Pressured Speech

Medically reviewed by Sara Minnis, MS, CCC-SLP on July 5, 2017Written by Diana K. Wells on July 5, 2017

Overview

Pressured speech is commonly seen in people with bipolar disorder. When you have pressured speech, you have an extreme need to share your thoughts, ideas, or comments. It’s part of mania. The speech will come out rapidly, and it does not stop at appropriate intervals. It’s difficult to understand what’s being said during pressured speech. It’s also not possible to carry on a conversation because the person with pressured speech will not stop long enough for another person to speak.

Symptoms

There are several symptoms to watch for in pressured speech. These symptoms include:

  • rapid speech that is difficult to understand
  • speech that is louder than appropriate
  • inability to stop speaking to allow others to interject their thoughts
  • speech that occurs at inappropriate times at work, home, or school
  • an urgency to say what you are thinking
  • unclear thought process when speaking
  • speaking numerous ideas at once that do not connect
  • including rhymes or jokes in the speech
  • difficulty speaking your thoughts because they are coming too fast

When talking to someone with pressured speech, you may not be able to stop them from talking or get them to speak at a slower rate. A pressured speech episode may continue for more than an hour.

Causes

Pressured speech is the result of mania or a manic episode. It’s most commonly seen in people with bipolar disorder. Bipolar can be caused by a physical change in the brain or from genetics. You may be more likely to have it if a close relative has bipolar disorder (usually a parent, brother, or sister).

Treatment

Because pressured speech is a symptom of mania usually associated with bipolar disorder, the focus is on treating the bipolar disorder. Pressured speech and bipolar disorder are mental illnesses and should be treated by a psychiatrist. A psychiatrist is a medical doctor that specializes in mental health conditions.

There are several treatment options for bipolar disorder. These treatments may be used in combination depending on your symptoms and needs.

Medications

Taking your prescribed medications regularly is the main way to manage bipolar disorder and its symptoms, including pressured speech. The types of medications your doctor may give you include:

  • antidepressants
  • mood enhancers
  • antipsychotic medications
  • anti-anxiety medications

You may be given just one medication or a combination of more than one depending on your symptoms.

Psychotherapy

This type of therapy will help you make lifestyle and behavioral changes in your daily life that will help reduce and better manage the symptoms of bipolar disorder, including pressured speech. Your psychotherapy may include:

Alternative treatments

Some natural supplements and alternative treatments are used to compliment medications and therapy in many mood disorders. However, not much research shows that they can help in the treatment of bipolar disorder. Be sure to talk to your doctor first if you decide to try a natural or alternative treatment for your bipolar symptoms. Many supplements can interfere with medications or increase their side effects.

Associated conditions

Pressured speech can be a symptom of several conditions. Some of these conditions include:

  • bipolar disorder, the condition most commonly associated with pressured speech
  • autism, when coupled with bipolar disorder
  • anxiety, with manic episodes or bipolar disorder
  • other mental health conditions that have manic episodes
  • schizophrenia

Complications

Pressured speech can be one of the more difficult symptoms of bipolar disorder. This is because it’s difficult to control or stop when it happens. It can also have wide-ranging repercussions or complications in all areas of life.

At school

Pressured speech causes the person to interrupt teachers and take over the direction of the class. It can make it difficult or impossible for the teacher to continue to teach. This results in removal from class, punishments, and sometimes an inability to continue in a normal school atmosphere.

At home

Pressured speech can make it challenging for those the person has relationships with. It can make regular communication difficult and sometimes impossible. The person with pressured speech can feel frustrated at not being heard or understood. Those who live with someone with pressured speech can feel stress and frustration. When communication breaks down, sometimes the relationship can break down as well.

At work

Pressured speech can start at inappropriate times in work situations like meetings, interactions with clients or customers, and interactions with coworkers. The pressured speech is so disruptive in the workplace that it can lead to disciplinary actions and even loss of a job.

Outlook

Pressured speech is manageable when you stick to the bipolar disorder treatment plan set out by your doctor and psychotherapist. The challenge is that when they start to feel better, many people with bipolar disorder stop taking their medications. This is because they feel better and think they no longer need it. However, it’s important to stay on your medications and continue your therapy sessions even when you feel better.

If you think your treatment needs to be adjusted, you should talk to your doctor. Only change your treatment if it is approved by a medical professional overseeing your care.

CMS Id: 124109