Depression and slurred speech
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Depression and slurred speech

Q: Often when I am in a depressed state, I wake during sleep with nightmares and an intense pressure which feels like it is coming from inside my head; at the centre of the frontal lobe. This sensation is concurrent with: extreme depression, speech slurring and retarded reflexes (like being unable co-ordinate hand and mouth movements for eating). The feeling will last until the next uninterupted sleep period. This happens either day or night. What is this? What is going on?

Dear Mr. or Ms. M' --
The way this changes with sleep is very consistent with bipolar disorder, and also the way it recurs.  However, that's about the end of the consistency.  To wake in sleep with nightmares doesn't direct us much, diagnostically.  But the sensation in your frontal area, the slurred speech, the uncoordination -- and their sudden onset together -- all suggest there might be something else going on.

That "something else" could be completely "benign", as the jargon goes in medicine.  Or it could be quite serious, like a blood vessel problem or a seizure-like condition.  You need a primary care physician to hear this story and give you a looking over, if not a neurologist.  I'd have that done pronto, not in a few months.  I hope it will be for nothing, that would be good news, and that is quite possible.  I wouldn't be surprised to hear that this is just another variation in how bipolar disorder can show up, but it would be very unusual and a serious version (I gather from your nickname, M', that there's some pretty serious depression in all this too).

Write back and tell me how this turns out, if you don't mind.

Dr. Phelps

Published November, 2000

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