What is psychomotor agitation?
Psychomotor agitation often affects people with bipolar disorder, but it is also associated with other conditions that affect mental health or neurological function. It is a physical expression of anxiety and mental tension.
It can take many forms, some that are less serious and others that are more severe. It involves repetitive, purposeless, or unintentional movements and behaviors. These movements and behaviors are made in response to feelings of restlessness caused by increased anxiety.
This article explores the ways of feeling, moving, and behaving that could be symptoms of psychomotor agitation. It also looks at what mood disorders are associated with psychomotor agitation.
Symptoms of psychomotor agitation may include being unable to sit still, being unable to relieve tension, and racing thoughts.
Psychomotor agitation can be distressing for people who experience it and may also cause concern to others around them.
For the person who is experiencing psychomotor agitation, becoming aware of these movements, or seeing that others have noticed them, can be upsetting.
However, being aware of the symptoms of psychomotor agitation also means people can seek help from a doctor if they, or someone they know, is affected.
People experiencing psychomotor agitation may feel:
- unable to sit still
- as if their body is stiff
- unable to relieve tension
- desperate to find a comfortable position
- increasingly anxious
- as if their thoughts are racing
These feelings may cause people experiencing psychomotor agitation to:
- pace around a room
- wring their hands
- tap their fingers
- tap their feet
- start and stop tasks abruptly
- talk very quickly
- move objects around for no reason
- take off clothes then put them back on
It is important for people to note that these behaviors are not concerning on their own. Many people do repetitive movements or behaviors out of habit.
Someone experiencing psychomotor agitation, however, may display these behaviors in a way that seems:
- without purpose
- very fast
People who are more severely affected by psychomotor agitation may behave in ways that could cause their body some harm, including:
- biting their lips until they bleed
- ripping skin off from around their lips
- pulling skin off from around their nails
- chewing the inside of their cheek
People may experience psychomotor symptoms that range from mild to severe.
As explained in a 2008 study, in people with mood disorders there is a dynamic link between their mood and the way they move.
People showing signs of psychomotor agitation may be experiencing mental tension and anxiety, which comes out physically as:
- fast or repetitive movements
- movements that have no purpose
- movements that are not intentional
These activities are the subconscious mind's way of trying to relieve tension. Often people experiencing psychomotor agitation feel as if their movements are not deliberate.
Sometimes, however, psychomotor agitation does not relate to mental tension and anxiety.
A 2010 study found that there was also a link between psychomotor agitation and nicotine, alcohol, and drug dependence.
In other cases, psychomotor agitation can be caused by antipsychotic medications.
Psychomotor agitation is a relatively common symptom of people diagnosed with bipolar disorder.
In addition, it can affect people diagnosed with a range of other conditions, including:
- post-traumatic stress disorder (PTSD)
- panic attacks
- generalized anxiety disorder
- alcohol withdrawal
- Parkinson's disease
- traumatic brain injury (TBI)
In bipolar disorder
Psychomotor agitation is a common feature of bipolar disorder, which is a type of mood disorder. People diagnosed with bipolar disorder can experience three different types of episodes called manic, mixed, and depressive.
Psychomotor agitation is a symptom of all three types of episode. However, the nature of psychomotor agitation can change, depending on which type is occurring:
- Manic episode: Psychomotor agitation may be accompanied by racing thoughts. Feeling overwhelmed by these racing thoughts can cause people to move without meaning to and to talk rapidly. Movements caused by psychomotor agitation in a manic episode may appear chaotic.
- Mixed affective episode: This is a particularly vulnerable state when a person experiences a mixture of depressive and manic symptoms. As well as feeling very low, they may feel agitated and irritable. This can cause them to make repetitive movements to try to shake off the feelings.
- Depressive episode: In a depressive episode people may feel extremely low, hopeless, and tearful. They may make some movements that are signs of psychomotor agitation, but these may be driven by feelings of desperation rather than irritability.
A doctor may prescribe drug therapy if a person has an associated mental health condition.
If a person is experiencing psychomotor agitation or knows someone who is, it is a good idea to speak to a doctor. A doctor can determine the cause of psychomotor agitation and give advice on the best way it can be managed.
When psychomotor agitation is caused by a reaction to medication, a doctor will prescribe an alternative type.
If psychomotor agitation is caused by a mental health condition, a doctor can help the person affected to access the right sort of help.
Most mental health conditions associated with psychomotor agitation are treated with drug therapy. The type of drugs prescribed will depend on the condition. Treatments that may help bipolar disorder include mood stabilizers and anti-psychotic drugs.
According to research from 2013, a type of drug called benzodiazepines may also help psychomotor agitation if it is caused by psychosis. Psychosis can affect people who are diagnosed with bipolar or schizophrenia.
As well as drug treatment, seeing a therapist can help people to manage mental health conditions associated with psychomotor agitation.
Also, introducing the following lifestyle changes to their routine may help a person to reduce their anxiety levels:
- regular exercise
- yoga and meditation
- deep breathing exercises
When someone has a diagnosed mental health condition, these lifestyles changes are best used alongside the treatments prescribed by a doctor.
It is normal to feel distressed by psychomotor agitation, but it can be managed with the right treatment.
Seeking treatment for psychomotor agitation can help a person manage the other aspects of their mental health. They may be affected by an underlying condition that is yet to be diagnosed or treated.
Starting treatment early for psychomotor agitation is the best way to reduce the impact it and associated conditions can have on someone's life.