What is pressured speech in bipolar disorder?

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

In all these cases, a person may experience:

• rapid speech without pause for others
• loud speech
• talking about subjects in a disorganized manner
• talking about inappropriate subjects
• not being able to speak fast enough to keep up with thoughts

Additional symptoms during a period of mania may include:

• inflated self-worth or delusions of grandeur
• reckless or behavior that may have harmful effects
• a decreased need or ability to sleep
• elevated mood
• exaggerated optimism
• feeling anxious or jittery
• inability to focus
• restlessness

Learn more about the main symptoms of mania.

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

Pressured speech is often the result of rapid thoughts during a manic episode. A person with bipolar disorder is not likely to experience issues with pressured speech during a depressive cycle.

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

A 2017 review found that pressured speech is more likely in adult-onset bipolar disorder than in children and adolescents.

A person may also experience pressured speech due to other conditions.

People with bipolar disorder may also have co-occurring conditions, including:

• Attention deficit hyperactivity disorder (ADHD): ADHD makes it difficult to focus and organize 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.
• Schizophrenia: This can cause a breakdown of the connectors between thoughts, emotions, and behaviors, which can lead to delusion and disorganized thoughts.
• Substance use disorders: People with bipolar disorder have a high risk of substance use disorders. This can include the use of alcohol, nicotine, and recreational drugs.

Doctors cannot cure or treat pressured speech as an isolated condition. Instead, they will focus on treating the underlying cause of the condition.

Bipolar disorder has a high rate of misdiagnosis. As a result, a person may experience difficulty getting the treatment they require.

Following correct diagnosis, a person can learn to manage bipolar disorder with a combination of medication and psychotherapy.

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

• antipsychotics, such as olanzapine or aripiprazole
• mood stabilizers, such as valproic acid or lithium
• antidepressants

Learn more about medications for bipolar disorder.

Alongside drug treatments, a person may benefit from psychotherapy. Types of psychotherapy that can help someone manage bipolar disorder include:

• cognitive behavioral therapy
• family focused therapy
• interpersonal and social rhythm therapy
• dialectal behavioral therapy

Learn more about types of psychotherapy.

Pressured speech is a common symptom of bipolar disorder and other mental health conditions. It typically occurs when a person is experiencing manic episodes.

During this time, a person may feel compelled to speak quickly, erratically, and without stopping.

Pressured speech is not a condition in itself, and treatment will typically focus on resolving its underlying causes.