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Abstract: Advancements in modern technology have brought tremendous changes in human behavior. One such change is in modes of communication such as text messaging, or texting. This form of communication has emerged as one of the dominant modes of communication in the world. This report presents a differential pattern of texting seen during the manic episode of a young adult with bipolar I disorder. We observed all the DSM IV manic symptoms; interestingly the patient's predominant medium for communication was texting. The patient reported a dramatic increase in the quantity of both texting and sex-texting (or sexting) in addition to a decrease in quality of the message content. In addition, there was a substantial increase in the number of people with whom the patient engaged in simultaneous texting conversations. This case provides evidence for the need to consider non-traditional forms of communication when evaluating a patient's communication pattern during mania.
Key words: Psychiatry, bipolar I, mania, mental health, cell phone, texting, text messaging, sexting, depression.
In 2008 2.5 trillion text messages were sent worldwide.1 The popularity of text messages has grown such that the term texting has entered the common lexicon. In some cases, text messaging is significantly cheaper than placing a phone call; in others, text messaging is popular despite the low cost of voice calls.
Texting, most often used between mobile phone users as a substitute for voice calls, became popular in the late 1990s. Initially teens and young adults were the predominant text messaging users, but subsequently other age groups have adopted this mode of communication.2,3
Texting became a popular communication choice partly because the quasi-subversive nature of texting (in the sense that is an activity in which one can often engage without being noticed by others, e.g., people in authority) gave it credibility among young teens.3 In addition, it provided a medium for teens to experiment with nonverbal communication and to develop texting-specific slang. Consequently, text messaging allowed young people to define themselves apart from parents and other groups.4,5
Bipolar I disorder is a brain disorder with a prevalence of 1% that causes extreme and unusual shifts in mood, energy, activity levels, and the ability to carry out day-today activities.6 At least half of all cases of bipolar I disorder...