What Are Crowded Thoughts in Bipolar Disorder?

I first heard the term "crowded thoughts" years ago. This term made, perhaps, even more sense to me than "racing thoughts," which is an official symptom of bipolar hypomania. So, let's take a look at what crowded thoughts are, how they may manifest in bipolar disorder, and why they matter.

What Are Crowded Thoughts?

Racing thoughts, or a flight of ideas, indicates that thoughts come one after another in quick succession. It's hard to have one thought because another one takes its place. I've found that when I have racing thoughts, it's almost impossible for other people to understand what I'm thinking because of the speed of my thoughts and the speed of the links between thoughts. 

Crowded thoughts are a bit different. When I was first told about crowded thoughts, I was told it was like you had many thoughts, and they were all stuffed into a tiny space like a phone booth. You can't make sense of one because it's smashed against so many others.

More scientifically, according to "Phenomenology of Racing and Crowded Thoughts inMmood Disorders: A Theoretical Reappraisal," crowded thoughts are:

"not only characterized by too many thoughts occurring at the same time in the field of consciousness, but perceived as unpleasant and induce the feeling that ideas are difficult to catch."¹

Another paper notes that crowded thoughts may be found in other illnesses like anxiety disorders, attention-deficit/hyperactivity disorder (ADHD), and even insomnia as well.²

When Do Crowded Thoughts Occur in Bipolar Disorder?

I identify with the idea of crowded thoughts, and I know when they occur for me. They occur quite frequently and are related to a mixed state (a mood with both depressive and hypomanic/manic symptoms). Mixed states are far more frequent for me than pure hypomania. This actually agrees with what the paper says:

"We suggest that crowded thoughts might result from the mixture of a hypomanic component, with an accelerated production of new thoughts (constituting the main source of this symptom in hypomania), and a depressive component, with a deficit of inhibition of previous thoughts (hence making thoughts crowded rather than truly racing)."¹ 

The authors are saying that crowded thoughts have a hypomanic and a depressive component, thus making them part of a mixed state.

Why Do Crowded Thoughts Matter in Bipolar Disorder?

You could go through your whole bipolar life and never need the idea of crowded thoughts. That said, I think that being able to describe what is happening in your brain accurately matters. I think being able to tell a psychiatrist what is happening for you accurately matters. And I think that understanding that this thought type may indicate the presence of a mixed state rather than depression or hypomania matters, too. For me, I find this type of insight helpful for my own understanding as well.

So, the questions for you are thus: Have you heard of crowded thoughts? Do you identify with the idea of crowded thoughts? When does this type of thought happen for you?

Sources

1. Piguet, C., Dayer, A., Kosel, M., Desseilles, M., Vuilleumier, P., & Bertschy, G. (2010). Phenomenology of racing and crowded thoughts in mood disorders: A theoretical reappraisal. Journal of Affective Disorders, 121(3), 189–198. https://doi.org/10.1016/j.jad.2009.05.006

2. Bertschy, G., Weibel, S., Giersch, A., & Weiner, L. (2020). Racing and crowded thoughts in mood disorders: A data-oriented theoretical reappraisal. L’Encéphale, 46(3), 202–208. https://doi.org/10.1016/j.encep.2020.01.007