Thought Disorders

A thought disorder is a problem with how thoughts are organized and expressed. Someone may jump between unrelated topics, answer a question with something that only loosely connects, make up words, or stop mid-sentence and lose the thread entirely. The American Psychological Association describes it as a disturbance in thinking that affects language, communication or the content of thought.

Thought disorder is a symptom, not a diagnosis on its own. It shows up most often with schizophrenia and schizoaffective disorder, and it can also appear during mania in bipolar disorder, in severe depression, and with some medical and neurological conditions.

Form and content

Clinicians usually split thought disorder into two kinds.

Problems with form. How thoughts are put together: rambling, derailed sentences, very slow or very fast speech, or saying very little at all.
Problems with content. What the thoughts are about: delusions, such as believing one is being watched or has special powers, or ideas that dominate everything else.

Why it gets in the way

When thinking is disorganized, almost every task with more than two steps becomes harder. Filling out a form. Following directions from a doctor. Explaining a problem to a landlord. Many people with thought disorder are capable and want to work, but conversations break down and others lose patience.

It also isolates people. Friends stop calling when they can't follow what is being said, and the person often senses it.

What Sanare does

Our clinicians spend time with clients in real settings, which is where disorganized thinking actually causes trouble. A visit might mean sitting together to sort the week's mail, practicing what to say at a medical appointment, or breaking a job application into small steps that get done one at a time.

Structure. Written routines, checklists and calendars that hold the plan when thinking won't.
Communication practice. Slowing down, staying on one topic and checking that the other person understood.
Working with delusions. Respectful ways to test beliefs and lower the fear behind them, drawn from CBT for psychosis.
Coordination. Regular contact with psychiatrists and therapists, since medication often helps thought disorder a great deal.
Family support. Helping relatives understand what is a symptom, and how to talk in a way that lands.

Clients are seen at home and in the community from one to five times a week, by a team of at least two clinicians.

Resources

For families in Colorado, our post on NAMI and other local resources is a good place to start. The American Psychiatric Association also has a guide to helping a loved one with mental illness.

Next step

If you're looking for thought disorder treatment in Denver for yourself or an adult in your family, contact Sanare or call 303.476.1974. We'll start with a short phone call and a free 30 minute consultation.