Communication can be a window into your thoughts, making it an important clue in understanding possible mental health conditions.
Almost everyone experiences moments of confusion. You might have a word on the tip of your tongue and you just can’t get it out, or maybe you’ve forgotten where you’re going with a conversation.
Many things can impact thought clarity, but disorganized speech that prevents you from daily communication may be a sign of something more than forgetfulness.
Disorganized speech is also known as “formal thought disorder” since language is the primary way to detect changes in your thought patterns.
Disorganized speech is any interruption that makes communication difficult — and sometimes impossible — to understand.
Brief disorganized speech can be common and nonspecific, according to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5).
But if it becomes severe enough to prevent effective communication, you may be experiencing formal thought disorder.
What’s formal thought disorder?
Disorganized speech is used interchangeably with “formal thought disorder.” This is because scattered communication is one of the primary ways disorganized thinking is identified.
Simply put, if your thoughts aren’t clear, your words may not be either.
Types and examples of disorganized speech
There are many ways your speech might be considered disorganized, but symptoms often fall into categories:
- Symbolism: pairing of thoughts with the correct meaning
- Tempo: the fluidity of words and conversation
- Processing: quality of thought content
- Continuity: direction of thought and conversation
Examples of specific types of disorganized speech may include:
- Paralogism: unusual word choice
- Verbal paraphasia: incorrect word usage
- Literal paraphasia: disordered sounds or sound sequence in words
- Neologism: creation of new words
- Displacement: citing a similar idea but not the correct one
- Contamination: fusing ideas into one another
- Accelerated thinking: rapid flow and increased volume of speech
- Flight of ideas: losing track of where a thought is going
- Inhibited thinking: slow processing of ideas
- Alogia: restricted speech and/or inadequate relay of information
- Circumstantial thinking: inability to determine essential information from unessential
- Desultory thinking: random topic jumps during conversation
- Derailment: sudden drop in train of thought
- Omission: inability to recall a main thought point
- Overinclusive thinking: conversation limits are never identified
- Echolalia: repetition of words or phrases
- Palilalia: fast repetition of words or phrases with decreasing audibility
- Thought blocking: Sudden gaps in thought for no obvious reason
- Verbigeration: nonsensical repetition of words
- Incoherence: complete speech disorganization; “word salad”
There’s no “one size fits all” way to describe disorganized speech. At its core, it can be any language-focused symptom that impairs communication.
If you’re experiencing disorganized speech, you may notice speech patterns related to:
- unexpected pauses
- incorrect words
- unusual pronunciation
- loss of thought placement
- lack of words
- excess of words
- slow or absent word processing
The exact cause of disorganized speech is still being investigated.
As a symptom closely associated with mental health conditions, disorganized speech may be partially due to differences in the central nervous system.
Language and words are skills you learn. They’re stored in your memories.
Many of the mental health conditions that feature symptoms of disorganized speech involve changes in regions of the brain related to memory, speech, and language.
If you’re unable to form the proper connections in the part of the brain that grants access to language memories, you may not be able to organize your thoughts into words.
Other factors may also influence disorganized speech. Times of extreme stress, anxiety, or fear could cause an interruption in your natural speech patterns.
Disorganized speech is most commonly linked to schizophrenia — particularly disorganized schizophrenia.
But experiencing disorganized speech doesn’t necessarily point to schizophrenia in all cases.
Schizophrenia is a diagnosable mental health condition in the DSM-5. Disorganized speech is a symptom but not a disorder on its own.
In addition to schizophrenia, other mental health conditions that may present with symptoms of disorganized speech include:
- dementia (neurocognitive disorder)
- schizoaffective disorder
- bipolar disorder
- delusional disorder
- traumatic brain injury
- schizotypal personality disorder
- schizophreniform disorder
- some types of depression
- psychotic disorder
- Alzheimer’s disease
- attention-deficit hyperactivity disorder (ADHD)
- attenuated psychosis syndrome
Living with disorganized speech can affect how you interact with those around you and may cause social problems for some.
Dealing with disorganized speech might generate feelings of frustration and irritation — for you and those who don’t understand that you’re experiencing something out of your control.
Over time, you may develop a tendency to isolate yourself. Worry and anxiety over when disorganized speech may happen next can keep you at home.
Seeking professional treatment can be one of the best ways to learn to manage disorganized speech and see an improvement.
Treatment largely depends on addressing the underlying condition causing disorganized speech as a symptom.
Seeking treatment for a traumatic brain injury, for example, may be significantly different than treatment for bipolar disorder.
Your physician or therapist can help identify why you’re experiencing disorganized speech. If a mental health condition is contributing, successful treatment may involve:
The medication you’re prescribed and the type of therapy recommended will depend on the condition your physician and therapist feel is at the heart of your symptoms.
Coping with disorganized speech
Aside from medications and therapy, there are many other strategies for coping with disorganized speech.
Self-care and simple lifestyle changes that can help you manage disorganized speech include:
- Social support: building a supportive network of understanding family and friends, joining support groups
- Building communication skills: participating in discussion groups around building social skills, developing alternative communication options with your therapist or counselor
- Medical self-care: staying on track with taking medications as directed, attending appointments regularly for the entire treatment protocol
- Lifestyle changes: developing stress-relief options and relaxation techniques, trying to eat a nutritious diet, focusing on sleep hygiene, exercising regularly, spending time outside
Disorganized speech can present in many different ways and may even prevent effective communication if it progresses. And while it can be a symptom of many mental health conditions, disorganized speech is not a diagnosis in itself.
Living with disorganized speech can be frustrating and may even cause social anxiety, stress, and isolation in some people.
However, disorganized speech can be managed with the proper treatment, which often involves addressing conditions causing this symptom.
Working with your doctor or physician to tailor a treatment plan to you is often the best first step. Depending on any underlying conditions, treatment plans for disorganized speech commonly involve a combination of:
- self-care and lifestyle changes
It’s not always easy to reach out for help with mental health conditions. If you’re ready to seek support but don’t know where to start, check out Psych Central’s guide to mental health help.