Bipolar Symptoms: Psychomotor Agitation

Hey Natasha, just discovered your blog. I think it's great. I just started a blog about my bipolar, I hope you'll visit! (So far, it's just an about me page and one post, but more to come!) Cheers.

Natasha, once again you shed light on something obscure about our condition. I appreciate all the research you do and your attempts to get to the bottom of things.

Hi Natasha,
I've been following your blog for about a month now and I just wanted to say thank you for your honesty and for your advice. Your perception of this disorder is similar to mine and I love that you put in the time to do the research and find creditable sources. I wanted to ask if I could suggest a topic for you to discuss. I'm bipolar and I'm currently tapering off my meds to try to get pregnant. Do you have any advice on the best forms of natural treatment for bipolar during pregnancy. My doctor said I should try be med-free during conception and the first trimester if I can help it but recommended Zoloft and Letuda(I'm not sure on the spelling) if I get stuck in one of my moods and need help. What's your opinion on this topic?

Hi Tonya,
I think I can help you, but could you contact me privately please?
http://natashatracy.com/about-natasha-tracy/contact-natasha-tracy/
- Natasha

i have that symptom and i always thought it was from anxiety. my official diagnoses are DID, PTSD, anxiety and depression. should i be screened for bipolar? as far as i know i've never had mania or hypomania.

I never knew that their was a name for this but relate to it's symptoms... but I sometimes find with some of the repetitive actions I do a distraction from the maelstrom within. I also would like to note that I have had these behaviours since childhood and was forever getting into trouble over them for behaving (to quote my Mum ' like a caged tiger '
Also your page is great, useful, informative and well balanced. Thank you.

great post. i related to it on a very personal level. i had to share it with my readers on my blog. thanks for bringing such important and upcoming information to the table for us all.

When I attempt to explain it to someone I generally tell them that everything inside of me, organs, muscles, everything, feel like a spring sprung way to tight and I have to move or figure out some way to release the pressure because if I don't I feel like I will explode.

I think my scratching is a form of this because I'm not really wanting to hurt myself as much as release tension and feel real again.

I think I just had an episode of that and the way I could describe it is I felt like I wanted to smash something or cry or just scream into a pillow. I had so much anger I didn't know what or how to do it. But finally I channeled it positively and constructively doing things that needed to be done and would help me.

Hey I can relate to this topic for sure. Also to the others writing in. I have been experiencing this more lately since my cycles are woooow right now... Be Well all.

I just went to this blog as it was the first one that came up and found this information. I am not sure that I have this Psychomotor Agitation but the reason I was looking for a blog is more of a mental-emotional agitation. I am easily agitated at work when too many people are milling around my desk or the chatter makes me want to rip my ears off. I actually tell people to go away or get back to work, or I shut the door to block them out. I know the job I currently have is not a good fit for me, I am a receptionist and I am also box office sales and info booth for a concert venue. I need the job! So I am open to hearing how I might "unagitate" until the end of August when this job ends.
Coming-out-of-my-skin...

By the way Natasha, you are very pretty. Thank you for reaching out to us!

Describing that agitation is like nailing down a rain shower.
My best way to handle it is going to the pool. I can thrash all I want in the water and hurt nobody.

This is horrible and I have this bigtime. I have to constantly shrug my shoulders up into my neck until it hurts. I have uncontrollable urges to tighten various muscles over and over. I also feel the need to squeeze my eyelids as tight as possible. It's such an out of control feeling and people look at my strangely sometimes. The only plus is that I burn a lot of calories throughout the day!

From the moment I am conscious in the morning until I fall asleep I have a constant dialog or song running through my head, and I clench my muscles repeatedly to the beat until I am now extremely stiff. Like tapping my feet, but just clenching the muscles. Fingers, too. It stiffens all the way up my legs and arms. Dr. is trying me on 40mg Lexapro but I don't know if that's the right thing. I agree with jsoltys above. I am SO sick of it! and I can't stop it!!

My girlfriend had bipolar and she only started getting really bad agitation in the legs 24 months after starting seroquel 200 and avanza 30. She is trying magnesium but its not helping yet

*has bipolar

I think that I only experience this when I am feeliing very angry, afraid or upset (and have no outlet for that...). Most commonly it seems to be anger. I'm not totally sure what that says or means though...

Excellent information. I have this problem every single morning for about an hour or more. Legs wont stop moving, can't sit still, clenching eyes shut, trouble breathing because I hold my breath. I've had no idea what was causing this. I also do the ripping clothes on and off again thing on occasion and like another person responded the song thing going on in my head over and over and over again can't stop moving to this beat in my head. I will be talking to my doctor about this. Thank you so much. How do I get ongoing posts from your blog?

Thank you for posting this again. I had no idea that this had a name. I thought I was the only person doing repetitive movements in my little cubicle. I am busy at work all day. But I will lift up the very edge of the back of my shirt and scratch my back. Then I scratch the back of my hand before I continue with typing and working. I don't really have a ritual. I will do it random times during the day. But I never see others lifting up the very back of their shirt. I feel like I have to scratch my back. And sometimes my back is not really itching at all. It is something I have to do. It is almost as if I am cutting my stress and getting my head together for a few seconds so I can keep working. I don't do it at home watching TV very much. For me at least it goes with my work day. Thanks for letting me know about it.

It turned out when I had this problem for years, it was caused by the prescribed drugs. It was probably akathisia, or something like it, but I didn't pace around and when I described it, the docs just said it was "my illness," just like my cognitive problems, which have mostly gone away, but that took 3 years to happen (doc says brain damage from the drugs, he saw me recover over the years).
I still have bipolar, still get depressed as hell now that I'm off the drugs, but that horrid restlessness that made me 10X more suicidal is GONE and has been ever since about 6 months after I got off the drugs (which ONLY happened because I ran out of drugs to try, and ECT failed, too).
I'm not sure my message is too welcome here, but my point in posting on here is for those of you who go years and treatment never helps and you just get worse, consider if you are like me, and the drugs are causing more problems. In hindsight, docs all nod their heads and say "oh yes, akathisia is a very common side effect," and "It's well known that this drug causes aggression" and "a lot of people who think for a living won't take most of these drugs" and so on, but at the time, they said it was 100% "my illness" or later, as I got even worse, tacked on borderline to my diagnosis.
If this restlessness first showed up AFTER you got drug treatment, consider if it's your antipsychotic (maybe some other drugs do this too). The docs won't spot it unless it's blatantly obvious. And you know, I couldn't tell I was having cognitive problems until I recovered. I started science fiction writing again, and doing my other nerdy hobbies that I couldn't understand. Took 3 years off the drugs to be able to think well enough to pick that stuff up again. I seriously question if bipolar causes any sort of cognitive damage. Those docs were all so sure it was all my illness. Now without treatment, I'm back to the old roller coaster, but that's a lot better than I was doing with the akathisia and cognitive problems and NEVER cycling out of depression.

I came across your blog recently, and I am really enjoying your articles. Several times, I have caught myself nodding my head in agreement. Today was definitely one of those times. You described psychomotor agitation perfectly. I'm going to direct friends and family to this particular article to help explain it! The only way I've really been able to describe it to them so far is that when it's really bad, I feel like I'm going to crawl out of my skin. In the early stages, though, I pace (and change my clothes!) or play repetitively with a yo-yo. Now maybe my husband will be able to "notice" and help me monitor a turn toward hypomania.

Also left out, is the agitated feeling one has. Where the slightest thing gets on your last nerve. Someone eating, the buzzing of the light fixture outside, tying to screw on a cap that is cross threaded, someone sighing. These things make us feel agitated and we get impatient and angry. "Calm down" doesn't help. I did try DLPA-an amino acid. It helped tremendously. However, for me had two side effects I could not tolerate. The search continues. The best meds for me, I am allergic to. So I am having to try to find different approaches.

psychomotor agitation
Psychiatry Physical and emotional overactivity in response to internal and/or external stimuli, as in hypomania.
I think this is a more inclusive, though brief, definiton. Note: Physical AND EMOTIONAL over activity...

i been diagnosed with depression.flappy and lurchy arm moving at work,several attempts to grab things
i also developed a stutter and write down words or letters more than once....can't always read back and correct it.think work tolerates me

THANK you for this. Since childhood, I have had a thing with my toes moving them to the syllables that people use and to get to sleep.
When angry, frustrated, or excited, I shake. Sometimes violently. I have a
bad habit of shaking my legs.
my diagnosis are Bipolar 2 disorder, PTSD, and Depression.
I'm very smart, but sometimes the simplest conversations confuse me and
when I state my confusion, people get angry and frustrated causing
me to also get frustrated and cry. Sometimes resulting in Panic attacks.
In this moment, I am angry and shaking and I would love to damage something.

I also wanted to add that my doctor prescribed me Limital and Celexa and says that because when I came to him since I was partaking in marijuana, I am an addict- so he won't prescribe anything stronger for fear of me becoming an addict.
I also take Vistril because I have horrible nightmares.

Finally a name for it. But I only get it about 2 hours after I have taken my medication of 75mg seroquel XR. Its so bad I want to go off my meds! I stretch and stretch, throw my arms around but that only helps for a second if that. Odly enough I find that eating is the only thing to make it stop, but as soon as I stop eating it's back! I get it til I finally fall asleep then am fine during the day. I am going insane as I type this. I need to know how to stop it..... is there anyone, or yourself of course, who can help me!

The movement and muscle clenching is uncomfortable but I can't take the feeling of my skull actually exploding as my brain swells and I'm unable to think. My insides want to get outside. I am inclined to hit stuff to feel a release. It's better if it hurts because then I feel something but only helps for a bit. It's hard to describe much of what I feel with BP but agitation is one the best words I found to describe my chaos without making people too uncomfortable.

THYROID. There are a lot of studies that link Thyroid dysregulation and bipolar disorder. "Agitation" and also be a lot of energy (and inappropriate times like at night) that you just don't know what to do with. You feel like you want to run a marathon, but can't explain why.

This is for Jonelle: seroquel has a side effect called akathesia. I get this as well from this med. Taking benadryl (or cogentin) along with drugs in this class will help. If not you should switch meds because that sort of suffering is unbearable. This is a HUGE thing to underline for your readers here: if the agitation is in reaponse to a sensory stimuli already in place, or after taking a medication, this may not be simply psychomotor agitation. This may be a neurological side effect from the med. Psychomotor agitation is found with an mentally agitated state. If you are fine but then feel like you are jumping out of your skin 'after' taking the med, it's akathesia and talk to the doctor.

do you think tosses and turns in bed for an hour or two, is an example of psych motor agitation?

I was wondering if anyone else has the symptoms I have. Stress causes me to have radiant agitation physically that is hard to describe. It manifest thru the muscles of my legs and arms like electrical shock where I can' stand my pants or boots to touch my skin. It's as if I am being cut by glass. I just want to blow out of my body. When it is real bad my eyes even bother me. I will feel mentally agitated as well. Doctors have been able to do nothing for me. Xanax won't even help. It takes a good while for it to go away. If I don't sleep well which is with a sleep medication I will start the day this way. It's an awful feeling.

Well, I am not going to say it's like glass but certainly not comfortable and it's like a straigned muscle, clinching, restless antsy feeling that goes from the small of my back down through my legs and out through my arms. It follows along with a rushed and hurried feeling that usually brings sadness and resentment for all the time lost and coulda woulda shoulda's.

The physo motor agitator ou affects me at night which in turn causes my insomnia worse. Please help I am not sleeping.

Wow, I didn't know it had a name. Thanks for the explanation
This is how psycho motor agitation manifested itself in me
Before I was diagnosed with bipolar disorder I was prescribed antidepressants that sent me into a mixed state, highly manic one moment then deeply depressed the next. I felt incredibly anxious, restless, paced alot, couldn't sleep. Burned out relationships with constant need to talk. Felt like a needle struck on a record player, did alot of repetative things like playing with tarot cards non stop 24/7. (I was extremely concerned about my future and looking for answers). Tried all the normal things to calm down meditation tapes, warm bubble baths, avoiding coffee, etc. Nothing worked not even Ativan. The stress on my mind and body was too much and preceed a brief psychotic episode. For me psychomotor agitation is a prodromal warning that something is wrong and I need to get help.

... in psychomotor agitation I also had anger issues, screamed a lot, broke dishes, ripped up things, etc. Also wrote never ending to do lists. Mentally I was pretty much overwhelmed by everything and had a deep need to do something physically to relieve it. I never realized until now that's why the suicide rate is probably so high among those with bipolar during mixed episodes. I also self harmed

I see an occupational therapist who specializes in sensory integration disorder. That's when a person can't properly regulate sensory stimuli and goes bat shit over little noises or people moving around them or can't stand being touched or to have their clothing touch them ect... Lisa Benson on here sounds like she has those symptoms. Its not bipolar its sensory overload. Adults are rarely properly diagnosed.

I thought I was the only one who felt this... Sometimes I feel like itching myself but I'm not itchy at all I just don't know how to get rid of this feeling it's unbearable...

I've recently been re-diagnosed (God, I used to be so smart but I swear 15 years of SSRIs/SSNRI's have had a cognitive impact on me-I think I meant reclassified) from having depression to tentatively bipolar 2 and I've been dealing with psychomotor agitation and other sensory issues that I had forgotten I had dealt with as a child through my teenage years which, quite frankly, I am surprised I made through. The psychomotor agitation and the sensory issues are the worst. One makes you want out of your own body, almost to the point of making you suicidal (that, a lack of stability -they're still figuring out my meds-& an anxiety attack scared me so much that I spent last Saturday in the ER-unfortunately there are no beds nearby & I'm too high functioning for the way the mental health system is currently set up according to the social worker I spoke to on Sunday-so they sent me on my way with an Rx for Xanax). The other can do the same or make you want to choke a b*tch. I kid, but the snoring of the one lady in the psych group area of the ER pushed me to tears & I had to ask for something for anxiety & when my fiancé & I first got to the ER I had to put on sunglasses & cover my ears bc the brightness & sounds were just too much. I also had to get my hair cut (it was down to about my midback) bc I couldn't stand it touching me anymore & suddenly cotton sheets that always felt soft started to feel like I was sleeping on hay. It was awful. I hope some of this goes away soon bc it has turned me into hell on wheels & I hate the person I am right now.

hello,
i'm diagnosed with ptsd, anxiety, depression and DID. i have symptoms similar to what you describe. should i talk to my psychiatrist? i wear shoes all the time because i rub my feet together and it keeps me awake and drives my sister crazy. also at night i sometimes get so anxious i can't stop moving and inside i feel terrible, like i'm being tortured. and i get pain in my legs. but i don't think i have bi-polar. what do you think?
thank you, jen

@ David with the "cut glass", eye issues. My bipolar brother goes naked at home fo this reason; takes lithium and dr has given him Neurontin (which does NOT help) However Klonipin does take care of it..........even Xanax didn't do enough.

As an ED psychiatric evaluator, when I see psycho motor agitation, it always looks more unconscious than intentional. Like a person is so wound up their body has to move, without thought, to release the tension within. I am glad to read this blog and the comments below -- it gives me something more to consider when I evaluate someone.

I've been dealing with psychomotor agitation off and on for over a year now. Finally had my new psychdoc prescribe something. I start taking it tomorrow. For me it has been squirming when sitting still, touching my face, itching in various places on my body alternately, running my fingers through my hair, rubbing my hands on the arm rests of my chair to the point that I have worn holes in them. Jerkingredients movements in my legs and trunk, shrugging my shoulders......all the while feeling restless inside. I can briefly stop these things, if I am concentrating on something, or if I concentrate on stopping. It's worst at night right now, but it has been just as bad regardless of the time. It has brought me to tears so many times. My thoughts are it has to do with the amount of dopamine in my system. Too little and the mentioned symptoms are the result, too much and I'm sedate. I've come to this conclusion because I seem to be treatment resistent on several antipsychotics and the intervals between new medications has brought about circumstances that seem to support my theory. I'm bipolar 1, obsessive compulsive disorder, general anxiety disorder, agoraphobic. My psychdoc recently started new on Saphris sublingual, which for me seems like a wonder drug......however, after every increase I have had a day or two of increased restless leg syndrome marked by pain in my right hip,and an inability to keep my legs still at night, along with leg pain. Also I continue to experience psychomotor agitation off and on. In the last seven days I have experienced psychomotor agitation four of those days, not all concurrently. Sometimes just in the evening, other times in the afternoon and evening. Before my afternoon dose of Saphris, and before my evening dose of Saphris. Again, I have experienced psychomotor agitation before taking Saphris, off and on for over a year, but it has gotten worse. I hope and pray that this new medication my psychdoc prescribed will alleviate these symptoms.

FINALLY. I found an article to explain this madness. What happens with me is that I get an urge to tighten my chest and arms, my arms go close to my chest, and I shake for a couple seconds until I can relax and get that urge under control. Usually happens when I'm anxious or mad or have any overwhelming emotion, in general. Only thing is, it was hard to find this article because all you ever see is "uncontrollable muscle movements" and stuff like this isn't as common to find. Thanks for writing this.

Natasha
An article from your personal blog "Calming The Cycle Of Anxiety"
has come in quite handy lately. My what if-Ing GAD symptoms tend
to take on a life of their own and have been known to lead to mania
If they are not reined in early...
Changes at work have recently increased my anxiety to
almost unbearable levels then when I came home from a
yoga class today I find a letter slipped under my door from
Corrections Canada warning me of a pedophile that has
recently moved into my building. It's brought up some
old childhood issues for me. I was on the downturn of
a recent manic episode where I was going days on only
3 hours of sleep. Trying to remain stable has been a real
challenge...

I struggle with bipolar nos, anxiety, psychomotor agitation, OCD and mixed state. Has anyone had these symptoms listed on this site and worse but could not find a medication that doesn't cause side effects, makes you worse or doesn't work? I have been struggling for 13 years and have found nothing that continually works. I have been struggling everyday for years. Has this happened to anyone else? Where they have struggled everyday for 13 years or more?

I seriously think Im bipolar the doc keeps saying it anxity but won't send me to b checked

I have this sort of static electrical field that moves around and through me all the time and I can feel it almost as if it is slightly ticklish. It is overwhelming, it feels like I am barely keeping my cells from rapidly expanding away from each other. At the same time, there are two voices in my head that are both me, having a conversation with each other all the time, constant back and forth banter. I mostly hear
(feel) it in a muffled sort of way. It is so distracting that I have to hear or see other things over and over again to get the whole message. I liken it to having the preverbal angel on one shoulder and the devil on the other, except neither is good or evil, just opposite. Like a constant debate that has no particular subject matter and never ends until I am asleep. I take medication for depression and am now weening off one and onto another because my doctor feels I have been on this one medication too long. Every time I go through a dosage change / adjustment, or a change of drug, I go through this up and down rollercoaster ride until it stabilizes again. Usually about three months or so of absolute torture. I am not violent, or particularly sad, but I am so empathic that I can literally feel what others around me are feeling. I can not tell you how intrusive it is to have to feel not only one other persons emotions but those of everyone who is around you. I often isolate myself to be free of this constantly intrusive emotional onslaught from all around me. I used to be able to be passionate, but now I have to hold back and avoid extreme states of emotion and passion, lest I become a lightening rod or worse a blow torch. I thank you for your insight. I read another comment earlier on this blog. the individual said that he gets relief from going to a swimming pool. I could see how this could be helpful. I will try this method, because the moment I read it I immediately was drawn to the idea. Thanks for your input, medicine has yet to work completely for me, but I do feel exercise and relaxation techniques are helpful in the short term. I just wonder if I will have to be this way until I die. I had no issues at all until I was around 35 or so, then my whole world came apart. I liken it to my personality fracturing. To say the least, nothing I have ever experienced has scared me more than living like this. Bless you all, and I hope you all find peace. Thank you.