Inside Bipolar Podcast: Managing Cluttered, Racing, and Disordered Thoughts

Do cluttered, racing, or disordered thoughts disrupt your daily life? Do you understand the differences between them? In this episode, Gabe Howard, who lives with bipolar disorder, and Dr. Nicole Washington, a board certified psychiatrist, unravel what these terms mean, how they differ, and discuss why they’re not exclusive to bipolar disorder. Using relatable analogies and personal insights, they explore the profound impact these thoughts have on mental well-being.

Listen to learn actionable tips to manage overwhelming thought patterns, from organizing your mental “papers” to differentiating between anxiety and bipolar-related symptoms. Whether you’re seeking clarity for yourself or a loved one, this candid conversation offers practical advice and compassion for navigating the chaos of an overactive mind.

“If you know that, okay, when I have these thoughts, there are certain things I typically like to do to help me manage them. I listen to music. I take a bath, I blow bubbles, I color dog coloring books. I jump up and down, I scream in a pillow, whatever that is for you. You know what? Those things are for you. But then you also are aware enough to know that those things don’t always work.” ~Dr. Nicole Washington, Host

Our host, Gabe Howard, is an award-winning writer and speaker who lives with bipolar disorder. He is the author of the popular book, “Mental Illness is an Asshole and other Observations,” available from Amazon; signed copies are also available directly from the author.

To learn more about Gabe, or book him for your next event, please visit his website, gabehoward.com. You can also follow him on Instagram and TikTok at @askabipolar.

Our host, Dr. Nicole Washington, is a native of Baton Rouge, Louisiana, where she attended Southern University and A&M College. After receiving her BS degree, she moved to Tulsa, Oklahoma to enroll in the Oklahoma State University College of Osteopathic Medicine. She completed a residency in psychiatry at the University of Oklahoma in Tulsa. Since completing her residency training, Washington has spent most of her career caring for and being an advocate for those who are not typically consumers of mental health services, namely underserved communities, those with severe mental health conditions, and high performing professionals. Through her private practice, podcast, speaking, and writing, she seeks to provide education to decrease the stigma associated with psychiatric conditions. Find out more at DrNicolePsych.com.

Inside Bipolar Podcast Episode Transcript:

Producer’s Note: Please be mindful that this transcript has been computer generated and therefore may contain inaccuracies and grammar errors. Thank you. 

Announcer: You’re listening to Inside Bipolar, a Healthline Media Podcast, where we tackle bipolar disorder using real-world examples and the latest research.

Gabe: Welcome to the podcast everyone. My name is Gabe Howard and I live with bipolar disorder.

Dr. Nicole: And I’m Dr. Nicole Washington, a board-certified psychiatrist.

Gabe: And today we’re going to talk about managing cluttered racing and disordered thoughts. Now, Dr. Nicole, I’m curious, are those things actual diagnoses or are they in the Diagnostic and Statistical Manual as something that you can diagnose?

Dr. Nicole: Gabe, they are absolutely not in the DSM. And so probably a good place for us to start would be to define what these things are.

Gabe: I think that many people experiencing bipolar disorder have experienced cluttered racing or disordered thoughts. I don’t think that they’re unfamiliar with them, but I do like the fact that we are identifying our terms. So let’s start with a cluttered thought. A cluttered thought. Or like when a lot of thoughts are sitting on top of each other. So, you

Dr. Nicole: Okay.

Gabe: Know, if every thought was its own page. It would be nice and organized, right? You turn the page and there would be the next thought, and you turn the page and there’d be the next thought. But you ever had, like, a stack of papers and you just throw them on the ground? All the thoughts are there, but you’re kind of like smooshing them together on top of each other. Corners are getting bent. The

Dr. Nicole: Okay.

Gabe: Work is there, the thoughts are there. You didn’t lose the thoughts, but they’re cluttered.

Dr. Nicole: Okay I’ll go with that. Cluttered. I like it like a cluttered room. Like there’s just stuff everywhere. There’s thoughts everywhere.

Gabe: There’s thoughts everywhere. But. But the thoughts are formed. Like I sort of should be clear on that. It’s it’s not word salad. It’s not psychosis.

Dr. Nicole: Mm-hmm.

Gabe: You’ve got the ideas in your head. You’re just having trouble organizing them in some meaningful way to utilize them, reach conclusions and things

Dr. Nicole: Okay,

Gabe: Like that. So it’s very cluttered in there.

Dr. Nicole: Okay, I got you.

Gabe: Oh yeah. And then, of course, this brings us to racing thoughts which, that’s actually in the DSM, right? Racing thoughts is like a real symptom of bipolar disorder, not just a discussion point of bipolar disorder.

Dr. Nicole: It is a real symptom of mania and hypomania, yes. So we’re thinking about those thoughts that are racing. They are going so fast it’s hard for you to even keep up with them. And so then you’re going from thing to thing because you can’t keep up with your thoughts. So the racing thoughts are literally that. If you think about your thoughts being in a cute little car, driving down the road, your thoughts are zooming by. It’s like when you watch those oh, the car races where they’re going in circles. Sometimes those cars are going so fast you can hardly keep up with them. That’s kind of what your thoughts are doing.

Gabe: And that brings us to disordered thoughts. Let’s get a definition of that. Do you want to take a stab at it or do you want me to.

Dr. Nicole: I want you to because honestly, I want to know where we’re going with this.

Gabe: In the bipolar community. When we think about disordered thoughts or disordered thinking, we tend to think about negative thoughts, right? They used to be called disturbing thoughts. You know, disturbing thoughts would pop into my mind. Things like suicide or

Dr. Nicole: Okay.

Gabe: Hurting ourselves or in very rare cases, hurting others. And these things are very disturbing. And they’ve tried to tone that down a little bit in the age of, of positivity and making mental health more available, and we really try to discuss it as disordered thoughts or disordered

Dr. Nicole: Okay.

Gabe: Thinking, these negative thoughts that we cannot control, that cause us a lot of pain.

Dr. Nicole: So for the purposes of this episode, we’re talking about thoughts you have that might lead to some unpleasant emotions.

Gabe: Yeah. Like I mean, but unpleasant. Not in like the growth potential way either. When I say disordered thoughts, I mean things that have like no practical basis in our lives. Not is this the right relationship for me where you’re Evaluating, you know, that friendship or thinking about setting a boundary. That’s not an example of a disordered thought. That’s your

Dr. Nicole: Okay.

Gabe: Thinking correctly. A disordered thought is like, would my mom miss me if I were dead? Or my mom wouldn’t miss me if I were dead? Or should I jump out of this car? Or What would everybody do if I stripped off my clothes and ran down the street? These are things that sometimes pop in the head of people with bipolar disorder that we have trouble controlling. And of course, in very rare cases, we sometimes act on them, which is why they’re so disturbing. Also, just as a matter of and I don’t think I need to convince anybody listening to this podcast, it can be a really big disruption to your thought process if you’re just sitting there and these things are just constantly bombarding your brain, so it’s

Gabe: Very disordered thinking,

Dr. Nicole: Got it. I think I’m ready.

Gabe: You are ready. Okay.

Dr. Nicole: I’m ready.

Gabe: So obviously the crux of this episode is what do you do about it? If you’re experiencing cluttered, racing or disordered thoughts, how do you manage them? Now? Dr. Nicole, I want to hit the low hanging fruit first, Obviously, if you are not in full control of your mind, that is, that is most often treated, of course, with medication and working with a mental health professional. And it doesn’t always lend itself to coping skills or trying harder or learning about your illness.

Dr. Nicole: Gabe. You’re right. You can absolutely do everything right in quotes. You can do all the yoga and the meditation and the journaling and all the things, but sometimes it comes down to discussing it with your Dr. Nicole I will say, one of the first things that I typically would do with someone is I would want to really define what these things mean to you. We’ve given you definitions that we plan to use for today, but I can tell you something like racing thoughts means very different things to different people. So one person might tell me racing thoughts and they’re absolutely describing mania. Another person might tell me racing thoughts and they are describing the racing thoughts that come with anxiety. It really just depends on the person as to how they describe them. So it is important as you start talking to your doctor, Nicole your therapist, whoever it is that you’re sharing these symptoms with that, that we come up with what your definition is so that you can make sure you’re having the same conversation and you’re on the same page.

Gabe: And and even individuals change their definition over time. I know that when I was first diagnosed with bipolar disorder, the racing thoughts were so bad they created word salad. They created nonsense. I wasn’t able to communicate with other people because so many thoughts were flying through my brain. At the same time, I couldn’t grab on to whole sentences, so I would just take like one word from each of the thoughts that were racing through my mind, and it would come out as nonsense. Now, since recovery, since treatment, since medication, since experience, since coping skills, I sometimes still get bogged down in this. And I will say to somebody, you know, give me a minute, I’m having some racing thoughts here, and I’ll take a moment to organize my thoughts before I answer. But the reality is, is that I never would have been able to organize racing thoughts with a few minutes pause all the way back in the beginning. It’s something that I can do now. So while I still call them racing thoughts that the speed has diminished

Dr. Nicole: Mm-hmm.

Gabe: For lack of a better analogy, dramatically in my recovery.

Dr. Nicole: Mm-hmm. And if someone has both bipolar disorder and anxiety. They’re prone to have racing thoughts from either disorder. It’s also important for you to be able to differentiate within yourself, what’s the difference between my anxiety racing thoughts and my manic racing thoughts.

Gabe: It’s so vital that you figure out what these concepts mean to you and how they are interfering with your activities of daily living. And don’t worry about everybody else. So don’t compare yourself to others. It’s very important to understand this in your own mind and figure out how some of these ideas that Dr. Nicole and I are going to be talking about can apply to you, and what mood state they work best in.

Dr. Nicole: And they may not apply to you the same between your anxiety and your depression and your mania. So we really have to come up with those definitions for ourselves.

Gabe: This is one of the hardest parts, about a one size fits all podcast, because this suggestion that I have for managing racing thoughts is absolutely, unequivocally not going to work on Gabe Howard. Before he was diagnosed and before I had the assistance of medication to help me better control my mind. But it’s absolutely a vital coping skill for me now, and one that I am a huge proponent of. So depending on how bad your racing thoughts are, your mileage may vary. But I do go back to that. Taking a moment and taking that moment does many things. It allows me an opportunity to slow my mind down, to breathe in. It allows me to take some notes. It allows me to practice in my mind, saying the thing that I want to say. It’s not just about taking 1 or 2 or 3 or 5 or 10 or 15 minutes. It’s about the active steps that I take in those moments.

Dr. Nicole: Mm-hmm.

Gabe: And look, if you’re not out with bipolar disorder, you don’t have to say, hey, I’m having racing thoughts with bipolar disorder. I need a moment. You can also say, hang on, I’ve lost the thread here. I’m a little confused. I just need to collect my thoughts. I think that that’s said a thousand times a day in the workplace, and nobody immediately suspects that that person has severe and persistent mental illness or bipolar disorder. So whatever phrase you can use and you know, Dr. Nicole, she has excellent tips for how to get out of a room and get yourself a few moments to collect those thoughts. If you are experiencing racing thoughts you know, in a meeting or in a situation and I. I love your tips because I, I feel like you utilize them without bipolar disorder just to get away from people who are annoying you.

Dr. Nicole: [Laughter] Oh, now my secret’s out. But there are things that you can do. I’ve said before, nobody questions. If you say, oh my gosh, I need to run to the restroom, I’ll be right back. Nobody says, no, you cannot go to the restroom. Nobody does that. So for you to need to sneak away in a social setting where you feel like, man, my thoughts are running away and I need to calm them down. There is nothing wrong with you taking your fake phone call and stepping away and saying, oh my gosh, I am so sorry, I need this, I need to take this, this is important. And you go out, gather yourself and come back in. Nobody’s going to know. You don’t have to, as Gabe said, lead with, oh, I have bipolar disorder. I need a moment. Nobody needs to know that. There are ways you can just excuse yourself and come back. And I don’t think people will think much of it because everybody does it.

Gabe: I think it’s worth repeating that people can’t read our minds. We can’t read people’s minds, people can’t read our minds. So they’re not going to figure out that you have bipolar disorder because you need to collect your thoughts. And I just want to say that because I know that, especially when experiencing racing thoughts or anything that impacts our thinking, we feel very vulnerable and we feel very exposed. So I want to reassure people, as somebody who has experienced all of these things, nobody can really tell what’s going on with me, especially when I’m managing it well. And that, of course, is one of the primary reasons I want to manage it well, because people absolutely notice when I’m managing poorly.

Dr. Nicole: Yeah.

Gabe: Another way that I manage racing thoughts is that sometimes I realize that the activity that I’m doing now is not the time, and I need a longer break. A couple of minutes is not going to cover it. I need to step away. And one of the big places that this comes up is when I edit these podcasts, you know, when I’m going through them, when I’m writing the description, when I’m utilizing the keywords, you know, there’s a lot of back-end work to do. And I personally find it tedious. And if my mind is going a thousand miles an hour, you know, this is just not the time. So one of my coping skills is to leave extra time so that if the moment that I have to do that podcast, I’m like, nope, today is not the day I have until tomorrow, I have another opportunity later in the week. This removes a lot of stress, removes a lot of anxiety, and it gives me the opportunity to go work on something where I may be more productive, instead of being forced to do something here.

Dr. Nicole: Racing thoughts are really tricky because there are so many different things that can cause your thoughts to race. And I think for people living with bipolar disorder, there is always the fear that there’s nothing they can do because if it’s racing thoughts, it has to be mania and it has to be medication. And that isn’t always the case. I mean, there are times, I mean, I want to be very clear, there are times when medication is it. I’m sure you have experienced times where there was not a coping skill in the world that you could have used to help you manage your racing thoughts. It had to be accomplished with medication and there are going to be those times. But then there are also going to be times that you can use these tools, and it’s up to you to be able to determine on what end of this spectrum am I on right now?

Gabe: You know, Dr. Nicole, I wanted to talk about racing thoughts first because it is very common. A lot of people with bipolar disorder have experienced racing thoughts, and even people in long term recovery have reported that racing thoughts sort of is a breakthrough symptom. It just kind of happens every now and again despite their best efforts. So I, I always think it’s a great idea to have some, some tangible things that you can do when racing thoughts come up. Now, this is an idea that works both for racing thoughts and cluttered thinking. But I got to be honest, I’ve never found it successful for racing thoughts. But a lot of people with bipolar disorder who I talked to have. So we’re kind of lumping them together. But once again, your mileage may vary. And that’s to actually write things down. If your thoughts are really cluttered and you can’t get them together, write down all the thoughts and put them in order, whether that’s to create a to do list or an action plan or an outline. Seeing it in writing is very helpful for a lot of people. Now it doesn’t work for my racing thoughts, but it does work for my cluttered thoughts very, very

Gabe: Well.

Dr. Nicole: So the writing down like a to do list or just to get them out of your head. What are we talking about here?

Gabe: So it’s a little bit of both, right? It depends on what the situation is. For example, sometimes my cluttered thoughts are all the things that I need to do in the day, and I’m having trouble organizing them because I’m like, well, I got to do this, this, this, this, this, this, this. Well, where do you start? Well, you got this, this this this this. Well, where do I start? Well, how long will this take? Well, I don’t know. And it’s just like everything is flying through my brain. And actually committing that to a to do list allows me to forget everything else. And just look at one item on the to do list and then do it. And here’s a little pro tip for that to do list. I never number them. I just write them down. So that way I can pick from anywhere on the list and write them off.

Dr. Nicole: Hmm.

Gabe: I don’t have to do them in order. That was a tip I got a long time ago, and it’s paid off like gangbusters.

Dr. Nicole: Wow. Because that feels very chaotic to me. [Laughter] To me, my to do list would make me a little more anxious if it was just all willy nilly all over the page. I don’t number mine, but I do recommend if there are things that you have to get done today, that they go at the top, that they’re at least grouped together at the top. No particular order. But I think whenever most of us put together a to do list, you have things that you know you have to get done today. There are things it would be nice if I got done today because I need to get them done in the near future. And then there are those things that I really want to get these things done, but they’re not imminent or urgent or anything like that. I kind of break my list up into those sections, not numbered, but I do break them up, because what I do find is that sometimes if you just go with your cluttered thoughts and your racing thoughts, and you just write them down in the order you think of them. That still may not be the order of importance. And then you could waste a lot of time doing something that’s higher up on your to do list, and then you get to the end of the day and you’re like, crap, I’m tired and spent and I want to go to bed, but I can’t because I missed some things that I wrote down lower that really were more important for me to get done. So I usually recommend you at least group them so that you know which of the things I must get done today, and to be able to not set yourself up for failure at the end of the day.

Gabe: I want to say that one. I agree with everything that you just said, that that sounds like the perfect to do list for you and for probably a lot of our listeners. I want to speak as somebody living with bipolar disorder. I like the flexibility. Flexibility makes me feel safe. So obviously designing the to do list for you is best, but that’s all a to do list. But let’s talk about conversations that we have with people that are just really banging around in our brain, right? I think all of us have had a deep conversation with somebody that has bothered us, whether it’s an argument with a loved one, whether it’s the come to Jesus talk with your boss at work, whether it’s a coworker who you’re trying to set boundaries with, human interaction is fraught with potential to have interactions that stick with us.

Gabe: And if we’re experiencing racing thoughts when those moments happen, it’s absolutely going to impact how we think about the issue. If we’re experiencing cluttered thoughts while that happens, it’s going to impact our ability to reach resolution or at least deal with it and understand it in our own mind. So in those moments, writing down a narrative or writing down what’s bothering us, or writing down the actual concern and getting rid of the fluff and being able to focus on what the actual issue is prevents me from doing things like kitchen fight fighting with my relatives, where I’m just bringing up things that have nothing to do with it. It allows me to not catastrophize right. This is an issue that I’m having with my boss, but everything else is fine. It’s just this one issue. And seeing it in writing really allows my brain to grasp it in a better way than if it’s just rambling around in my brain. Especially with the racing thoughts or the cluttered thoughts. It’s just not gelling in a way that I can utilize it.

Dr. Nicole: That sounds like a fantastic skill, but not one that everybody can do in the beginning.

Sponsor Break

Gabe: And we’re back discussing managing cluttered, racing and disordered thoughts with bipolar disorder.

Dr. Nicole: One of the techniques that therapists have used for years with people who have anxiety is having them write all those worries, those cluttered thoughts, those racing thoughts, write them down. A lot of times when folks have cluttered thoughts and racing thoughts outside of the mania, it is usually at night. It is usually once things quiet down and it’s time to be quiet and you’re not distracted by the stuff of the day. And then all the things from the day come flooding back into your brain. So being able to write those things down and get them out can sometimes help slow down your brain to allow you to relax enough to get to sleep. That is a technique that people have used, so we use writing a lot to help with these kinds of thoughts.

Gabe: And, you know, writing has really evolved since I was diagnosed, you know, 20 some years ago. It was literally get a pen and paper and write it down. But, you know, there’s online journals now. There’s people doing

Dr. Nicole: Yeah.

Gabe: It on their phones, their iPads, their tablets. There’s , there’s people who are using apps to do this. So when we say write it down, it doesn’t necessarily mean physically write it. You can also

Dr. Nicole: Yes.

Gabe: Type it. It’s just I really feel that there’s the value in reading it back and

Dr. Nicole: Yes.

Gabe: Being able to take a break from it and come back and see what I wrote. You’re absolutely right. It’s a two-step process. It’s not just set it and forget it. It’s not, you know, write it in. You’re cured. It’s write it and then know how to manage that information. And I want to talk about that for a moment too, as a tip, because so often we think that in order to manage cluttered thoughts or racing thoughts, we have to do it all alone. Now, this next one is a is a difficult one because obviously we don’t want to overburden the people who were around, and we only want to talk to people we trust. But if you have a good support system or you have access to peer support, support groups, etc., being able to go someplace and be your true authentic self and say exactly what’s coming in your mind and then being open to feedback from others. I have found very helpful over the years too, because sometimes what my brain comes up with in its state is not good. And hearing all of these different opinions, whether I agree with them or not, whether I accept them or not, whether I like them or not, is very helpful in calming down my mind and giving me other things to think about and ways to focus.

Dr. Nicole: Using the people in your life can be extremely tricky, but it can be very valuable and you learn along the way how much you can share with whom. And depending on the nature of that relationship, that’s part of your your growth in managing your illness.

Gabe: I do want to put up some quick guardrails here. We don’t want to turn our best friend or our parents or somebody that we love and turn them into our coping mechanism. We want them to be an active participant. We want them to be willing to help us, and we need to pay attention to the whole relationship, not just the coping mechanism part of the relationship, and make sure that they are a safe person to confide in and that they want to help us. So that’s how come I also brought up going to support groups and using peer support. And I also want to bring up online forums. I think those are great places. And one of the things that I think about is Reddit has a thread called “Am I the Asshole?” Where people can type in anything and then get feedback on how the world is viewing the situation that they went into. And I read it because I do find it very interesting. I do find it entertaining, but I’m also very fascinated because I think a large number of those people asking if they’re the asshole, they have a lot of social anxiety, they have mental health issues that they’re managing. There seems to be an underlying current in there, and they genuinely want feedback from what the outside, unbiased observer thinks, so that they can inform their own decisions to have better social interactions in the future. And that’s what I mean by utilize people. I don’t want anybody to get the idea that I’m saying that every single time you have disordered thinking, or you have a cluttered thought, or you have a racing thought that you immediately call, text or drive straight to this certain person and expect them to fix it for you. But I do think that outside support and outside feedback is vital to helping us manage these thoughts.

Dr. Nicole: Yeah, we talk almost at every episode about your team and having a team and all the people that your team is comprised of, and this is no different.

Gabe: You know, Dr. Nicole, I’m just curious. I know that racing thoughts are specific to bipolar disorder, but what about cluttered thoughts and disordered thinking? Is that specific to bipolar disorder?

Dr. Nicole: I would disagree with you that racing thoughts are even specific to bipolar disorder.

Gabe: Nice. Okay.

Dr. Nicole: I mean.

Gabe: They’re just common with bipolar disorder?

Dr. Nicole: I mean, yeah, and we do think of them in terms of mania. But racing thoughts can also occur in anxiety disorders. I lots of my patients who don’t have bipolar disorder but who do very much have. Let’s use generalized anxiety disorder, for example. They describe these racing thoughts. They describe these thoughts that just take off. And I sort of equate them to like when you watch a video on social media, or you watch a YouTube video and you have this this video you watch and your plan is to stop, but then the next one loads and the next one loads and the next one loads. And before you know it, 30 minutes have passed and you’ve watched like six videos when you were only intending to watch one. That’s what you’re racing thoughts of anxiety do for you. You have this one thought of this. What if this happens and and you think that’s the only thing you’re going to worry about? But then that what if takes you to another, what if to another, what if? And then you’ve spent so much time focusing on all the what ifs? Those thoughts can feel very racy. They can feel like racing thoughts. So I would say that racing thoughts aren’t even unique to bipolar disorder, but definitely something we use when we’re describing mania.

Dr. Nicole: Cluttered thoughts? Take your pick. I mean, you could feel your thoughts are cluttered when you’re depressed because you could feel like you’re not necessarily able to organize your thoughts in a way, so things just feel cluttered. You feel like your short-term memory is off. You feel like you can’t put a sentence together. You feel like you can’t organize things in your brain that can happen during depression. That can happen for somebody who has ADHD. Someone with ADHD can describe their thoughts as being cluttered and just being a page of a bunch of words, and they have a hard time organizing them to make the right sentences and to tell the story. This could be the experience of someone who has more of an obsessive compulsive disorder, where they feel like they’re obsessing about certain things, and it feels cluttered in their brain. These are just some of the things that people can be dealing with that lead them to describe their thoughts as cluttered, which have nothing to do with bipolar disorder. So these things are not unique to bipolar disorder. And we know that disordered thinking. Those very negative thoughts, those dark thoughts are not unique to bipolar disorder in any way.

Gabe: I like that we never miss an opportunity to point out that some of this is human nature. Some of this is is struggle. Some of this has nothing to do with bipolar disorder, especially because I think that sometimes we don’t utilize really good advice or really good coping skills, or just really good support because we think, oh, it’s only relevant if it comes from a source that is connected to bipolar disorder. I think we can learn a lot from the humans around us. So thank you so much for saying that. I’m I want to continue on this doctor trend for a moment. I, I know a lot of people when cluttered thoughts pop up, disordered thinking, racing thoughts, they’re really fearful that this is proof that a symptom is coming on, that that mania is coming, depression is coming. Is there any correlation to that or is it much murkier than that?

Dr. Nicole: It goes back to your history, your pattern, your illness. There are some people that these things are very much linked to them having an episode. And then I think most people with bipolar disorder can also look at times when they’ve had a disordered thought or they felt cluttered or they felt racing and it had nothing to do with their bipolar disorder. It was because they were going through a very stressful time in life because, let’s face it, life comes at you fast sometimes, and we all have experienced some of these things. So it really should be more based on what else is going on around you, and what is your specific pattern of your episodes to these particular symptoms?

Gabe: So once again, as we’ve been saying, your mileage may vary. Figure out what works for you and don’t compare yourself to others. Sometimes I feel like we sound like a broken record. If you throw in there, it’s important to see your therapist and to see your Dr. Nicole I tell you, we just don’t have much of a podcast here, do we?

Dr. Nicole: No, but we’re all different. So pay attention to your your symptoms. Know your pattern, know, know these things for you. But then be open to the idea that it could be something unrelated. I mean, life happens.

Gabe: As we near the end of the episode, I want to take a moment to talk about disordered thoughts. We’ve talked about racing thoughts. We’ve talked about cluttered thoughts, but disordered thoughts has sort of been a little bit abandoned because frankly, they’re sort of the hardest. Disordered thoughts are those negative thoughts that just pop into your head uncontrollably, and we have to do everything we can to not respond to them. And trying to find coping skills or experience to learn how to manage that is exceedingly difficult. I want to disclose to the audience and to you, Dr. Nicole, that this is the one that scares me the most because I’m just. I’m just. I’m just having a good time, you know? I’m managing my day. It’s like in the Barbie movie. Remember? She was dancing and she was happy, and then she just asked her friends if they thought about death. And, you know, they do the record scratch, and everybody’s like, what? It’s like, where did that come from? There are some coping techniques that I’ve learned from the community, but once it’s done the damage, it’s sort of hard to backtrack that. And also, I want to be very clear, I know of no coping skill to prevent it from happening. I only know of coping skills for the aftermath.

Dr. Nicole: I really can’t think of a thing that you can do to prevent them. Aside from making sure that your depression episodes are in check and under control and adequately treated, because that can help prevent them from happening as often or as frequent or being as intense. But there are some people that these episodes and these things are going to happen to them regardless of how well controlled they feel in general.

Gabe: One of the most popular coping mechanisms that I’ve come across is since we can’t control that it pops in our head. That’s really the hallmark of disordered thinking. But what we can control is whether or not we respond to it and how. The first thing I learned is that it’s important to respond to it in your own mind, not just to try to ignore it or push it down, or dampen it or worry about it, but instead to answer it. So if a if a disordered thought comes in your mind, like, I’m going to jump out of this moving vehicle, then immediately challenge it and say, no, that would be unsafe. And you know what? This isn’t an 80s action movie. You can’t just leap out of a car. You won’t be okay. That’s dangerous. And then maybe try to try to focus on your favorite 80s action movie or something away from that very negative and otherwise disturbing thought into something better. I can see where that takes. It takes me a lot of practice, but I can also see where that would work, because I would much rather think about how stupid 80s action movies were than I would about jumping out of a moving car.

Dr. Nicole: And it would be effective for people who have more chronic thoughts like this, but who also do not want to act on those thoughts. So a lot of times when people tell me about these thoughts, they’re popping into their head and it doesn’t align with what they want to do. It doesn’t align with, you know, I don’t want to jump out of a car. That would be dangerous. I would hurt myself. That is not what I want for myself. That thought is not the thought that I want to have. So being able to take it in a different direction could be very valuable in that situation. But what if those thoughts do align with how you’re feeling and they do go along with your current mood state, and those are things that you’re entertaining? I think we need to have a plan. And I know everybody is rolling their eyes, you know? Oh, the doctor is talking about a safety plan. She’s talking about a crisis plan. Yeah, she is, because it’s her job. And so the safety plan is important. These thoughts are disturbing. We may not call them disturbing thoughts anymore, but they are disturbing and they’re bothersome. And so if there is anything that we can do to help prevent them, we should. And then I do have to reach out to the people that I say, hey, I’m not in a good place, whatever that looks like for you. I just don’t want to end this and not bring up having a formal safety plan, because sometimes that is what is needed.

Gabe: Leave it to Dr. Nicole to get all clinical. It’s almost like she’s

Dr. Nicole: Yeah.

Gabe: A psychiatrist who went to medical school. You know, a lot of people describe that these disordered thoughts sort of pop in their head at night. And that during the day they don’t really happen because there’s a lot of stuff going on. At night, when everything gets quiet, these thoughts just pop in their head and they can’t control them. And there’s a few different things. One, absolutely report that symptom to your treatment team because it’s really specific. Right. And there there may be help that you can seek in that way. But aside from that, one of the things that people have reported that’s very helpful is things like falling asleep with music, falling asleep with the television on, falling asleep with a white noise machine, or falling asleep with a guided meditation. And of course, in that particular case, sleep hygiene is also very important as well. If you notice that you’re going to bed at all different times, that might exacerbate these disordered thoughts. But again, I don’t want to make it just about sleep. If you notice that this only happens during your workday because you’re alone and you have a solitary job, maybe it’s time to ask if you can get headphones. Ask if you can listen to podcasts or music, etc. try to find some way to occupy your mind to keep those things from jumping in there. Once you figure out where that happens, trying to find that intervention to keep this from happening is always a great, great idea.

Dr. Nicole: Yeah. Problem solving your particular symptoms with your team is the best way to deal with this.

Gabe: Dr. Nicole, we have been discussing managing cluttered racing and disordered thoughts and whenever we get to this part of the episode. I always want to make sure that I feel like our listeners have tangible takeaways of things that they can do and a tangible understanding of what these things are, and I just want to make sure, from your perspective as a psychiatrist, are there anything that you want to leave our listeners with to make sure that they understand that while this does happen, it happens to a lot of people. It’s understandable, and some of it might not have anything to do with bipolar disorder at all.

Dr. Nicole: But it also doesn’t mean that it’s not something that you should bring up with your Dr. Nicole. So if you do feel like, man, I have these cluttered thoughts and my thoughts are just racing and da da da da da, don’t not bring it up. So if I can leave you with one thing, it is to make sure you’re sharing these ongoing, distressing symptoms with your therapist, with your Dr. Nicole, maybe they can help you. Don’t just resolve to the fact that you have to deal with these things.

Gabe: All right, everybody, thank you for tuning in. And thank you so much for listening. We need a couple of favors from you. First, wherever you downloaded this episode, please follow or subscribe to the show. It is absolutely free and you don’t want to miss a thing. And hey, do us a favor, recommend the show to the people that you know. Share your favorite episode on social media. Send somebody a text message. Bring it up in support groups. Tell everybody you know about the Inside Bipolar podcast. My name is Gabe Howard and I’m an award-winning public speaker, and I could be available for your next event. I also wrote the book “Mental Illness Is an Asshole and Other Observations,” which you can get on Amazon. However, you can grab a signed copy with free show swag or learn more about me by heading over to gabehoward.com. You can also follow me on TikTok or Instagram @AskABipolar.

Dr. Nicole: And I’m Dr. Nicole Washington. You can find me on my website, DrNicolePsych.com, or on all social media platforms @DrNicolePsych.

Gabe: And we will see everybody next time on Inside Bipolar.

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