When you have pressured speech, you have an extreme need to share your thoughts, ideas, or comments. It can be difficult for others to understand and may indicate a manic episode.

Pressured speech is commonly seen as a symptom of bipolar disorder.

It’s often a part of experiencing a manic episode. The speech will come out rapidly, and it doesn’t 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.

There are several symptoms to watch for in pressured speech, which include:

  • rapid speech that’s difficult to understand
  • speech that’s 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’re thinking
  • unclear thought process when speaking
  • speaking numerous ideas at once that don’t connect
  • including rhymes or jokes in the speech
  • difficulty articulating thoughts because they’re 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.

Pressured speech can be part of a manic episode. It’s most commonly seen in people with bipolar disorder. Although scientists don’t know the actual cause of bipolar disorder, it’s believed to be caused by changes in brain biochemistry and may have a genetic link.

You may be more likely to have it if a close relative has bipolar disorder, usually a parent, brother, or sister.

Because pressured speech is a symptom of experiencing a manic episode, usually associated with bipolar disorder, the focus is on treating the bipolar disorder. Pressured speech and bipolar disorder are psychiatric disorders and should be treated by a psychiatrist.

A psychiatrist is a medical doctor who specializes in mental health conditions.

Some primary care physicians will treat bipolar disorder.

In almost 50 percent of states in the United States, and the District of Columbia, a psychiatric mental health nurse practitioner (PMHNP) can also treat people with this mental health condition, independent of physician involvement.

This means the nurse practitioner has full practice authority (FPA).

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


Taking prescribed medications regularly is the main way to manage bipolar disorder and its symptoms, including pressured speech.

The types of medications your healthcare provider may prescribe include:

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

Depending on your symptoms, your healthcare provider may prescribe one medication or a combination of medications.


Psychotherapy will help you make lifestyle and behavioral changes in your daily life that’ll 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 complement medications and therapy in many mood disorders. However, conflicting research on their effectiveness limits widespread adoption of some of these treatments.

Be sure to talk to your healthcare provider first if you decide to try a natural or alternative treatment for your bipolar disorder symptoms. Many supplements can interfere with medications or increase their side effects.

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, when experiencing manic episodes from bipolar disorder
  • schizophrenia
  • other mental health conditions
  • stroke

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

At school

Pressured speech can present problems for students and teachers. It may make it difficult for teachers to direct a class.

For the student, it could result in being removed from class, and in some cases, the inability to continue in a normal school atmosphere.

At home

Pressured speech can be challenging to relationships with loved ones. It can make regular communication difficult and sometimes impossible.

The person with pressured speech may feel that they’re not being heard or understood. Those they live with may feel stress and frustration. When communication breaks down, sometimes the relationship can break down as well.

At work

Pressured speech may start during meetings, interactions with clients or customers, or interactions with coworkers. In the workplace, when pressured speech happens at inappropriate times, it can be disruptive. That may lead to disciplinary actions or even loss of a job.

Pressured speech is manageable with a bipolar disorder treatment plan created by a healthcare provider and psychotherapist.

If you think your treatment needs to be adjusted, you should talk to your healthcare provider. Only change your treatment if it’s approved by the medical professionals overseeing your care.