What to Know About Psychomotor Retardation

Medically Reviewed by Melinda Ratini, MS, DO on March 06, 2024
4 min read

Psychomotor retardation is one of the main features of major depressive disorder (MDD) or, more simply, depression. Psychomotor retardation is the slowing down or hampering of your mental or physical activities. You typically see this in the form of slow thinking or slow body movements. 

There is a lot of existing research on psychomotor retardation. However, more studies are necessary to improve the current methods of diagnosis as well as the treatments for depression. Here's what you need to know.

The word "psychomotor" refers to physical actions that are the result of mental activity. When a person has psychomotor retardation, their mental and physical functions slow down. Your thought processes and body movements can be affected. So can your eye movements and facial expressions. 

Psychomotor retardation was discovered more than a century ago. Some potential causes have been identified since then. Clinicians also have several methods they use to diagnose the condition. But more research is still needed to understand how it works.  

Psychomotor retardation can be a symptom of depression. While research on the causes of psychomotor retardation is ongoing, factors that can cause the condition include:

  • Biological causes. Changes in how the basal ganglia of the brain work can cause psychomotor retardation. Neuroimaging studies show links between psychomotor retardation and decreased blood flow in certain parts of the brain, such as the dorsolateral prefrontal cortex, left prefrontal cortex, angular gyrus, and the anterior cingulate.

Neurochemical research suggests links between psychomotor changes and faulty dopaminergic neurotransmission in patients with melancholic types of depression or MDD. Neurotransmission is the process of certain cells in your brain passing messages to each other. In melancholic depression, the symptoms can often be more severe than those seen in other types of depression.

Other research has shown a link between psychomotor retardation and overactivity of the hypothalamic–pituitary–adrenal (HPA) axis, or the communication routes between your hypothalamus, pituitary gland, and adrenal glands. The HPA axis produces cortisol, which is the hormone your body releases to deal with stress.

  • Other medical conditions. Psychomotor retardation symptoms can be more pronounced if you have other medical conditions such as diabetes or premenstrual exacerbation (PME). Bipolar depression may also make you more likely to develop psychomotor retardation symptoms.
  • Aging. Sometimes, psychomotor retardation can be caused by aging. Some slowing down of mental and psychical activities is normal with aging. But with psychomotor retardation, this slowing down may appear to be more severe.

A clinician will diagnose psychomotor retardation by carefully looking at your speech patterns, facial expressions, eye movements, posture, and body movements for signs of psychomotor slowing. Special tools, tests, and rating scales are often used to measure the symptoms.

Psychomotor retardation symptoms in speech can show up as longer gaps between your words and sentences or a decrease in your speaking volume, for example. If you have psychomotor retardation, you may also show less expression on your face.

The clinician will also look at your posture. A person who has psychomotor retardation usually slumps forward.

The clinician will watch for increased self-touching behaviors, especially around your face, which is a symptom linked to psychomotor retardation. They will also look for slow movements of your legs, hands, head, and torso.

Psychomotor retardation symptoms are usually diagnosed by a clinician in the morning. This is because the symptoms may be more obvious during the morning hours.

Medication is often the first option to treat psychomotor retardation. About 50% of patients show improvement with medication. Your doctor may start you on a class of medications called SSRIs (Selective Serotonin Reuptake Inhibitors). They may also consider atypical antidepressants, TCAs (tricyclic antidepressants), or MAOIs (monoamine oxidase inhibitors) at a later stage in the treatment.

ECT, or electroconvulsive therapy, is another treatment option in some cases. In ECT, small electric currents are passed through to the brain under general anesthesia. ECT can be an option if the patient isn’t responding to antidepressants or shows signs of psychosis or being suicidal.

In psychosis, a person loses touch with reality because of the way their brain processes information. ECT is also an option if a person has catatonia, a group of symptoms in which a person may stop moving and speaking.

Another type of treatment called rTMS, or repetitive transcranial magnetic stimulation, has been cleared by the FDA to treat major depressive disorder. With rTMS, magnetic pulses are sent repeatedly to the nerve cells in the brain. There isn’t much research on rTMS yet, but the treatment does help reduce the severity of psychomotor retardation symptoms in some cases.