Pressured speech in bipolar disorder: Symptoms and causes

Pressured speech is when someone's speech is rapid and disorganized.

Pressured speech is a symptom of several mental health conditions. Bipolar disorder is one of the more common disorders that includes pressured speech among its symptom.

Pressured speech occurs when an individual speaks at a rapid and sometimes frantic speed. The pace makes it difficult for people listening to make sense of what is being said.

Pressured speech can be jumbled and difficult to understand, as the person speaking may not stop at appropriate points.

Symptoms

Pressured speech is not a disease or disorder by itself. Rather, it is a symptom of an underlying disorder. There are many potential causes of pressured speech, including schizophrenia, some forms of anxiety, and bipolar disorder.

In all these cases, pressured speech may present with some or all of the following:

• rapid speech that does not pause for others to speak
• disorganized thoughts expressed through words
• loud speech that is above a normal volume for the situation
• speaking about numerous ideas at once
• talking about inappropriate things at work, school, home, or in the community
• including jokes or particular rhythms in speech
• speaking with a sense of urgency
• not being able to speak fast enough to keep up with thoughts

People with bipolar disorder experience cycles of mania and depressive moods. How quickly an individual cycles through the moods varies from person to person. Pressured speech is a symptom of bipolar disorder that occurs during a period of mania.

Bipolar disorder is characterized by alternating episodes of mania and depression. Pressured speech occurs during manic episodes.

Additional symptoms during a period of mania may include:

• inflated self-worth or delusions of grandeur
• reckless or risky behavior
• decreased need or ability to sleep
• elevated mood
• exaggerated optimism
• feeling anxious or jittery
• inability to focus
• restlessness

Complications

Pressured speech has no significant complications by itself. However, the underlying cause of the pressured speech may have bigger implications that affect a person's overall health and well-being.

Due to the fact that pressured speech can come from a variety of potential disorders, the complications vary widely between individuals.

People with bipolar disorder may also have co-occurring conditions, including depression, ADHD, or anxiety disorders. These disorders often require additional treatment to help a person manage their symptoms.

A person with bipolar disorder is likely to experience periods of low self-esteem. Additionally, people with bipolar disorder are more likely to attempt suicide.

A person's relationships may suffer due to their frequent mood changes. Difficult relationships and poor work performance may also affect a person's ability to maintain a steady career or job.

Causes in bipolar disorder

A person with bipolar disorder is not likely to experience issues with pressured speech during their depressive cycle. It is believed that pressured speech is a result of rapid thoughts that a person with bipolar disorder experiences during a manic episode.

The brain can usually prioritize thoughts based on their importance to the situation at hand. A person with bipolar disorder may have difficulty separating these thoughts, meaning irrelevant thoughts may appear pressing, as soon as they enter the mind.

This means someone with bipolar disorder may spend more time thinking about unrelated things throughout the day, or experience an excessive number of thoughts at once.

During cycles of mania, when someone with bipolar disorder is more prone to hyperactivity, these thoughts arrive faster and with increased intensity. As a result, the person may try to explain these thoughts to others around them as they occur.

The person may feel pressured to get the thoughts out, as quickly as possible, and share what is on their mind. The outpouring of thoughts results in pressured speech.

Treatment

Common treatments for bipolar disorder are mood stabilizers and anti-psychotic medication. These can manage symptoms such as pressured speech.

Pressured speech cannot be treated or cured directly. Instead, treatment focuses on the underlying cause of the pressured speech.

In cases of bipolar disorder, a person may experience some difficulty getting a diagnosis. It is not uncommon for a person with bipolar disorder to be treated by several different doctors before they are diagnosed correctly.

Once successfully diagnosed, a person with bipolar disorder can learn to manage their condition with a combination of medication and psychotherapy.

There are three main types of medications to help treat bipolar disorder that can help reduce or eliminate pressured speech. These medications are:

• antipsychotics, such as lithium carbonate
• mood stabilizers, such as valproic acid or lithium
• antidepressants, which are used the least

A person with bipolar disorder should receive ongoing counseling, as a regular part of their treatment. The counseling component of treatment may be the key to success for a person with bipolar disorder.

Similarly, a stable and supportive home environment often directly affects the overall likelihood of success for a person with bipolar disorder.

Other associated conditions

Pressured speech can be a symptom of other conditions besides bipolar disorder. Many disorders associated with periods of mania have pressured speech as a potential symptom.

One such condition is schizophrenia. This mental disorder is associated with a breakdown of the connectors between thoughts, emotions, and behaviors.

People with schizophrenia often experience delusions and general withdrawals from reality. The often jumbled thoughts are what produce symptoms, such as pressured speech.

Some other more common disorders associated with pressured speech include:

• Attention deficit hyperactivity disorder (ADHD): A condition that makes it difficult to focus and be organized in thoughts and actions. People with ADHD may experience frantic or fast-paced thinking, which can cause pressured speech.
• Anxiety: This condition may cause a person to experience pressured speech if their anxiety results in being unable to explain something quickly. They may experience rapid, uncontrollable thoughts in response to their situation.
• Drug use: This habit may cause symptoms of pressured speech. Drugs that cause pressured speech include stimulants, such as cocaine.

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