Mental confusion/indecisiveness

Confusion, of a pathological degree, usually refers to loss of orientation (ability to place oneself correctly in the world by time, location, and personal identity) and often memory (ability to correctly recall previous events or learn new material). Confusion as such is not synonymous with inability to focus attention, although severe inability to focus attention can cause, or greatly contribute to, confusion. Together, confusion and inability to focus attention (both of which affect judgment) are the twin symptoms of a loss or lack of normal brain function (mentation).

The milder degrees of confusion as pathological symptoms, are relative to previous function. Thus (for example) a mathematician confused about manipulation of simple fractions, may be showing pathology which would not be diagnosable in a person without training in this area. Thus, as with the case of delirium, the minor degrees of pathological confusion cannot be diagnosed without knowledge of a person's "baseline", or normal, level of mental functioning.

Confusion may result from a relatively sudden brain dysfunction (see delirium). It may also result from chronic organic brain pathologies such as dementia. In either case, confusion is usually associated with some degree of loss of ability to focus attention, but (as noted) the association is not invariable, especially for lesser degrees of impairment.

Many health problems may cause the syndromes of delirium or dementia. These syndromes may also occur together, and both of them usually include the symptom of confusion. Since mental function is extremely sensitive to health, the appearance of either a new confused state, or a new loss of ability to focus attention (delirium), may indicate that a new physical or mental illness has appeared, or that a chronic physical or mental illness has progressed (become more severe).

Possible causes

Confusion, like inability to focus attention, is a very general and nonspecific symptom of brain or mental dysfunction. In addition to many organic causes of confusion relating to a structural defect or a metabolic problem in the brain (analogous to hardware problems in a computer), there are also some psychiatric causes of confusion, which may also include a component of mental or emotional stress, mental disease, or other "programming" problems (analogous to software problems in a computer). Another use of the term describes the experience of persons without medical or psychological pathology, who suffer from confusion on a regular basis. Evidence can readily be gathered by entering "confused" in a search engine: in Google, the word produced 280 million hits on 1/22/08. Many types of information pathology such as propaganda, lies, and disinformation contribute to the confusion of ordinary people, as described in "Lethal American Confusion." Medical and psychiatric causes of confusion are too many to list by specific pathology. However general categories of possible causes of mental confusion include:

Gross structural brain disorders

• Head trauma (i.e., concussion, traumatic bleeding, penetrating injury, etc.)
• Gross structural damage from brain disease (stroke, spontaneous bleeding, tumor, etc.)

Neurological disorders

• Various neurological disorders

General metabolic causes

• Lack of sleep
• Body temperature problems (hypothermia, heat stroke, hyperpyrexia, etc.)
• Infection (sometimes independently of fever)
• Nutritional deficiency
• Allergic reactions and autoimmune diseases

Circulatory

• Intracranial Hypertension

Lack of essential metabolic fuels, nutrients, etc.

• Hypoxia,
• Hypoglycemia or hyperglycemia
• Electrolyte imbalance (dehydration, water intoxication)

Toxication

• Intoxication by various drugs (alcohol, anaesthetics, marijuana, etc.)
• Poisons (including carbon monoxide and metabolic blockade)
• Medications, including psychotropic medications

Mental illness

• Mania
• Depression
• Schizophrenia

Psychological stressors

• Distraction
• Emotional shock (great fear, grief, anger, etc.)
• Many types of information pathology such as propaganda, lies, and disinformation contribute to the confusion of ordinary people, as described above.

Possible co-existing symptoms

Confusion is a symptom. It may range from mild to severe. The confused state may include also:

• Jumbled or disorganized thought
• Unusual, bizarre, or aggressive behavior
• Difficulty in solving problems or tasks, especially those known to have been previously easy for the person
• Inability to recognize family members or familiar objects, or to give approximate location of family members not present.
• Illusions
• Hallucinations
• Paranoia
• Disorientation
• Inability to focus attention (see delirium)
• Drowsiness
• Abnormal sleeplessness and/or hyperactivity

Cures

Confusion is a symptom, like shortness of breath or pain. Like other symptoms, the cure relates to the underlying cause.

Sources

• Yahoo! Health
• National Library of Medicine - National Institutes of Health

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