Psychomotor agitation is a feeling of anxious restlessness that can lead to unintended movements. A person may experience muscle tension, an increase in heartbeat, or physical tremors. They may also tap their fingers, speak faster, or be unable to sit still.

Psychomotor agitation often affects people with bipolar disorder, but it is also associated with other conditions that affect mental health or neurological function. It is a physical expression of anxiety and mental tension.

This article explores the ways of feeling, moving, and behaving that could be symptoms of psychomotor agitation. It also looks at what mood disorders are associated with psychomotor agitation.

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Psychomotor agitation can be distressing for people who experience it and may also cause concern to others around them.

The condition can cause behavioral, physical, and mental symptoms, including:

This anxious tension may lead a person to:

  • pace around a room
  • wring their hands
  • tap their fingers
  • tap their feet
  • fidget
  • start and stop tasks abruptly
  • talk very quickly
  • move objects around for no reason

People with psychomotor agitation and mental health conditions such as bipolar disorder and schizophrenia may feel uneasy, nervous, or that there is no hope of controlling their agitations.

Someone experiencing psychomotor agitation may display these behaviors in a way that seems uncontrolled or erratic. This can often place them and others around them at risk of physical harm.

People with severe psychomotor agitation may:

  • bite their lips until they bleed
  • pull skin off from around their lips
  • pull skin off from around their nails
  • chew the inside of their cheek

Typically, psychomotor agitation will not have a single cause. A person may experience the condition due to a combination of psychological and environmental factors, including stress, trauma, and substance withdrawal.

Associated conditions

Psychomotor agitation has associations with the following mental health conditions:

Psychomotor agitation is particularly prevalent among people with bipolar disorder. People diagnosed with bipolar disorder can experience three different episodes called manic, mixed, and depressive.

Psychomotor agitation is a symptom of all three types of episode. However, the nature of psychomotor agitation can change, depending on which type is occurring:

  • Manic episode: Alongside psychomotor agitation, a person may experience racing thoughts. Feeling overwhelmed by these can cause people to move without meaning to and to talk rapidly. Movements resulting from psychomotor agitation in a manic episode may appear chaotic.
  • Mixed affective episode: This is a particularly vulnerable state when a person experiences a mixture of depressive and manic symptoms. As well as feeling very low, they may feel agitated and irritable.
  • Depressive episode: In a depressive episode, people may feel extremely low, hopeless, and tearful. They may make some movements that are signs of psychomotor agitation.

Learn more about bipolar disorder here.

If a person is experiencing psychomotor agitation or knows someone who is, they should speak with a doctor. A doctor can determine the cause of psychomotor agitation and advise how to manage it.

This may include changes to medication programs or psychotherapy and drug treatments to treat underlying mental health conditions.

Management plans can include:

  • treating the underlying cause of psychomotor agitation
  • learning de-escalation and coping strategies
  • minimizing stressful stimuli
  • managing drug and alcohol withdrawal, if relevant
  • medications such as antipsychotics, benzodiazepines

Learn about the treatments for bipolar disorder here.

Psychomotor agitation can often cause distress. However, a person can manage it with the right treatment.

Seeking treatment for psychomotor agitation can help a person identify and manage conditions or environmental factors that may contribute to their agitation.

Starting treatment early for psychomotor agitation can help reduce its impact and associated conditions on someone’s life.