Pressure of speech or pressured speech is a tendency to speak rapidly and frenziedly. Pressured speech is motivated by an urgency that may not be apparent to the listener. The speech produced is difficult to interpret. Such speech may be too fast, erratic, irrelevant, or too tangential for the listener to understand. It is an example of cluttered speech, and is often associated with certain mental disorders, particularly

mania Mania, also known as manic syndrome, is a mental and behavioral disorder defined as a state of abnormally elevated arousal, affect, and energy level, or "a state of heightened overall activation with enhanced affective expression together wit ...

and

schizophrenia Schizophrenia is a mental disorder characterized by continuous or relapsing episodes of psychosis. Major symptoms include hallucinations (typically hearing voices), delusions, and disorganized thinking. Other symptoms include social withdra ...

. It can be unrelenting, loud, and without pauses.

Description

Pressured speech is unrelenting, rapid, often loud talking without pauses. Those with pressured speech do not respond to verbal and nonverbal cues indicating that others wish to speak, turning from one listener to another or speaking even when no listeners remain. They are unable to listen to others, either talking nonstop until they run out of steam, or just standing there and looking at the other speaker before moving away. The speech can be either intelligible or unintelligible, and it is a hallmark symptom of a manic episode.

Causes

The pace of the speech indicates an underlying

thought disorder A thought disorder (TD) is any disturbance in cognition that adversely affects language and thought content, and thereby communication. A variety of thought disorders were said to be characteristic of people with schizophrenia. A content-thought ...

known as "

flight of ideas This glossary covers terms found in the psychiatry, psychiatric literature; the word origins are primarily Greek language, Greek, but there are also Latin language, Latin, French language, French, German language, German, and English language, Engl ...

" wherein the flow of ideas and information through one's mind is so fast that it is difficult to follow their train of thought. This is also tied to an inability to focus on one topic or task. People with

, as well as anyone experiencing extreme

anxiety Anxiety is an emotion which is characterized by an unpleasant state of inner turmoil and includes feelings of dread over anticipated events. Anxiety is different than fear in that the former is defined as the anticipation of a future threat wh ...

, may also exhibit pressure of speech. Pressure of speech usually refers to the improperly verbalized speech which is a feature of

hypomanic Hypomania (literally "under mania" or "less than mania") is a mental disorder, mental and Abnormal behaviour, behavioural disease#Disorder, disorder, characterised essentially by an apparently non-contextual elevation of Mood (psychology), mood (e ...

and manic illness. Pressure of speech has commonly been observed in people diagnosed with

attention deficit hyperactivity disorder Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterised by excessive amounts of inattention, hyperactivity, and impulsivity that are pervasive, impairing in multiple contexts, and otherwise age-inap ...

Stimulants

Psychostimulants Stimulants (also often referred to as psychostimulants or colloquially as uppers) is an overarching term that covers many drugs including those that increase activity of the central nervous system and the body, drugs that are pleasurable and inv ...

such as

cocaine Cocaine (from , from , ultimately from Quechuan languages, Quechua: ''kúka'') is a central nervous system (CNS) stimulant mainly recreational drug use, used recreationally for its euphoria, euphoric effects. It is primarily obtained from t ...

amphetamines Substituted amphetamines are a class of compounds based upon the amphetamine structure; it includes all derivative compounds which are formed by replacing, or substituting, one or more hydrogen atoms in the amphetamine core structure with sub ...

may cause speech resembling pressured speech in individuals with pre-existing psychopathology and produce hypomanic or manic symptoms in general, owing both to the substance's own qualities and the underlying nature of an individual's psyche. In many psychotic disorders, use of certain drugs amplifies certain expressions of symptoms, and stimulant-induced pressured speech is among them.

Related conditions

* Cluttering is a speech disorder that is related to pressure of speech in that the speech of a clutterer sounds improperly verbalized. However, cluttering is a distinct

language disorder Language disorders or language impairments are disorders that involve the processing of linguistic information. Problems that may be experienced can involve grammar (syntax and/or morphology), semantics (meaning), or other aspects of language. ...

. Even though cluttering sounds almost identical to pressure of speech, it differs in that pressure of speech is rooted in

, where cluttering is not. * Pressure of speech is an instance of tachylalia, or rapid speech. Pressure of speech is also variously related to agitolalia, agitophasia, tachyphasia, and verbomania. * Circumstantial speech is a

communication disorder A communication disorder is any disorder that affects an individual's ability to comprehend, detect, or apply language and speech to engage in dialogue effectively with others. The delays and disorders can range from simple sound substitution to t ...

in which the focus of a conversation drifts.''Problem-Based Psychiatry'' by Ben Green 2009 page 15 In circumstantiality, unnecessary details and irrelevant remarks cause a delay in getting to the point.

Stutter formation

Pressured speech may also lead to the development of a

stutter Stuttering, also known as stammering, is a speech disorder in which the flow of speech is disrupted by involuntary repetitions and prolongations of sounds, syllables, words, or phrases as well as involuntary silent pauses or blocks in which the ...

. The person's need or pressure to speak causes them to involuntarily stutter. Therefore, the person's need to express themselves is greater than their ability to vocalise their thoughts.

References

External links

{{Medical resources , ICD10 = R47.8 , ICD9 = {{ICD9, 784.5 Bipolar disorder Communication disorders Symptoms and signs: Speech and voice