Thought Broadcasting is a psychotic symptom in which the patient has the experience that his or her thoughts are being broadcast aloud so that people around can hear the thoughts. This symptom is most common in bipolar disorder, schizoaffective disorder, and schizophrenia. The experience can be extremely upsetting and sort of like being “mentally naked.” Suppose that when a young man standing in line at the local coffeehouse notices a cute girl, he believes that she can hear all of his private thoughts about her.  Also imagine that he thinks the guy he is standing behind in line also might go after this girl. He is jealous of him, but he also thinks the other man can hear everything he is thinking. He is afraid the man in front of him can hear his every thought, and as a result is going to turn around and smack him in the face, and the girl is going to laugh at him. He gets very upset, leaves the coffee shop without getting his coffee, and goes home embarrassed, frightened, and discouraged. The patient who is having the experience of thought broadcasting believes that all of this is really happening. It can be a devastating and crippling condition.

Consequences of Thought Broadcasting
Patients with Thought Broadcasting rarely volunteer that they are having this symptom. They can go years without family, friends, or treating professionals becoming aware of the presence or severity of this symptom. It is always a good idea to ask a patient who might be at risk for Thought Broadcasting whether they are experiencing these symptoms.  Patients with Thought Broadcasting often withdraw from social interactions. They frequently stay at home and become socially isolated so as to avoid having others hear their thoughts. In extreme cases they believe that people on the street or in the house next door can hear their thoughts. These symptoms often wax and wane in response to stress, and may be less severe around people whom they are familiar with.

Treatment for Thought Broadcasting
Antipsychotic medication is the first line treatment for Thought Broadcasting. Medications such as Abilify, Zyprexa, Risperdal, and Clozaril can reduce or eliminate Thought Broadcasting. Psychotherapy can help the patient manage symptoms of Thought Broadcasting.  Avoiding alcohol and street drugs also is very important. Social support networks such as 12 Step meetings are often difficult for these patients because they believe that everyone in the meeting can hear what they are thinking. As a result, meeting attendance drops off and then discouragement sets in. Helping the patient find a sober plan that they can adhere to if they have an addiction is another key predictor of success when helping to overcome this sometimes debilitating symptom.