Pressured speech, racing thoughts, bipolar disorder

Descriptions of bipolar disorder symptoms, each time I read them, feel simultaneously familiar and far-removed.

"Irritability"? You could say that. Fair enough as a vague collective term. But this common depiction feels consciously palatable rather than pure.

"Pressured speech" rings truer. Likewise "flight of ideas". What do these terms mean? Think racing thoughts of paranoia, expressed in a form that feels aggressive, disarming, guilt-inducing and, dare I say it, abusive. Accusations and rhetorical questions coming at you like an assault on your senses, provoking you to either retreat or attempt to retaliate through rationalising, reassuring or responding in kind.

• See also: Disorders explained
• See also: Do you identify as having a disorder or as having survived something?
• See also: Sweet, sweet fantasy? Mariah Carey knows what all of us with Bipolar II know, hypomania can be both as sweet and sticky as honey

It doesn't come from an "abusive place". In contrast, it may come from a place of abuse, psychological or physical. In other words, the behaviour is more likely to be learned rather than designed. It may be catalysed by stress or disappointment in others.

Regardless, it can get loud and it feels deeply hurtful, disorienting and demoralising.

Being on the receiving end of pressured speech is draining, or certainly it has been in my experience. It's difficult to write in general terms for a few reasons. One: it's not a symptom that has received much attention from researchers. Two: it's not something that you bring up in conversations with your friends. 

These two factors accounting for the lack of discussion about the symptom are not unrelated. "Pressured speech" and "flight of ideas" come out of nowhere in mania and - like all arguments or hostile experiences- are not episodes you typically choose to relive or dwell upon.

Forgive and forget?

Because the episodes disappear as swiftly as they surfaced, it's tempting to put the occasions down to aberrations - if you're forgiving - or explain them away as reflecting some malice in the person's character. Not something you want to do with a loved one who is otherwise on your side.

Can we aim higher than this? We are in the age of enlightenment and empathy about mental health. It's generally recognised that it's something that each of us will work to maintain at one time or another. Should we / can we rise above the disturbing impact of pressured speech? Should we offer non-judgement emotional or medical support when flight of ideas rain down?

Bipolar presents itself differently in all individuals. It it essentially a term that groups together some shared manifestations of distress: nothing more, nothing less. What can be hardest to process when compared to some other illnesses, is that some of the "symptoms" of bipolar - not experienced by all, it should be acknowledged, are positive: characterised by compassion, creativity, intelligence and productivity.

Pressured speech in itself however is harmful and leaves wreckage in its wake. I've heard it described as "emotional parkour". I'm interested to hear how you reconcile the aftermath. Tweet to @mhtodaymag using the hashtag #pressuredspeech to feedback.