Psychomotor Retardation: Symptoms, Causes, Treatment

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.

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

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

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).  

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.

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.