What is Pressured Speech?
The best way to communicate and share thoughts and emotions is by talking. However, at times, talking tends to become annoying and disturbing especially if it is fast paced and difficult to understand. If someone has a habit of speaking continuously out of turn in a fast paced manner which is difficult to understand is a first sign of bipolar disorder. This has been proved by various studies conducted on this mood disorder. This medically is referred to as spressured speech. It normally occurs with other symptoms like hyperactivity, agitation, irritability, and racing thoughts. Pressured speech is different than normal talking in that there will be a clear change in the manner in which the individual is talking [1].
The individual will have an uncontrollable desire to talk endlessly without any purpose. The flow of speech will also be incredibly fast making it tough for others to understand what the individual is talking about. The voice will be louder than normal and more often than not the individual will interrupt others from speaking. Another problem with pressured speech in diagnosed bipolar patients is that while speaking these people tends to have racing thoughts. This causes the individual to jump from one topic to another unknowingly making it tough for others to understand the context of the speech [1].
In case if the individual is having a manic episode which is also a characteristic feature of bipolar disorder, then again what the affected individual speaks will be completely illogical, out of topic, and at times every scary. Thus, if an individual has a family member or friend who has pressured speech but has not been diagnosed with bipolar disorder, then he or she needs to be thoroughly evaluated. The physician will evaluate the patient and carry out a battery of tests to ascertain whether the patient is actually bipolar or not [1].
In cases, where an individual has a known diagnosis of bipolar disorder then pressured speech normally indicates the onset of a manic episode that may go on to a full blown mania. This calls for an urgent evaluation of the patient to manage the condition. This article details the presenting features of pressured speech in bipolar disorder and different ways to cope with the situation [1].
What Are The Presenting Features Of Pressured Speech In Bipolar Patients And How To Cope Up With It?
Before going into the details of the presenting features of pressured speech in bipolar disorder it is always important to understand as to what causes it to occur. It is well known that an individual with bipolar disorder will have extremes of emotions. Either the patient will be too sad and depressed where he or she will prefer to stay alone and not talk to anyone or they will have periods where they will be hyperactive and speaking continuously. Studies suggest that a bipolar patient will have no issues with pressured speech during the depressive cycle [2].
It is only when the patient is at the other end of the spectrum of emotions where he or she will have racing thoughts or during a manic episode is when they will start having pressured speech. The brain processes thoughts depending on the situation the individual is in. However, in people with bipolar disorder the brain finds it difficult to differentiate multiple thoughts that enter the mind based on the situation the individual is in. This will cause thoughts that have no bearing on the situation will be prioritized by the brain. This is precisely the reason as to why bipolar patients tend think about things irrelevant to them [2].
These thoughts become more intense and move fast during the mania cycle of the condition where the patient is extremely hyperactive. This causes the patient to vocalize and express whatever that comes in the mind even if it is not related to the subject that is being discussed. The patient will have an uncontrollable urge to speak his mind out as fast as possible. This is what results in pressured speech. This is not considered to be a separate medical entity but is rather a symptom of an indwelling condition [2].
Aside from bipolar disorder, other conditions that tend to cause pressured speech include schizophrenia and anxiety disorder. In all such cases, the individual will speak incessantly and will not even stop for anyone else to speak. The choice of words and topics will be completely disorganized and far away from what is being discussed. The speech will be excessively loud. Coming to the presenting features that occur along with pressured speech in people with bipolar disorder, the symptoms will be variable depending on the frequency at which the cycles of the patient changes from depressive mood to maniac episodes [2].
Pressured speech occurs during the maniac phase of the condition. The individual will in addition have periods of insomnia. He or she will have abnormally elevated self-worth and will believe that he or she is always correct. These individuals tend to get involved in risky behavior and are extremely reckless. These individuals will always have an elated mood irrespective of the circumstances they are in. They will always be restless and their focus on specific task will be lacking [2].
Coming to the treatment of pressured speech, unfortunately there is no specific treatment for this symptom of bipolar disorder. The treatment is aimed at controlling the manic episodes of bipolar disorder. The accurate diagnosis of bipolar disorder is somewhat tricky for the physicians as the symptoms mimic the features of various other mood disorders. The individual may have to work with different physicians before getting a confirmative diagnosis of Bipolar Disorder. However, once the diagnosis is made then treatment can be started immediately [2].
Treatment will normally involve a combination of medications and psychotherapy. Bipolar disorder is mainly treated by antipsychotics, mood stabilizers, and antidepressants. Aside from medications, the patient will also require continued counseling to calm down the symptoms of bipolar disorder. How well the patient responds to the counseling will determine the overall success of the treatment. In addition, the physician will recommend providing a supportive environment for the patient as that holds the key to a successful treatment of bipolar disorder [2].
In conclusion, bipolar disorder is a form of a mood disorder in which the affected individual has two extremes of emotions. The individual will either be extremely depressed and would prefer to stay alone or he or she will be extremely elated and hyperactive, and is termed as manic episodes. These two emotional states form a vicious cycle where the patient will have extremes of these states alternatively [1, 2].
Pressured speech is the initial symptom of a manic episode in an individual with bipolar disorder. In such situations, the individual will start talking in a loud voice incessantly and will not even stop to allow others to speak. There talks will be inappropriate and not consistent with that is being discussed. Pressured speech is something that cannot be cured but can be reduced significantly by treating the underlying cause, in this case bipolar disorder [1, 2].
The treatment for bipolar disorder is twofold and is done with medications and psychotherapy. A strong support system is absolutely necessary for people with bipolar disorder to reduce the symptoms and prevent the patient to get into the vicious cycle of bipolar disorder [1, 2].
