How To Recognize Disorganized Speech, And What To Do About It
Updated August 28, 2020
Medically Reviewed By: Laura Angers
Being with someone who speaks in an unintelligible way can be confusing, concerning, or even frightening. If a loved one is suddenly talking in ways you don’t understand, the problem might be something called “disorganized speech.” Here’s what it means when someone’s speech is disordered and what you can do about it.
What Is Disorganized Speech?
In simplest terms, speech that’s disorganized is incoherent speech. When you’re talking to someone who speaks in a disorganized way, you might have a lot of trouble following their train of thought or predicting what they might say next. This phenomenon includes several unusual types of speaking.
Loosening of Associations
Loosening of associations means that the person puts ideas and words together that don’t seem to go together. They might quickly move from one idea to another idea that doesn’t seem related in any way. For example, they might say something like, “I went to the store today, soccer is a boring game, grapefruit is too sour.”Psychologists call this way of speaking derailment.
Answering Questions with Irrelevant Answers
Another feature of this type of speech is responding to questions with irrelevant answers. Psychologists call this way of speaking tangentially. The answer might be vaguely related to the question, or it might not seem to be an answer to it at all. For instance, if you asked them how they’re feeling today, they might answer by saying, “It’s cloudy outside.”
Reaching Conclusions That Don’t Make Sense
Sometimes disorganized speaking involves coming to an illogical conclusion. For example, they might say, “I heard a bird outside, so I know Friday is the last day of the month.”
New Words and Non-Words
Sometimes, it’s the words themselves that are disorganized. The person might make up a new word that’s close enough to a real word for you to guess what they mean. Or, they might combine words to make a new word. Other times, they might use non-words that have no relation to the languages that others use.
In the most severe cases, the person uses both words and sentences that don’t bear any resemblance to ordinary speech. It’s difficult or even impossible to understand what they’re trying to say. Psychologists often refer to this as word salad, and people with schizophrenia often speak in this way.
The Brain and Speech Disorganization
So, where does the brain fit into all of this? As it turns out, the brain might have a lot to do with why people speak this way. Most scientists agree that people who talk in disorganized ways also think in disorganized ways. What’s more, they’ve found evidence that people who speak this way have brains that are both physically different and function in unusual ways.
Problems with Semantic Memory
People who have schizophrenia might have problems with semantic memory. This term refers to the part of your long-term memory that deals with concepts and ideas that are outside the realm of your own experiences. It includes common knowledge, such as how to turn on the television or the name of your state capitol. Semantic memory involves a network of connected words and concepts that are associated or naturally occur together.
Many scientists have recognized that semantic memory deficits are a factor behind disorganized speaking. You might wonder if the person knows enough common information to speak coherently. However, a review of 91 studies on semantic memory impairments concluded that problems with semantic knowledge aren’t enough to explain why people have impaired semantic memory.
Problems with Working Memory
Your working memory is the part of your memory that holds conscious, short-term thoughts. People with schizophrenia may have problems with their working memory. And, that makes sense. After all, if you can’t use your mind to think about what you want to say at this moment effectively, it’s hard to speak in an understandable way.
Low Cognitive Control Task Performance
Cognitive control is the part of thinking that involves planning, organizing, and scheduling. This is the part of the mind that organizes the flow of information processing. People who have low cognitive control task performance have a hard time putting words and thoughts together in ways that others understand.
Symptoms and Signs of Schizophrenia
If someone in your life often speaks in disorganized words and sentences or exhibits disorganized behavior, they might have schizophrenia. Or, if you notice that you can’t seem to make yourself understood, it might be worth considering that you might have a mental health issue.
Symptoms of Schizophrenia
The mental disorder that’s usually associated with disorganized thinking is schizophrenia. If you’re concerned that you or someone you know might have this disorder, they might have other symptoms as well. Here are some of the signs you might notice.
- Disorganized thinking and speech
- Delusions – false beliefs not based on reality
- Hallucinations – seeing or hearing things that aren’t really there
- Childlike behavior
- Being agitated
- Doing things that aren’t focused on any goal
- Resisting instructions
- Sitting, standing, or lying in inappropriate positions
- Not responding
- Moving excessively
- Neglecting personal hygiene
- Lacking any signs of emotion
- Loss of interest in daily activities
- Disorganized behavior
- Socially isolating
- Inability to feel pleasure
Delusions, hallucinations, disorganized ways of behaving, thinking, and talking – all these can be signs that you or someone you care about has a severe mental health disorder like schizophrenia.
People with schizophrenia may have many differences in the structures of their brains. The volume of certain parts of the brain is often different than in mentally healthy people. An MRI might show that the cortex is thinning in the frontal and temporal lobes of the brain. These are just a few of the types of differences in the brains of people with schizophrenia.
However, at least right now, doctors don’t use neurological tests to diagnose schizophrenia. That may be because, although tests can often reveal neurological abnormalities in people with schizophrenia, having such abnormalities doesn’t necessarily mean you have that mental illness.
Instead, if there’s a possibility you have this mental disorder, a psychiatrist or therapist talks to you, observes your behavior and speech patterns, and assesses your symptoms. The diagnosis is based on this type of information and clinical process rather than by an MRI or other neurological tests.
What to Do When Someone Speaks in a Disorganized Way
It’s hard to know what to do when you can’t understand another person. It can be even harder if you’re having trouble saying anything that makes sense to others. But there are some things you can do if either of these things ever happens.
Don’t Jump to Conclusions
Avoid trying to diagnose the problem yourself. What seems like disorganized speech may be something else. For instance, if a person quickly shifts from one subject to another, it might be that they are distracted easily and possibly have ADD. Or, if a person responds to a question with an answer that doesn’t have anything to do with the question asked, it might be that they’re trying to deceive you. If you suspect what you’re seeing is disorganized speech, don’t take it on yourself to decide if that’s true or if it indicates a serious mental health condition like schizophrenia.
Although disorganized speaking can be distressing, you need to stay calm when you notice it. Responding with anger, fear, or agitation can only make things worse. You need to be relaxed and have a clear mind if you want to do something to help the situation. If you’re having trouble staying calm, try practicing some deep breathing or systematic muscle relaxation techniques.
Avoid Judging or Criticizing
It might feel natural to point out the problems in someone else’s speech or their disorganized behavior. You might feel like you’re being helpful. And it’s a good thing to try to help someone. However, the problem is that they might feel like you’re judging or criticizing them.
Encourage Them to Seek Help
Sometimes, the person you’re trying to help needs support in getting help from a mental health professional. If you see that their mental health issues are beyond your ability to fix, consider encouraging them to go to a psychiatrist or counselor. Kindly offer your suggestion, and then allow them to decide on their own what to do next.
Know When You Need to Call for Help Yourself
If your loved one has disorganized schizophrenia, a time may come when you need to call for help. Call for emergency help if:
- They are a danger to themselves
- They are a danger to others
- They can’t care for themselves by providing themselves with food, shelter, or clothing
Once you get them to an emergency room or somewhere else where they can get help immediately, the doctors will determine whether they need to go into an inpatient treatment facility. They’ll diagnose the problem, keep them safe, and help them deal with the symptoms of their disorder.
Get Help for You
Whether you are having symptoms of schizophrenia or someone close to you is having them, getting help from a mental health counselor or doctor can be beneficial. If your loved one is exhibiting disorganized symptoms, a counselor might help you deal with the stressful situation and learn how to support your loved one appropriately.
You can go to a community mental health clinic or counselor’s office for assistance. It’s important to see someone locally now if you or your loved one is in any danger. Another way to get non-emergency help is by talking to a licensed counselor at BetterHelp. There, you can get private online therapy. All you need is an internet-connected device. You can discuss what’s happening, any problems you’re having in coping with it, and what you need to do next to improve the situation. Dealing with a problem like disordered speech may not always be easy, but getting the help you need can make a significant difference in your life.