Delirium is a state of confused thinking and losing mental balance. It is a type of mental disorder that interferes with the normal functions of your brain. The individual may forget daily routine and lose contact with the environment. He/she may in a state of confusion seeing and hearing unnatural things that does not exist.
Delirium can occur due to many causes like head injury, brain infection, drug toxicity and sudden metabolic changes. Intake of certain medications, certain type of chronic diseases and overuse of alcohol or drug can cause delirium. Delirium symptoms can be managed by combined approach of medications and supportive care.
Symptoms :
The signs of delirium may not last long and in most of the cases it occurs only for short period. For some people, it may last for few hours only and for some others it can continue for few days. There will be fluctuation of symptoms throughout the day. The affected person may have reduced awareness which can cause poor concentration, confused thinking and easy distraction over things. He may appear withdrawn paying no attention to the happenings and gives little or no response to the environment.
Delirium can cause symptoms like poor memory, disorientation (inability to identify the place or time of the day) and difficulty in understanding conversation. He may talk nonsense and may not respond to the questions in normal way. Delirium can also cause restlessness, irritability and aggression. The person may see and hear non-existent things. He may not sleep properly and may express strong emotions.
Causes :
Under normal conditions, brain sends and receives signals promptly. But delirium occurs when there is abnormality in the brain which would impair the route of signals. Brain’s activity may get disturbed by various factors. Severe infectious diseases, dehydration and intense skin problem can trigger the brain signals and block them. Prolonged stay in the hospital can make vulnerable to develop delirium.
Old age, Dementia, any type of acute infection, visual disturbance and poor nutrition can trigger impulses in the brain leading to delirium. Chronic illnesses like lupus or arthritis and severe immune disorders and intake of several drugs for long term and alcohol abuse can cause delirium. Drugs given for inducing sleep, pain-killers, drugs given for stabilizing mood and medicines given for treating Parkinson’s disease can induce delirium. Delirium can occur in people who suffer from anxiety and Depression.
Complications :
Delirium is not a disease and often the symptoms would vanish within few hours. But for some people it may last for several weeks. Once the root cause of delirium is found and treated, the patient can recover quickly. If delirium develops in terminally ill patients or people with mental disorders it may permanently damage their thinking skills and impair the normal functions of the brain.
Tests :
The doctor would listen to the patient’s family and close friends and collect complete medical records of the affected person. He would give suitable questionnaire to assess his mental status. He would check his mental awareness and his thinking ability by asking a series of questions. He would also identify about his perception ability.
He may order for neurological tests to find out the root cause of delirium. Neurologist would evaluate his ability of vision and motor balance and reflexes. He may also order for imaging tests like CT or MRI scan of the brain to get accurate picture.
Treatment :
Before starting any treatment the doctor would identify the factors that trigger the delirium. He would analyze the list of medications taken by the patient, to find if that can be the factor for inducing imbalance in brain. If necessary he might reduce the strength of doses or give suitable alternate medications. There are certain drugs that can interfere with normal thinking ability of the person. Sometimes it may endanger the person’s mental status or create danger for society.
Coping Techniques :
Coping and supportive care are vital in treating the person affected with delirium. Family people can attend to the immediate need of the affected person by providing wall clocks and calendar in every room. The atmosphere of the home should be calm and cool. Nowadays many electronic devices are available to remember important events of the day.
The person should be in close contact with his family and friends. Needless to say, he should have quality sleep which can help considerably in keeping his brain calm. Going for brisk walk or doing aerobic exercises will promote quality sleep. Taking healthy diet and supplementing with fluids is effective in preventing dehydration. Attending yoga classes and practicing relaxation techniques can reduce agitation and stress.
Prevention :
You cannot totally prevent getting delirium. You can reduce the risk factors that can be inducing an episode.
