What is ment by pressured speach

[hell1971]

I am having some mania type symptoms after starting Anti Depressants, I have also found that I feel like I am talking really fast, like I cant get the words out quick enough, it has only started happening the last few days. Have been on the meds about 20days. I get really excited when speaking to my friends and almost dont want them to speak, is this what they mean by pressured speach???
I must admit I thought that my elevated mood would have settled by now but I am finding that I am becoming more and more excited and more and more happy and doing more and more at both ends of the day, still not able to get to sleep without the sleeping pills, only have three left and I know my doc wont give me any more so need to know if I need to come off these meds and risk going back to the depressed state I was in before I started them or perhaps discuss the possibility that I may have undiagnosed mild BP.

Thanks for any comments

[hell1971]

Thanks

I cant get out of it, I run my own business and this is a huge annual affair, its not an option to bail on my business partner, I feel a little calmer now. It seems to be in waves or I am able to self calm whichever at this particular moment I feel in control, I will just have to take things one step at a time and take myself away if I feel like Im loosing it again. Im sure I can manage, thank you for your support, I will see my normal doc on monday and get a referral, I have been keeping a sort of journal and I have just read it through and I dont think im going to have any trouble getting refferred. Thank you again

[ILADVOCATE]

I think the doctor is stepping beyond their boundaries. A psychiatrist can diagnose a psychiatric disability and refer a person back to their primary care physician for follow up but most physicians refer a person for diagnosis and treatment for a psychiatric disability to a psychiatrist. This is not saying anything against physicians but they deal with general medical issues. That's why there are specialists such as for example my neurologist. And my psychiatrist. I have a competent physician but he will not make changes to my psychiatric medication. Obtain a referral to a psychiatrist. That's probably why you were diagnosed incorrectly. Psychiatrists recieve additional training different from standard physical doctors. As for your event unless its work related or neccessary, you might think about canceling it. There will be some physical and mental withdrawal symptoms and its best to not be out at a public place if you don't feel well. Think about how you are feeling. Perhaps you could explain to them. And if its people you don't know you don't have to say its a psychiatric medication issue. You could just say you were not feeling well. But I would obtain a referral to a psychiatrist and have them do a consult and hopefully change you to the correct medication rather than let a physician try and solve a situation that may be beyond them.

[hell1971]

Thanks for your comments, just to clarify, I am only under a normal doctor, the therapist I saw is for my daughter I was only seeing her for an weekly update on my daughter, she noticed my shaking leg and was concerned and said she could get me some physciatric help if I wanted, I told her I think my doctor has it under control.
Im not sure what my normal doctor is going to do, he is taking me gently off these meds and seeing how I am next week thats all I know.

Since I posted this morning, I am making mistakes at work I feel like I cant concentrate and that I am shaking internally, sort of like a fever but not, I dont know how to explain it, Im not sure if I am anxious or not or just sort of jumpy, no one is looking at me weird so from the outside I think I look normal, I feel like Im going a bit mad. I was scared when I was driving this morning because I felt unsafe because of the flicky feeling, whats happening to me, is this the meds ? what should I do? Im working I cant go to the doctors until monday I have a huge event on this weekend that I have to attend Frid/Sat and Sunday.

[ILADVOCATE]

I don't understand. Did your psychiatrist take you off all medication? It sounds like he misindentified depression when in reality you had bipolar disorder. If he's changing your medications that's fine. If he took you off all medications he has to explain why. If your psychiatrist is not going to put you on a mood stabilizer (as opposed to an anti-depressent) I'd be concerned as what you are describing does sound like emergent mania then I would speak to him again and if that's not workable get a second opinion. I am not a provider and I can't diagnose of course but what you are describing sounds like bipolar to me, perhaps cyclothymia (mild bipolar) and most psychiatrists would prescribe a mood stabilizer unless there was a specific reason otherwise. They should titrate you from one medication to another unless they said they would interact and there has to be a period in between without. Otherwise all the symptoms will return in full and it sounds like they are.

[hell1971]

Hi All, I have been back to my doc and he said I have had a obessive compulsive reaction to the meds and my blood pressure is too high so he is taking me off them gradually over the this week. I have had two days of half the dose and today is my first day of nothing then I have to take half again tomorrow. I saw my daughters therapist and she is worried about me and wants to refer me for some help as she hasnt seen me like I was on tuesday, I was irratated thats all, I explained to her that I was coming off the meds but she thinks I need help and said she would speak to my GP if I wanted.   I had the most bizzarre experience last night that I have never had before. Yesterday my mood was up and down, I felt energized then flat then energized and happy then flat, I then became irratated and felt like something was brewing inside me, I went and had a bath to see if this would calm my insides down, it then became really strong so I went to have a lie down, I cried uncontrollably for 1/2 hour or so, my husband asked if I was ok what was wrong, I couldnt tell him, I didnt know why I was crying then as if someone had flicked a switch I felt  ok like someone had lifted the cloud and then I was happy it was so dramatic, I was then joking and laughing, it is the first time I have ever felt like that it was bizzarre, normally if you get upset you are left with a bad feeling for sometime and then you gradually feel better, this mood swing or what ever you call it was within minutes, is this a normal response to reducing medication or is this one step closer to confirming im probably BP, its funny for the first time Im not worried about it I feel at peace with myself. However today I am feeling really weird, I feel really anxious and a little flicky, distracted like im a telly that is flicking on and off, just for split seconds feeling like time is jumping, im ok I just feel strange. Any comments are a great help.

[Lizz67]

Yes, you can have symptoms of mania (or the less severe hypomania) and be aware of them. But as mania moves towards psychosis this insight (ability to realistically assess your symptoms) goes away.
It's very common for anti-depressents to cause mania in BP patients, and this is one way that BP is diagnosed.
I'd recommend talking to your doctor ASAP.  Your mania needs to be halted. Immediately.  Then you can reasses your need for medications to deal with your depression.

Hope you're well.

[ILADVOCATE]

Well its more complex with me. I have schizoaffective disorder but I am identified as fully recovered with glycine, an antipsychotic in Phase II FDA study. So I can look and see when I wasn't and what was going on. However, its not a mood stabilizer so I needed one in addition so I did have extreme mood swings when I was off one. I was never misdiagnosed with depression. But I was misdiagnosed with ocd. And I was given Anafranil, the only anti-ocd medication available then which is also an anti-depressent and it made the bipolar aspect of my schizoaffective flair up and I ended up in the psychiatric hospital in 1991. Its hard to tell the difference between "being manic" which is feeling wildly speeded up and unable to concentrate and having pressured speech and everything else you've read about and "medication enduced mania" which is what you are describing because I've had both. The most recent offender (for me, its usually not used to treat bipolar because it can bring on depression, mania is an idiosyncratic reaction) was Clonidine where I would feel wildly elated and not know why. It wasn't natural mood swings. But after a while I couldn't tell. But then I realized something was wrong so my psychiatrist changed it. But that is legitimately used as an experimental mood stabilizer. Anti-depressents are not used to treat bipolar disorder except if there is remaining depression and then Wellbutrin can be used safely but is among the only ones in this category. But only with a mood stabilizer. What you might be experiencing now is euphoria or hypomania. It appears to feel good until it spirals into full blown mania. But by then its too late. But perhaps you just explained your symptoms of depression to your psychiatrist as they were your over riding concern. So explain what's really going on that you believe you have bipolar and that the anti-depressent is making you worse and then the medication can be changed. This link is a resource for people with mood disorders in general from a well known mood disorders specialist and should be helpful:
http://www.psycom.net/depression.central.html

[hell1971]

Thanks, I think I know im manic or at least hypomanic but i am trying to avoid the realism of it I guess. It doesnt feel bad to me I feel great and havent felt this great in a long time, its been so long than when I asked my husband if I am different to when I was before I became depressed he said he couldnt remember, he said sort of maybe a bit OTT but I have been like this before just never for this long, I think I have had days like this but never longer than a few days at the max then I usually setlle down. im not doing anything I havent done before just more in the time and maybe a little exagerated but even I can hear myself talking ina really excited manner when really the subject doesnt warrant it or saying stuff that is very inappropriate and laughing out load in an exagerated manner. If you are BP are you aware of this or am I just talking myself into this reaction, is that possible.

[ILADVOCATE]

Yes what you describe is pressured speech and what you are going through would indicate you are becoming manic. But yes its true if you go off the anti-depressents you'll become depressed again. So don't make the change yourself. Speak to your psychiatrist immediately. Make an appointment. Have them change the anti-depressent to a mood stabilizer such as Lithium, Depakoate or Lamictal (those are the three most commonly used ones, Lamictal was the one I found the most tolerable, there are many others as well). Explain exactly what is going on. And how even though the depression has gotten better you have started to feel increasingly manic such as having pressured speech or losing sleep. It happenned to me. And to other people I know. If a person is misdiagnosed as having depression when they have bipolar of a type where they experience mostly depression the anti-depressent will worsen things. But it doesn't treat the depression. But a mood stabilizer will treat both. So give your psychiatrist a call as soon as possible. And make sure to stay calm and not act on any impulsive judgements in the meantime. They will help you. But make sure to explain everything in detail. Then they will change your medication to one that can help you. Its a frightening experience but if they take care of it now you'll be alright.