Bipolar Disorder Symptoms Depression Psychomotor Retardation: Symptoms, Causes, Treatment By Marcia Purse Marcia Purse Marcia Purse is a mental health writer and bipolar disorder advocate who brings strong research skills and personal experiences to her writing. Learn about our editorial process Updated on April 13, 2023 Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Steven Gans, MD Medically reviewed by Steven Gans, MD Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital. Learn about our Medical Review Board Print Caiaimage / Rafal Rodzoch / Getty Images Table of Contents View All Table of Contents Symptoms Diagnosis Causes Treatment Coping FAQs Psychomotor retardation is a condition characterized by sluggish or diminished body movements, usually accompanied by a slowing of thought processes. It is also sometimes referred to as psychomotor slowing or psychomotor impairment. Experiencing psychomotor impairment feels as if a dial has been turned back, putting you on slow speed. The physical manifestations of psychomotor impairment vary in scope and severity, but are usually obvious to both loved ones and healthcare professionals. Psychomotor retardation occurs commonly during depressive episodes of bipolar disorder, as well as during major depressive disorder. In these circumstances, the effects are usually temporary and recede as the depression lifts. That said, the development of psychomotor retardation does not always signal a depressive episode. Other situations and conditions, such as drug side effects and certain medical conditions, can also trigger slowed physical and mental activity. Symptoms of Psychomotor Retardation People with psychomotor retardation move, speak, react, and often think more slowly than normal. This can manifest in a variety of ways, largely depending on the severity of the impairment. Delayed responsiveness and difficulty following another person's conversation are common. Complex mental processes—such as calculating a tip or mapping out directions—take longer to accomplish. Common examples of physical impairment include: Sluggishness when walking or changing positions, such as when getting up from a chair Impaired ability to perform tasks requiring eye-hand coordination, such as catching a ball, shaving, and applying makeup Reacting to situations slowly, such as when reaching for a falling object Diminished facility with fine motor tasks, such as writing, using scissors, and tying shoelaces Slumping when standing and having poor posture Speaking in a soft, monotonous voice Speaking noticeably more quietly, or speech that is punctuated by long pauses or lost trains of thought Staring into space and reduced eye contact A person with severe psychomotor retardation may appear catatonic. In this state, the person does not respond normally to others or the environment. Catatonia is a medical emergency as it can become life-threatening. Diagnosis Psychomotor retardation isn't a diagnosis in and of itself. Instead, it is a symptom of major depressive disorder. That said, the extent of psychomotor retardation may help healthcare providers better understand how many depressive episodes have been experienced. To identify psychomotor retardation severity, a healthcare provider will likely look at the person's: Bodily movements Eye movements Facial expressions Posture Self-touching actions Speech patterns If you have psychomotor impairment without depression or bipolar disorder, a healthcare provider will investigate other causes for the condition, such as a reaction to a medication. Causes of Psychomotor Retardation The slowed mental and physical activity associated with psychomotor impairment occurs most frequently in people experiencing a depressive episode due to either major depression or bipolar disorder, potentially by disturbing the brain's white matter. The degree of physical and mental blunting often correlates to the severity of the depressive episode. Other psychiatric disorders sometimes associated with psychomotor retardation include: Schizophrenia spectrum disorders Other depressive disorders Obsessive-compulsive disorder Post-traumatic stress disorder Psychomotor impairment is also sometimes present with substance abuse. Nervous system diseases and other conditions might cause blunted or slow physical and mental activity as well, including: Certain genetic conditions, such as Huntington's disease Dementia Hypothyroidism Medication side effects, especially with psychiatric medicines Parkinson's disease and related conditions A person's age and sex can also influence the prevalence and extent of psychomotor slowness. Treatment Several steps can be taken to help treat psychomotor slowing. Medication Reviewing current medications is one of the first steps in addressing psychomotor retardation. This is important to determine whether medication side effects might be triggering the physical and mental slowness. Certain anti-anxiety drugs and antipsychotic medications commonly prescribed for bipolar disorder are possible culprits. If current medication side effects are not the cause, and other potential causes have been ruled out, prescribing a new medication is typically the first line of defense in treating psychomotor impairment associated with a depressive episode. Common medication options for people with bipolar disorder who are experiencing a depressive episode include Abilify (aripiprazole), Depakote (valproic acid), Lamictal (lamotrigine), Latuda (lurasidone), lithium, Seroquel (quetiapine), and Zyprexa (olanzapine). The choice of medication or combination of medicines is made on an individual basis. Current and past medications, and an individual's response to them, are important considerations in drug treatment decisions. Other Treatment Options Once the right combination of medications is found, psychotherapy and other non-medical therapies may be used in addition to medication to support long-term mood stabilization. With severe depression, especially if accompanied by catatonia, loss of touch with reality, or a high risk of suicide, electroconvulsive therapy (ECT) may be an option. While it is one of the fastest and most effective ways to treat bipolar depression, ECT is generally undertaken only if other treatment options fail. If you are having suicidal thoughts, contact the National Suicide Prevention Lifeline at 988 for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911. For more mental health resources, see our National Helpline Database. Coping With Psychomotor Retardation In addition to medication and other treatment options, there are a few things you can do to better cope with psychomotor slowness. Identify potential triggers: Is there a certain time of day or a particular situation in which psychomotor impairment is worse? Knowing this can help you plan your day in a way that reduces the effects.Keep working on your skills: If certain actions or skills are slowed, continuing to practice them may help reduce the slowness. At a minimum, you can look for ways to work around the impairment (such as wearing slip-on shoes instead of shoes with laces, if shoe-tying is difficult).Offer yourself some grace: With proper treatment, psychomotor retardation can improve over time. Until then, be kind to yourself. While you may not resolve this issue overnight, what matters most is that you are working toward feeling better. Progress is progress, so try not to let your psychomotor impairment bring you down. Frequently Asked Questions Can psychomotor impairment be reversed? If psychomotor impairment is a side effect of a certain medication, discontinuing that medication or switching to a new medication can resolve these effects. Your healthcare provider can help you do both of these safely as you should never stop taking a medication without talking to your healthcare provider first. If psychomotor impairment is due to a depressive episode, treating the depression can help reduce the impairment. How long does psychomotor retardation last? Everyone is different. For some, psychomotor slowness is short-term, easing or resolving as depression is treated. In cases of recurrent major depressive disorder and bipolar disorder, the psychomotor impairment may last longer—even continuing after the mood-related symptoms have been resolved. Does having psychomotor slowing mean that I am depressed? Not necessarily. Psychomotor slowing can be caused by factors other than those associated with depression. Certain medications can lead to psychomotor impairment, for instance. Psychomotor retardation is also sometimes associated with other health conditions. Your healthcare provider can help determine the cause of your slower movement and thought patterns. 9 Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Bennabi D, Vandel P, Papaxanthis C, Pozzo T, Haffen E. Psychomotor detardation in depression: A systematic review of diagnostic, pathophysiologic, and therapeutic implications. Biomed Res Int. 2013;2013:158746. doi:10.1155/2013/158746 Gunja N. In the zzz zone: The effects of z-drugs on human performance and driving. J Med Toxicol. 2013;9:163-71. doi:10.1007/s13181-013-0294-y Schwartz D. Neurocognitive functioning in children and adolescents at the time of type 1 diabetes diagnosis: Associations with glycemic control 1 year after diagnosis. Diabetes Care. 2014;37(9):2475-82. doi:10.2337/dc14-0103 Primo de Carvalho Alves L, Sica da Rocha N. Lower levels of brain-derived neurotrophic factor are associated with melancholic psychomotor retardation among depressed inpatients. Bipolar Disord. 2018;20(8):746-752. doi:10.1111/bdi.12636 Gorwood P, Richard-Devantoy S, Baylé F, Cléry-Melun ML. Psychomotor retardation is a scar of past depressive episodes, revealed by simple cognitive tests. Eur Neuropsychopharmacol. 2014;24(10):1630-1640. doi:10.1016/j.euroneuro.2014.07.013 Buyukdura JS, McClintock SM, Croarkin PE. Psychomotor retardation in depression: Biological underpinnings, measurement, and treatment. Prog Neuropsychopharmacol Biol Psychiatry. 2011;35(2):395-409. doi:10.1016/j.pnpbp.2010.10.019 Hyett M, Perry A, Breakspear M, Wen W, Parker G. White matter alterations in the internal capsule and psychomotor impairment in melancholic depression. PLoS One. 2018;13(4):e0195672. doi:10.1371/journal.pone.0195672 Pereira J, Bruera E. Depression with psychomotor retardation: Diagnostic challenges and the use of psychostimulants. J Palliat Med. 2001;4(1):15-21. doi:10.1089/109662101300051906 Averill I, Beaglehole B, Douglas K, et al. Activation therapy for the treatment of inpatients with depression - protocol for a randomised control trial compared to treatment as usual. BMC Psychiat. 2019;19:52. doi:10.1186/s12888-019-2038-2 Additional Reading Frankland A, Cerrillo E, Hadzi-Pavlovic D, et al. Comparing the phenomenology of depressive episodes in bipolar I and II disorder and major depressive disorder within bipolar disorder pedigrees. J Clin Psychiatry. 2015;76(1):32-38. doi:10.4088/JCP.14m09293 Mitchell PB, Frankland A, Hadzi-Pavlovic D, et al. Comparison of depressive episodes in bipolar disorder and in major depressive disorder within bipolar disorder pedigrees. Br J Psychiatry. 2011;199(4):303–309. doi:10.1192/bjp.bp.110.088823 By Marcia Purse Marcia Purse is a mental health writer and bipolar disorder advocate who brings strong research skills and personal experiences to her writing. See Our Editorial Process Meet Our Review Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit Speak to a Therapist Online Advertiser Disclosure × The offers that appear in this table are from partnerships from which Verywell Mind receives compensation.