Wait, I forgot to pick my kids up from school."

• What’s the difference between flight of ideas and racing thoughts?

  Racing thoughts occur rapidly and can be confusing and distressing. However, racing thoughts tend to follow a logical path and are connected. Racing thoughts are often a symptom of anxiety, and while they are common with mood and thought disorders, they also may occur in people who have no disorder but are in a stressed state.

  Typically, racing thoughts focus on a particular topic, often related to a stress-inducing event; for example:

  "My big test is tomorrow, but I don't know the information. I could know the information if I studied more but studying also makes me feel more stressed. If I'm more stressed I'll likely do poorly on the test but if I don't study I'll also do poorly and either way, I'm in trouble because this test is half my grade and if I fail I'll fail the class which means summer school and ..."

  What is it called when someone can't stay on topic?

  Tangential speech or tangentiality is a communication disorder in which the train of thought of the speaker wanders and shows a lack of focus, never returning to the initial topic of the conversation.

  When someone jumps from one subject to another?

  (Desultor and desultorius, by the way, come from the Latin verb salire, meaning "to leap.") A desultory conversation leaps from one topic to another and doesn't have a distinct point or direction. A desultory student skips from one subject to another without applying serious effort to any particular one.

  What is tangential thinking?

  Tangential thinking occurs when someone moves from thought to thought but never seems to get to the main point. Instead, the thoughts are somewhat connected but in a superficial or tangential way.

  What is an example of tangentiality?

  Examples of Tangentiality For example, when a therapist poses the question, “How was your week?” a person may respond with, “When I was five, my cat was killed.” When the therapist asks about the cat the person may then begin to discuss something completely different such as religious beliefs or previous illnesses.