Is it confusion or delirium?


What happens when there’s a disturbance in your mental abilities? Your mind often feels foggy. You find yourself losing track of time, struggling to concentrate and can’t seem to keep track of your whereabouts.

Are you simply confused or delirious? Similar to dementia (a loss of memory and mental abilities), delirium is a severe and abrupt state of confusion. The beginning stages of delirium are usually rapid, reaching a peak within hours or a few days. 

Symptoms include a reduced awareness of the environment, altered consciousness (hallucinations) and an inability to focus. Delirium can develop at any age, but it’s more common as we age and are more at risk of mental health problems. 

Delirium is often linked to a severe or chronic condition like a stroke or Parkinson’s disease (a disorder of the central nervous system that affects movement). It can also be triggered by a change in metabolic balance (low sodium), an infection, surgery, medication, and alcohol or drug withdrawal.

What causes it?
Severe mental confusion caused by any condition can significantly change your brain function. For example, pneumonia and other diseases that cause inflammation and infection can interfere with your brain function. Drug abuse and taking certain medications like blood pressure medicine can disrupt chemicals in the brain, causing mental dysfunction. 

Risk factors include:

  • Previous delirium episodes.
  • Brain disorders like dementia or a stroke. Hearing or visual impairment.
  • Multiple medical problems.

There are three types of delirium and at times they may take place together:

Delirium tremens: Suffered by people who have been drinking large amounts of alcohol for years (alcohol withdrawal.
Hyperactive delirium: You may be overactive and feel agitated and restless.
Hypoactive delirium: You may be underactive and feel sleepy and respond.

Delirium leads to: cognitive impairment (poor thinking skills):

  • Poor memory, especially of recent events.
  • Disorientation, not knowing where or who you are.
  • Difficulty speaking or recalling words.
  • Rambling speech.
  • Trouble understanding speech.
  • Difficulty reading or writing.

Behavioural changes

  • Hallucinations, seeing things that don’t exist.
  • Agitation or restlessness.
  • Crying out or moaning. 
  • Being quiet and withdrawn. 
  • Lethargy or slow movement.
  • Disturbed sleeping patterns.

Emotional disturbances

  • Personality changes.
  • Unpredictable mood shifts.
  • Depression.
  • Irritability or anger.
  • Anxiety, fear or paranoia.
  • A sense of feeling overjoyed (euphoria)
  • Lack of interest.

Finding help
According to the Harvard Medical School the first steps to treating delirium is to identify underlying causes, like medical history, drug use (includes over-the-counter medication) and alcohol abuse. Your doctor would be the best person to make an accurate diagnosis, along with input from a caregiver or family member who can speak to previous episodes and signs of the condition.

Medicines for treating delirium symptoms include anti-psychotic drugs and other medication (to treat agitation and hallucinations and to improve sensory problems). Therapy to help treat delirium includes support therapy which was designed to help improve and sustain your mental wellbeing. 

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