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Delirium

Delirium is a sudden, usually time-limited disturbance of a person's general mental functions, where it becomes difficult for the person to concentrate and focus their attention, to think clearly, to be aware of their surroundings, and to perceive things normally. People in a state of delirium will be confused, disoriented, and will have a fluctuating level of consciousness. They can become agitated and aggressive, can experience delusions and hallucinations, but can also appear very quiet and subdued.

Delirium usually has a fluctuating course, where the above symptoms can at different points appear better or worse. Some patients with this condition will experience more of the symptoms come evening or nighttime after being awake for many hours, which is a phenomenon known as "sundowning."

Delirium is most easily identified by the fact that people with this condition will be confused about the current time, date, and their present location. They may think that they are in their homes when they are in fact in hospital, and may believe that the current date is decades earlier than it really is.

Delirium is not considered a psychiatric disorder, in the sense that it is not caused or triggered by emotional stress. Rather, delirium is a symptom that is caused by any number of medical problems, drugs, or medications that acutely disrupt the brain's normal state of functioning.

It is thus important that delirium not be mistaken for various other psychiatric conditions. For example, dementia is different than delirium because it has a very long-term, progressive course rather than a sudden, fluctuating course, and in the early and middle stages people with dementia tend to be aware of their surroundings. People suffering from Psychotic Disorders or Depression will also be aware of their surroundings and oriented to their time and place.

The proper treatment for delirium is thus to identify and correct the underlying medical problem. However, in hospital settings where patients can be well monitored, and where their delirium can cause them to act in an agitated or aggressive manner, low doses of antipsychotics or benzodiazepines are often used to manage these symptoms.