Pressured speech often occurs when someone is experiencing an elevated mood, strong emotions, or racing thoughts, resulting in one speaking rapidly and with urgency.1,2 This behavior can be a symptom of multiple mental and neurological disorders, so treatment will depend on one’s associated underlying condition.
What Is Pressured Speech?
Pressured speech, also known as hyperverbal speech, is defined as the act of speaking in a rushed, frenzied, or urgent manner. A person experiencing pressured speech may over-emphasize certain words or skip pauses between sentences. While this response isn’t categorized as a disorder in itself, it commonly arises from unstable thought patterns or moods. Unfortunately, pressured speech makes it hard to understand and communicate with others.1
Anyone can struggle with becoming pressured when they’re especially nervous, excited, or stressed. However, for some this can occur more often than normal. In this case, pressured speech is most likely due to an underlying mental health condition such as bipolar disorder.1,2 Alternatively, substances including amphetamines or stimulants can also result in rapid speech.2,3
Symptoms of Pressured Speech
A person experiencing pressured speech may not make sense, as their words can become incredibly disorganized.1 Noticing this behavior in someone isn’t difficult, as their speech pattern will deviate from their typical diction. If you notice that a loved one is engaging in quickened speech more often than usual, there are a few signs of pressured speech you can look out for.2,4
Some of the common signs and symptoms of pressured speech include:
- Speaking at a rapid or frantic speed (aka hyperverbal speech)
- Being forceful or insistent when speaking
- Excessive or compulsive talking that’s hard to interrupt
- Speaking with urgency or excitement
- Erratic or disorganized speech
- Switching topics often
- Talking in tangents
- Offering inappropriate comments
- Excessive rhyming, wordplay, punning, or joking
- Impulsive comments
- Speaking loudly
- Illogical sequences in speech
Associated Conditions
Mental health professionals will pay close attention to chronic instances of pressured speech, as they are frequently associated with serious mental illnesses that are not being well managed.2 For example, behavioral disorders, bipolar psychosis, anxiety, and impulsivity are all common among people who display pressured speech.1,2,3,4,5,6
Disorders associated with pressured speech include:
- Schizophrenia or psychosis: During a psychotic episode, a person might see, hear, or perceive things that are not real. These delusions and hallucinations can cause a person to become excited, afraid, or agitated. This may result in one’s speech becoming pressured or incoherent.
- Bipolar disorder: During a manic episode, a person with bipolar disorder experiences elevated moods, heightened energy, and a reduced need for sleep. Additionally, manic episodes may influence one to speak and act in impulsive ways, sometimes resulting in pressured speech.
- Attention deficit disorders: Many diagnosed with ADHD have trouble focusing and concentrating. The associated racing thoughts and impulsivity can lead to pressured speech.
- Anxiety disorders: On e’s frequent pressured speech when stressed or anxious may be a clear indicator of an undiagnosed anxiety disorder.
- Substance use disorders: Excessive substance use of drugs or alcohol can increase the likelihood of pressured speech. For example, stimulants are known to cause racing thoughts that can result in this behavior.
- Autism spectrum disorders: Those on the autism spectrum may struggle with social skills, communication, and abnormal speech patterns–sometimes including pressured speech.
What Causes Pressured Speech?
How a person speaks is often seen as a reflection of their emotional and mental states; abnormalities of such can be indicative of internal thought process and emotional dysfunction.1,5,6 The most common source of pressured speech is mania, a core feature of bipolar disorder that involves elevated mood, energy levels, and impulsivity.2,4,5 Also, many report racing thoughts when they’re experiencing a manic episode – sometimes referred to as a ‘flight of ideas.’
High stress and anxiety levels may also cause a person’s speech to become pressured. Intense emotional states have the potential to make one speak in a fast and frenzied manner. However, once the stress or anxiety relents, a person’s speech will usually return to normal.1 Less commonly, disorders like autism, schizophrenia, psychosis, or ADD can cause pressured speech. When symptoms are not being managed effectively with therapy and/or medication, this behavior can become much more frequent.1
Treatment for Pressured Speech
Because pressured speech is not considered a disorder, the kind of treatment recommended will depend on the underlying condition causing the behavior.1 For example, someone with bipolar, ADHD, or schizophrenia may be encouraged to change their medications and/or dosages, along with increasing therapy sessions. CBT or mindfulness skills may be recommended to someone with an anxiety disorder and addiction treatment to one with a substance use disorder. A person with autism can improve their communication difficulties through social skills training and/or speech therapy.2
Those who experience pressured speech, but haven’t received an overarching diagnosis, should consider reaching out to a licensed therapist or mental health professional. During the initial appointment, a clinician will complete an assessment, determine a diagnosis, and recommend a treatment plan. If you’re looking to better understand yours or a loved one’s behavior, you can ask for a referral from your doctor or a trusted loved one, or use an online directory to find a therapist that matches your specific needs.
Final thoughts
Pressured speech can make communication difficult. However, with an effective treatment plan or self-coping skills, you can find ways to manage this behavior. While you may feel overwhelmed or alone when addressing your symptoms, there is always someone ready and happy to help! Over time, you’ll be able to overcome these difficulties and decrease the frequency of pressured speech.
For Further Reading
- What is Pressured Speech? – Great Speech
- International Bipolar Foundation
Pressured Speech Infographics
