Everything You Should Know About Psychomotor Agitation

Medically reviewed by Elaine K. Luo, MD on April 25, 2017Written by Annamarya Scaccia

Overview

Psychomotor agitation is a symptom related to a wide range of mood disorders. People with this condition engage in movements that serve no purpose. Examples include pacing around the room, tapping your toes, or rapid talking.

Psychomotor agitation often occurs with mania or anxiety. It’s seen most often in people with bipolar disorder. Psychomotor agitation can be caused by other conditions, too, such as posttraumatic stress disorder or depression.

Symptoms

People with psychomotor agitation can’t stay still or remain calm. They use movement to release tension and anxiety. If you have psychomotor agitation, you may regularly fidget, move fast, or move with no reason or purpose.

The most common signs of psychomotor agitation include:

  • emotional distress
  • restlessness
  • tapping
  • starting and ending tasks abruptly
  • fidgeting
  • pacing
  • hand-wringing
  • fast talking
  • racing thoughts
  • crowded thoughts
  • moving objects for no reason

People who have psychomotor agitation will display a set of behaviors, including:

  • pacing back and forth in a room
  • taking off clothing, then putting it back on
  • twisting their hands
  • tapping their feet on the floor
  • tapping their fingers on any surface
  • picking up and moving objects around the room for no reason

In severe cases, psychomotor agitation can lead to self-inflicted harm. People may rip, chew, or pull at the skin near their lips, fingernails, or other body parts until they bleed.

Causes

Psychomotor agitation is often seen in people with bipolar disorder. It's also less commonly seen in people with other conditions, including:

Researchers have also found a link between akathisia and psychomotor agitation in people with TBI. Akathisia is a movement disorder marked by restlessness.

Psychomotor agitation and bipolar disorder

Psychomotor agitation is a common symptom of bipolar depression. It mostly occurs during manic episodes, but it’s also seen during depressive episodes. It’s often linked with other noneuphoric hypomanic symptoms and suicidal thoughts. Signs of noneuphoric hypomania include:

  • crying
  • trouble sleeping
  • racing thoughts
  • trouble making decisions
  • confusion
  • false belief someone is out to harm you
  • inflated feelings of self-importance
  • hearing sounds or voices that aren’t there

Psychomotor symptoms differ depending on whether they occur during a manic episode, mixed affective episode (depression and mania), or depressive episode. During a manic episode, a person is more like to move aimlessly. For example, they may pace, wring their hands, or tap their fingers.

During a mixed affective or depressive episode, movements will be used to reduce tension and stress. The person may feel anxious, upset, irritable, and restless.

See a doctor

See your doctor as soon as you first notice signs of psychomotor agitation. Your doctor will be able to determine if your symptoms are caused by bipolar disorder or another mental health condition. They will also help you decide on the best treatment plan to help you manage your symptoms.

You should also see your doctor if you notice changes in your psychomotor agitation symptoms. Changes in motor activity may indicate changes or progression of the underlying cause of the condition.

Diagnosis

Your doctor will ask you questions and review your medical history. They will also run some tests and perform a physical exam. Your test results will be used to rule out causes of psychomotor agitation.

Once you receive a diagnosis, you and your doctor can work out a treatment plan to manage your symptoms.

Treatment

Treatment depends on the underlying cause of your symptoms. For example, if your doctor finds that antidepressants or anti-anxiety pills are causing psychomotor agitation, they may switch your medication.

If psychomotor agitation is related to manic or depressive episodes, your doctor may prescribe mood stabilizers or antipsychotic drugs. A 2013 study found that the anti-anxiety drug benzodiazepine can help treat types of psychosis-induced agitation.

You may be able to manage psychomotor agitation using relaxations techniques that help people with anxiety. Try these:

  • See a talk therapist once or twice per week.
  • Practice yoga and meditation often.
  • Exercise most days.
  • Use deep breathing exercises.

Learn more: Alternative treatments for anxiety »

You should use these techniques in addition to medication or other treatments recommended by your doctor. It may be difficult to manage psychomotor agitation with relaxation techniques alone.

Outlook

Psychomotor agitation can be managed with the right treatment. It’s important to pay attention to the signs and symptoms. Sharing what you experience with your doctor can help them make a diagnosis.

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