Psychomotor Activity in Bipolar Disorder

Evaluating how moods impact motor skills

woman awake in bed
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The term "psychomotor" refers to physical activity and how your mental processes either affect or govern it. It is used in the diagnosis of bipolar disorder to describe any changes indicative of a manic or depressive episode.

For example, if you are depressed, you will generally have less psychomotor activity as your emotions can make you feel sluggish and weak. By contrast, during a manic episode, you may exhibit accelerated psychomotor activity such as fidgeting or making repetitive movements.

These movements, or lack thereof, are directly related to what's going on in your brain at that moment

In bipolar disorder, as with other mood disorders, psychomotor activity can be affected in one of two ways: it can be either increased, which is known as psychomotor agitation, or it can be decreased, which we call psychomotor retardation.

Understanding Psychomotor Agitation

Psychomotor agitation occurs in bipolar disorder, as well as in other mood disorders such as depression or schizophrenia. It is characterized by purposeless, agitated, and sometimes unintentional movements.

Examples of psychomotor agitation include:

  • fidgeting
  • tapping your foot or fingers repeatedly
  • pacing
  • switching channels on the remote repeatedly
  • talking faster than normal

Psychomotor agitation tends to show up during manic or hypomanic episodes. It may be accompanied by symptoms of expansive mood, a condition characterized by excessive, impulsive, and/or grandiose behavior, such as:

  • an escalation in goal-oriented activities (either big or incidental tasks that need to be completed now)
  • increased risk-taking and difficulty distinguishing between safe and unsafe gambles
  • socially inappropriate behaviors
  • being overly friendly in a way that is awkward or inappropriate
  • excessive spending or lavishing gifts on others
  • irritability and sudden bursts of anger

Understanding Psychomotor Retardation

Psychomotor retardation in bipolar disorder is characterized by movements that have become slow or impaired. This most often occurs during depressive episodes and is associated more with bipolar I disorder than bipolar II.

Examples of psychomotor retardation include:

  • having trouble getting out of bed
  • taking a long time in between bites of food
  • moving slowly, often hunched and with a lower head
  • talking more slowly
  • having difficulty writing or typing

Psychomotor retardation is usually accompanied by classic symptoms of depressions, including:

  • crying or feeling sad and empty
  • sleeping too much or too little
  • having trouble focusing or remembering things
  • having a hard time making decisions
  • having a hard time getting out of bed
  • having suicidal thoughts

Treating Bipolar Disorder

Evaluating psychomotor activity not only helps doctors diagnose bipolar disorder, it allows them to evaluate the severity of a manic or depressive episode. 

While there is no cure for bipolar disorder, there are treatments that can help. These typically include the use of certain medications in association with psychotherapy. 

Medications can include antipsychotic, antidepressant, and anti-anxiety drugs.

Psychotherapy may consist of cognitive-behavioral therapy (CBT), dialectical behavior therapy (DBT), family counseling, and/or group therapy.

Finding the right combination of drugs or therapies can take time, so try to be patient. The most important thing is to keep communications open and honest and to work with your doctor as a partner in your own care.

Source:

Yildiz, A.; Ruiz, P.; and Nemeroff, C. The Bipolar Book: History, Neurobiology, and Treatment. Oxford University Press; New York, New York (2015).

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