Editing Hypergraphia (section)

==Causes==
Some studies have suggested that hypergraphia is related to [[bipolar disorder]], [[hypomania]], and [[schizophrenia]].<ref name=Flaherty2011 /> Although creative ability was observed in the patients of these studies, signs of creativity were observed, not hypergraphia specifically.  Therefore, it is difficult to say with absolute certainty that hypergraphia is a symptom of these psychiatric illnesses because creativity in patients with bipolar disorder, hypomania, or schizophrenia may manifest into something aside from writing.  However, other studies have shown significant accounts between hypergraphia and temporal lobe epilepsy<ref name=Frequency_of_Hypergraphia>{{ cite journal |last1 = Sachdev |first1 = H S |last2 = Waxman |first2 = S G |year = 1981 |title = Frequency of hypergraphia in temporal lobe epilepsy: an index of interictal behaviour syndrome. |journal = Journal of Neurology, Neurosurgery, and Psychiatry |quote = Patients with temporal lobe epilepsy tended to reply more frequently to a standard questionnaire, and wrote extensively (mean: 1301 words) as compared to others (mean: 106 words). The incidence of temporal lobe epilepsy was 73% in patients exhibiting hypergraphia compared to 17% in patients without this trait. These findings suggest that hypergraphia may be a quantitative index of behaviour change in temporal lobe epilepsy. |pmid = 7241165 |pages = 358–60 |issue = 4 |volume = 44 |doi=10.1136/jnnp.44.4.358 |pmc=490963}}</ref> and chemical causes.<ref>{{Cite journal |last=Flaherty |first=Alice W |date=2012-12-28 |title=Writing and Drugs |url=https://journal.equinoxpub.com/WAP/article/view/7422 |journal=Writing and Pedagogy |volume=4 |issue=2 |pages=191–207 |doi=10.1558/wap.v4i2.191 |issn=1756-5847|url-access=subscription }}</ref>

=== Temporal lobe epilepsy ===
[[File:Gray728.svg|thumb|Image of the temporal lobe]]
Hypergraphia was first studied as a symptom of [[temporal lobe epilepsy]], a condition of reoccurring seizures caused by excessive neuronal activity, but it is not a common symptom among patients.  Less than 10 percent of patients with temporal lobe epilepsy exhibit characteristics of hypergraphia.{{medical citation needed|date=December 2013}}  Temporal lobe epilepsy patients may exhibit irritability, discomfort, or an increasing feeling of dread if their writing activity is disrupted.<ref>{{cite journal |vauthors=van Vugt P, Paquier P, Kees L, Cras P |title=Increased writing activity in neurological conditions: a review and clinical study |journal=J. Neurol. Neurosurg. Psychiatry |volume=61 |issue=5 |pages=510–4 |date=November 1996 |pmid=8937347 |pmc=1074050 |doi=10.1136/jnnp.61.5.510}}</ref> To elicit such responses when interrupting their writing suggests that hypergraphia is a compulsive condition, resulting in an obsessive motivation to write.<ref name=Flaherty2011>{{cite journal|last=Flaherty|first=AW|title=Brain illness and creativity: mechanisms and treatment risks |journal=Canadian Journal of Psychiatry|date=March 2011|volume=56|issue=3 |pages=132–43|pmid=21443820|doi=10.1177/070674371105600303|doi-access=free}}</ref> A temporal lobe epilepsy may influence frontotemporal connections in such a way that the drive to write is increased in the [[frontal lobe]], beginning with the [[Prefrontal cortex|prefrontal]] and [[premotor cortex]] planning out what to write, and then leading to the [[motor cortex]] (located next to the [[central sulcus|central fissure]]) executing the physical movement of writing.<ref name=Flaherty2011 />

Most temporal lobe epilepsy patients who suffer from hypergraphia can write words, but not all may have the capacity to write complete sentences that have meaning.<ref name="Yamadori" />

=== Bipolar disorder ===
The disorder most often associated with high-output writers is bipolar disorder, especially during hypomania.<ref name=":1">{{Cite book |last=Jamison |first=Kay R. |title=Touched with fire: manic-depressive illness and the artistic temperament |date=1994 |publisher=Free Press |isbn=978-0-02-916003-9 |edition=1. paperback |location=New York}}</ref> In fact, temporal lobe epilepsy is more likely to produce hypergraphia if it also produces manic symptoms. While depression has been linked to increased writing, it appears that most writers with depression write little while depressed, and high output periods correspond to rebound mood elevation after the end of a depression, or in mixed mood states.<ref name=":1" />

=== Chemicals ===
Drugs that boost mood and energy have been known to induce hypergraphia, possibly by increasing activity in brain networks utilizing one of the body's neurotransmitters, [[dopamine]].  Dopamine has been known to decrease [[latent inhibition]], which causes a decrease in the ability to habituate to screen out unexpected stimuli.  Low latent inhibition leads to an excessive level of stimulation and could contribute to the onset of hypergraphia and general creativity.<ref>{{Cite journal |last=Carson |first=Shelley H. |last2=Peterson |first2=Jordan B. |last3=Higgins |first3=Daniel M. |date=September 2003 |title=Decreased latent inhibition is associated with increased creative achievement in high-functioning individuals |url=https://pubmed.ncbi.nlm.nih.gov/14498785/ |journal=Journal of Personality and Social Psychology |volume=85 |issue=3 |pages=499–506 |doi=10.1037/0022-3514.85.3.499 |issn=0022-3514 |pmid=14498785}}</ref>  This research implies that there is a direct correlation between the levels of dopamine between neuronal synapses and the level of creativity exhibited by the patient.  Dopamine agonists increase the levels of dopamine between synapses which results in higher levels of creativity, and the opposite is true for dopamine antagonists.

In one case study, a patient taking donepezil reported an elevation in mood and energy levels which led to hypergraphia and other excessive forms of speech (such as singing).<ref name="Wicklund">{{cite journal |vauthors=Wicklund S, Wright M |title=Donepezil-induced mania |journal=J Neuropsychiatry Clin Neurosci |volume=24 |issue=3 |pages=E27 |year=2012 |pmid=23037669 |doi=10.1176/appi.neuropsych.11070160}}</ref> Six other cases of patients taking donepezil and experiencing mania have been previously reported.  These patients also had cases of [[dementia]], cognitive impairment from a [[cerebral aneurysm]], bipolar I disorder, and/or depression.  Researchers are unsure why donepezil can induce mania and hypergraphia.  It could potentially result from an increase in [[acetylcholine]] levels, which would have an effect on the other neurotransmitters in the brain.<ref name="Wicklund" />