MENTAL HEALTH | Is speaking too much a sign of mental illness?

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THE WASHINGTON POST – Many of us overtalk, for instance, when we’re socially anxious or deeply interested in a topic. At other times, we’re baffled by people who repeatedly monopolise conversations. Rarely, though, do we realise that overtalking could be rooted in mental conditions.

Talking too much got Shawn Horn into lots of trouble.

As a child, she once accompanied her grandmother to a hair salon and told everyone the details of her parents’ divorce. When people would praise her mother’s beauty, Horn would pipe up with “my mom is 34 years old” or “she’s wearing false eyelashes.”

“I had no filter, and I would just talk to everyone, everywhere,” Horn said.

Teachers scolded her for interrupting and blurting out answers. When she tried to chat up kids at her school, they often rejected her, she said.

People who talk excessively are labelled “compulsive talkers” and “oversharers.” Garrulousness could be a personality trait, but sometimes, talking a lot can stem from health conditions such as attention-deficit/hyperactivity disorder (ADHD), autism, generalised anxiety disorder and bipolar disorder.

For Horn, now 54, an adult diagnosis of ADHD provided the first insight into the excessive talking, as well as childhood fidgeting and trouble with focusing on tasks, she said.

 

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Speaking impulsively could be related to ADHD

ADHD, a neurodevelopmental condition, includes symptoms such as inattentiveness, hyperactivity and impulsiveness.

Not everyone with ADHD talks a lot, but among those who do, “the impulsiveness is at the bottom of this,” said L Eugene Arnold, a psychiatrist and resident expert at Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD), an ADHD education and advocacy group.

“They tend to act impulsively, speak impulsively and think impulsively.”

In her teen years, Horn would often exult that a conversation went well, only to discover later that others had felt annoyed.

“In this energy, we’re so excited to talk, we want to talk, we want to share what we know, but the listener doesn’t understand,” she said.

“They will say those negative terms, like ‘You’re being inconsiderate, disrespectful, self-centred, and narcissistic. You’re rambling too much,’ which is not reflective of our intention and makes it so disheartening.”

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Autism is often marked by communication issues

People with autism are misunderstood, too, said Andy Shih, chief science officer at Autism Speaks, an advocacy organisation that sponsors autism research. It’s not always obvious that someone has autism, which is often marked by difficulties with social communication and restricted topics of interest.

Some autistic people are nonverbal, but others can be highly talkative.

“The typical social interactions between neurotypical individuals are more difficult for autistic people,” Shih said.

In a typical conversation, “you can pick up the cues about taking turns, when the question is ending, when the set of statements is ending, so that you can engage in an interaction,” he said.

“Sometimes with autistic people, it’s more difficult to pick up those social cues.”

Autistic people can find it difficult to transition from one conversation, topic or area to another, Shih said.

“It’s more comfortable just to continue on something that they know about and just keep talking,” he said. “It’s not a sign of rudeness or being narcissistic. It’s just the way their brains are wired.”

Some autistic people are fascinated with Lego collections, Star Wars movies and trivia, and train schedules, for instance, Shih said.

An autistic friend in Japan knows all the sports statistics of sumo wrestlers, Shih said.

“You often see people rolling their eyes,” Shih said.

“Sometimes when you talk to an autistic person, they talk about things that they’re really interested in. That interest doesn’t always translate to other people.”

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Generalised anxiety disorder and worry

Generalised anxiety disorder shows up as persistent, excessive worry that interferes with daily life.

People who suffer from it “worry about everything: what did they do wrong, what should happen next, what’s the decision that needs to be made,” said Christian Kohler, a professor of psychiatry at the University of Pennsylvania Perelman School of Medicine.

“Those are people who can be very wordy and always need feedback.”

Mania is connected to rapid, wordy speech

Bipolar disorder causes extreme mood swings, from emotional lows such as depression to emotional highs called mania or hypomania, which is less severe.

At the beginning of a manic or hypomanic episode, speech remains coherent, so red flags might not go up, Kohler said. But “the classic change in speech is that a person becomes wordier and that the speech becomes pressured, so the rate increases,” Kohler said.

Talkative people without bipolar disorder will stop when others speak up, but pressured speech is difficult for others to interrupt, Kohler said.

“It’s driven by them having thoughts that come at a greater speed,” he said, “and so in a colloquial sense, they want to get the words out, but there are too many thoughts.”

They feel energetic and euphoric and perhaps might describe new business ideas, even if the goals are unattainable, Kohler said.

With a form called bipolar disorder type 2, people can stay hypomanic.

With bipolar disorder type 1, people progress toward full mania. “You get this flight of ideas where the person jumps from one topic to another that may be somewhat related thematically, but altogether, it makes less sense,” he said.

“Then in the extreme form, it doesn’t make any sense,” Kohler said.

When is overtalking a concern?

Unusual talkativeness doesn’t necessarily indicate a problem, Kohler said. Other symptoms specific to each health condition must be present for a diagnosis by a mental health practitioner.

For instance, with bipolar disorder, doctors will check for other symptoms, including exaggerated self-confidence, increased activity, racing thoughts, decreased need for sleep, and poor decision-making.

“You look for other behavioural signs and you look for, ‘Does it affect social, occupational, academic functioning?’” Kohler said.

Bipolar disorder is often diagnosed in the teen years or early adulthood, according to the National Institute of Mental Health.

“We are all kind of limited observers of our own behaviour,” Kohler said. “This is where, especially for younger people, family members and caregivers are very important for picking up on those symptoms.”

Autism is a lifelong condition, and Shih suggested allowing an autistic person to decide “whether ‘overtalking’ is actually an issue for her or him,” he said.

“For us, the neurotypicals, maybe just think, ‘Is that really that big of a deal? It’s okay, right? We’re all a little different.’”

How to manage overtalking

Horn considers herself naturally empathic and chose a profession that involves deep listening. She’s now a licensed psychologist in Spokane, Wash.

These are some strategies that have helped her manage her inclination to overtalk.

– Use a notepad to jot down thoughts. In appropriate situations, making notes can minimise interrupting and misdirecting a conversation, and remind one to address an issue later.

– Speak in succinct sentences. Rather than delivering a drawn-out account, “use techniques like bottom-lining, where you talk with bullet points,” she said.

– Look for cues to proceed. If a listener asks a close-ended question, share barely more than a yes or no answer and wait to see if the person requests to hear more. “But if you want to tell them the story without being asked, ask them if they’re willing to hear the story,” she said.

Whether someone has ADHD or autism, “sometimes, what is perceived as different behaviours or perhaps even strange behaviours, it’s not always a sign of a poor personality or difficult personality,’ Shih said.

“Especially in this day and age, I think it will benefit all of us to be patient and more open-minded and take our time to listen to each other.” – Katherine Kam