Understanding Delirium: When Your Mind Suddenly Gets Confused

Introduction

Delirium is a sudden state of confusion of the mind which also creates a difficulty in concentrating. Delirium can affect anyone, from the young to the elderly. Decoding its causes, symptoms, and management strategies is crucial for both caregivers and patients alike. Let’s know all about delirium and how to manage the condition.

What Is Delirium?

Delirium isn't just something that happens when you get older or take certain medications. It is a serious health problem that can make you suddenly confused, affect your way of thinking and change your awareness. It can happen fast, so it's crucial to spot its signs quickly.

What Are The Symptoms Of Delirium?

The delirium symptoms influence different aspects of your well-being, impacting your mental clarity, emotional stability, physical movements, and even sleep patterns.

Delirium symptoms may include:

• Difficulty to focus
• Losing track of time and place
• Mood swings
• Confusion
• Forgetting recent events
• Trouble speaking clearly or joining conversations
• Easily getting distracted
• Feeling anxious or paranoid
• Poor sleep or feeling sleepy
• Struggling with everyday tasks like eating or walking

In cases where alcohol withdrawal progresses to delirium, additional delirium symptoms may emerge, including:

• Confusion
• Hallucinations
• Rapid heartbeat
• Excessive sweating
• Agitation
• Elevated blood pressure
• Dangerously high body temperature

What Are The Types Of Delirium?

Delirium types can be categorised into three main types which are based on the features and symptoms observed:

Hyperactive Delirium:

• In hyperactive delirium, people are excessively excited, nervous, and experience a high motor activity.
• They may be seen agitated and constantly on the move or appear restless.
• Hyperactive delirium may also manifest as an aggressive behaviour, either verbally or physically.
• Despite the excitement, people may still feel confused and disoriented.

Hypoactive Delirium:

• Hypoactive delirium is characterized by a state of reduced activity, lethargy and poor responsiveness.
• People with hypoactive delirium appear withdrawn, apathetic, or unusually quiet.
• They lie in bed or sit still for long periods with little interaction with their surroundings.
• Hypoactive delirium can be difficult to recognize because it can be confused with depression or simply attributed to aging.

Hypoactive Delirium:

• Hypoactive delirium is identified by a state of reduced activity, lethargy and poor responsiveness.
• People with hypoactive delirium appear isolated, pathetic, or unusually quiet.
• They lie in bed or sit still for long periods with a minimum interaction with their surroundings.
• Hypoactive delirium can be difficult to recognize because it can be confused between depression or simply attributed to aging.

Mixed Delirium:

• Mixed delirium results from a combination of hyperactivity and hypoactivity, with symptoms fluctuating between agitation and drowsiness.
• A person may transition themselves from a state of restlessness to reduced activity.
• Treatment of mixed delirium is particularly challenging due to the diversity in symptoms and a need for tailored interventions.

It is important to note that people with delirium can transition from one type to another during their illness. In addition, some people may not fit neatly into a particular type, but may have a combination of characteristics from different types.

What Causes Delirium?

Delirium causes can be multiple as it is a complex condition that does not happen for a single condition. Delirium causes include:

1. Medical conditions: Infections such as urinary tract infections and pneumonia can cause delirium. Other medical problems such as electrolyte imbalances, metabolic disorders, neurological problems, and respiratory problems can also cause delirium.
2. Medications: Certain medications you take, like painkillers, sleep aids, psychiatric drugs, and those with sedative or psychoactive effects, can cause delirium.
3. Substance Use or Withdrawal: Alcohol, drugs and certain medications can cause delirium, especially during intoxication or withdrawal. If you are experiencing an alcoholic withdrawal, it can escalate into a serious form of delirium known as Delirium Tremens
4. Surgery or medical procedure: Delirium can occur as a complication of surgery or medical procedures and is often due to factors such as anaesthesia, postoperative pain, or changes in medication.
5. Environmental Factors: Being in a hospital or unfamiliar environment, sensory deprivation and disturbed sleep patterns can lead to delirium, especially if you are vulnerable.
6. Psychological Stress: Emotional stress, anxiety, and trauma can also cause delirium, especially if you have a pre-existing psychiatric condition.
7. Underlying Cognitive Impairment: If you already have problems with your memory or thinking, such as dementia or Alzheimer's disease, you are more likely to develop delirium, and it can be worse when it happens.
8. Dehydration and Malnutrition: Lack of adequate hydration and nutrition can affect your brain functions and increase the risk of delirium, especially if you are an older or have a chronic illness.

Understanding these possible causes of delirium is important to identify and address any underlying problems that can help effectively control and treat the condition.

Who’s At Risk For Delirium?

Adults with multiple health conditions are more likely to develop delirium, but it can also occur in younger people.

Factors that increase the risk of delirium include:

• Advanced age
• Cognitive impairment
• Chronic medical conditions
• Undergoing major surgeries
• Dehydration
• Sleep deprivation
• Sensory impairment

How Is Delirium Diagnosed?

To diagnose delirium, a health care professional will evaluate your medical history, they will perform a physical exam, and test your thinking skills. They will also observe your behaviour and mental state.

What Tests Will Be Done To Diagnose This Condition?

Although there is no specific test to diagnose delirium, a health care provider can perform a variety of tests to determine the underlying cause.

These may include:

1. Physical Exam:  Healthcare providers evaluate your overall health and look for physical signs of underlying conditions that could cause delirium. For example, they can check for signs of infection, such as fever or abnormal heart sounds that indicate heart problems.  
2. Review of medical history:  They will review your medical history to identify any previous conditions or medications that may be contributing to delirium.  
3. Observation of behaviour and symptoms:  They observe your behaviour and the symptoms you show to understand the extent of confusion and disorientation.  
4. Blood tests:  Blood tests can help detect infections, metabolic disorders, or abnormalities that may be causing delirium.  
5. Imaging studies:  A CT scan or MRI scan provides detailed images of the brain to detect structural abnormalities or signs of stroke that may contribute to delirium.  
6. Electrolyte level assessments:  An electrolyte assessment involves measuring the levels of essential minerals in the blood, such as sodium, potassium, and calcium. Electrolyte imbalances can affect brain function and can contribute delirium.  

How Is Delirium Treated?

Delirium treatment aims to address underlying causes, manage the managing delirium symptoms, and provide supportive care. This mode of delirium treatment may involve discontinuing medications that cause delirium, treating infections, correcting metabolic imbalances, and ensuring that you stay in a calm and familiar environment.

What’s The Outlook For Delirium?

The outcome of delirium life expectancy depends on what causes it, how quickly it is diagnosed, and how well you have adapted to the mode of delirium therapy. If you get help quickly and receive the right treatment, you are likely to make a full recovery from delirium. But if left untreated, you can develop complications, so it's important to detect and treat it early.

Conclusion

Understanding the delirium symptoms, causes and treatment of delirium is critical for health care. By understanding this and using proven methods to manage it will allow us to provide better care for people who have this condition. At Metropolis  we  offer the convenience of in-house visits to collect blood tests, ensuring ease of access to our diagnostic services. For accurate results check out our diagnostic tests and read our blogs to learn more about staying healthy.