Thursday, January 22, 2009

Thought Acceleration and the Hypomanic Edge

Clinicians and patients have long observed a connection between "racing thoughts" and the experience of euphoria in mania. In some ways it "feels good" to be racing along, though in true bipolar affective disorder the experience often becomes overwhelming or distressing, and is almost always followed by a period of low energy or "crash."

In his book The Hypomanic Edge, John Gartner suggests there is something uniquely American about the hypomanic experience. He offers illustrative historical figures such as Christopher columbus, Alexander Hamilton, and Andrew Carnegie as evidence that hypomania may be related to success, or some component of potential success and that it can actually be rewarded in certain organizations or systems or cultures. He's referring here to the risk-taking, slightly grandiose, euphoric feelings associated with hypomania. Others, too (e.g., Dr. Ronald Fieve
and Tom Wootton) have pointed to the impact of manic experience on productivity and creativity.

Patients who suffer with bipolar disorder are unlikely to see the "advantage" or benefit of the condition, but are likely to report that when they are hypomanic they enjoy a sense of well-being and a capacity to get things done. And it may take several cycles or crashes to fully appreciate that the highs come at a real cost.

Still, many have mused that they wish there were some way to enjoy the productivity and pace of the "moderate" hypomanic experience - before the sleep deprivation and disorganization kick in.

As reported in the journal Emotion, Pronin, Jacobs, & Wegner found that test subjects who are instructed in thought acceleration (reading quickly or brainstorming or even narrating a silent video in fast forward) report positive affect. For these test subjects, it feels better to think faster. Here's a .pdf of the article, and here's a summer in Boston Globe article . No clinical application is described, but the obvious hypothesis emerges: could the mildly depressed individual experience a subjective mood with some of these practices, either as part of therapy or as self-administered mood management?

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