Before we begin: Delirium is a mental state in which you are confused, disoriented, and not able to think or remember clearly. It is often temporary and treatable.
This tutorial walks you through everything you need to know about delirium. We explain it in plain language, step by step, so whether you are a student, a patient, or simply curious, you will come away with a solid understanding.
We cover what it is, why it matters, how it is diagnosed, and what you can do about it. Key facts are called out along the way.
What is delirium? Delirium is a mental state in which you are confused, disoriented, and not able to think or remember clearly. It usually starts suddenly. It is often temporary and treatable.
There are three types of delirium:
Hypoactive, when you are not active and seem sleepy, tired, or depressed
Hyperactive, when you are restless or agitated
Mixed, when you change back and forth between being hypoactive and hyperactive
What causes delirium? There are many different problems that can cause delirium. Some of the more common causes include:
Advanced cancer.
Alcohol or drugs, either from intoxication or withdrawal. This includes a serious type of alcohol withdrawal syndrome called delirium tremens. It usually happens to people who stop drinking after years of alcohol use disorder (AUD).
Dehydration and electrolyte imbalances.
Dementia.
Hospitalization, especially in intensive care.
Infections, such as urinary tract infections, pneumonia, and the flu.
Medicines. This could be a side effect of a medicine, such as sedatives or opioids. Or it could be from withdrawal after stopping a medicine.
Metabolic disorders.
Organ failure, such as kidney or liver failure.
Poisoning.
Serious illnesses.
Severe pain.
Sleep deprivation.
Surgeries, including reactions to anesthesia.
Who is more likely to get delirium? Certain factors put you at risk for delirium, including:
Being in a hospital or nursing home
Having dementia
Having a serious illness or more than one illness
Having an infection
Older age
Having surgery
Taking medicines that affect the mind or behavior
Taking high doses of pain medicines, such as opioids
What are the symptoms of delirium? The symptoms of delirium usually start suddenly, over a few hours or a few days. They often come and go. The most common symptoms include:
Changes in alertness (usually more alert in the morning, less at night)
Changing levels of consciousness
Confusion
Disorganized thinking, talking in a way that doesn’t make sense
Disrupted sleep patterns, sleepiness
Emotional changes: anger, agitation, depression, irritability, overexcitement
Hallucinations and delusions
Memory problems, especially with short-term memory
Trouble concentrating
How is delirium diagnosed? Your health care provider may use many tools to make a diagnosis:
A medical history, which includes asking about your symptoms
Physical and neurological exams
Mental status testing, which checks for problems with your thinking and alertness
Lab and diagnostic imaging tests
Delirium and dementia have similar symptoms, so it can be hard to tell them apart. You can also have both at the same time. The differences between them are that:
Delirium starts suddenly and can cause hallucinations. It is mainly a problem with attention and staying alert. The symptoms may get better or worse and can last for hours or weeks.
Dementia develops slowly and does not cause hallucinations. It usually starts with memory loss. The symptoms don’t change often, like they can with delirium. Dementia almost never gets better.
What are the treatments for delirium? Treatment of delirium focuses on the causes and symptoms of delirium. The first step is to identify the cause. Often, treating the cause will lead to a full recovery. The recovery may take some time - weeks or sometimes even months. In the meantime, there may be treatments to manage the symptoms, such as:
Controlling the environment, which includes making sure that the room is quiet and well-lit, having clocks or calendars in view, and having family members around
Medicines, including those that control aggression or agitation and pain relievers if there is pain
If needed, making sure that the person has a hearing aid, glasses, or other devices for communication
Can delirium be prevented? Treating the conditions that can cause delirium may reduce the risk of getting it. Hospitals can help lower the risk of delirium by avoiding sedatives and making sure that hospital rooms are kept quiet, calm, and well-lit. It can also help to have family members around and to have the same staff members treat the person each day (if possible).
Categories: Mental Health and Behavior, Brain and Nerves.
Key Takeaways
Understanding delirium is an important part of taking charge of your health. Here is what to remember:
- Know the signs — Recognizing early symptoms can lead to earlier diagnosis and better outcomes.
- Talk to your provider — If you have concerns or a family history of this condition, bring it up at your next checkup.
- Stay informed — Medical knowledge evolves. Keep learning and asking questions.
- You are not alone — Many people deal with this condition. Support groups and educational resources can help.