Having a thought disorder means you have difficulty processing and expressing thoughts. It’s common in people with schizophrenia.
It’s common to occasionally have difficulty expressing what you’re thinking or feeling. But regularly having trouble articulating thoughts or emotions may be a sign of a thought disorder.
For example, being sleep-deprived can make it tough to think clearly and coherently express your thoughts.
But, frequently having difficulty with verbal or written expression could be a symptom of a thought disorder. Thought disorders can make it more difficult for people to follow what you’re saying. Your speech may also be confusing to people other than you.
Thought disorder, also known as formal thought disorder, causes eccentricities in thinking, language, and communication.
Someone with a thought disorder may have trouble organizing, processing, or expressing their thoughts. They may also have trouble expressing themselves verbally and in writing.
Thought disorder is common in schizophrenia, psychosis, and mania. Someone with a thought disorder may be difficult to understand.
What is the most common thought disorder?
Although schizophrenia isn’t the only form of thought disorder, it’s one with a large body of research behind it.
Thought disorder subtypes
There are two subtypes of general thought disorder or formal thought disorder:
- positive thought disorder
- negative thought disorder
Positive and negative don’t refer to good or bad. Positive symptoms are signs of added behaviors, like hallucinations or disorganized behavior. On the other hand, negative symptoms refer to the absence of something. Examples of negative symptoms include limited emotional response or lack of speech.
Various signs could indicate you have a thought disorder. Some are outwardly visible, while others may only be obvious to you.
Outward signs
Many of the outward signs associated with thought disorder are related to disruptions in speech.
Here are some examples:
- Loose associations or lack of connection between ideas. You have incoherent thoughts or thoughts that are unrelated to one another.
- Tangentiality or excessive and irrelevant information that doesn’t answer the original question. You may regularly go off on tangents and never answer what was initially asked.
- Incoherence or speech that doesn’t quite make sense. You may produce “word salad” or a jumble of speech that isn’t coherent.
- Illogicality or coming to conclusions that don’t follow basic logic. You may think that there are illogical reasons for situations or events.
- Circumstantiality or long-winded explanations. You may take a long time to get to the point.
- Pressure of speech or talking very rapidly. You may feel like you can’t stop talking or need to get everything out.
- Distractability. You become easily distracted, especially if something else catches your attention.
- Clanging. With clanging, the sound of words dictates word choice. For instance, you may answer a question only with words that rhyme.
Inward signs of thought disorder only you might notice
Inward signs of thought disorder may include:
- loss of sleep
- ruminating
- cognitive distortions
These symptoms may not be obvious to folks not experiencing them.
Research indicates that sleep disruptions occur in up to 80% of people who have been diagnosed with schizophrenia. Additionally, one study from 2019 involving people with psychosis suggests a link between psychosis and excessive rumination.
There’s a high degree of variability in how thought disorders present. For example, negative thought disorder is sometimes seen in people with depression but isn’t as common as thought disorder with mania and schizophrenia.
Research from 2017 suggests that thought disorders are more common in people with schizophrenia. Certain thought disorder symptoms were also more likely in people with mania, including:
- circumstantiality
- pressured speech
- clanging
There’s ongoing research into why people develop thought disorders, but there’s currently no consensus on the cause.
Some experts suggest that differences in brain structure and genetics may play a role in thought disorders.
Mental health professionals often use assessments to diagnose thought disorders. A few of these include:
- scale for assessment of positive symptoms (SAPS)
- scale for assessment of negative symptoms (SANS)
- formal thought disorder-self scale (FTD-S)
- thought and language communication scale (TLC)
- thought and language index (TLI)
- Rorschach ink blot test
These help clinicians identify symptoms consistent with thought disorder.
Medications and therapy are both helpful tools for treating thought disorders.
Doctors commonly prescribe antipsychotic medications to help with symptoms. They may also recommend cognitive-behavioral therapy (CBT) to treat thought disorders.
In one 2020 paper, researchers used secondary data from large, single-blind randomized controlled trials and found that CBT effectively reduced the frequency of delusions in people with thought disorders compared to supportive counseling.
Thought disorder, or formal thought disorder (FTD), is a symptom of schizophrenia and other mental health conditions. It can affect both verbal and written language.
If you suspect you have a thought disorder, you may feel scared or confused. If your loved one has a thought disorder, you may feel distant from them or have trouble communicating with them.
Help is within reach, and treatment options are available. Because there are many options, working with a mental health professional may help you find the right treatment combination for you.
Feeling overwhelmed by the possibility that you or a loved one is living with a thought disorder? Help is available, and you’re not alone. Consider checking out RAISE for more information and helpful resources on schizophrenia, the most well-researched thought disorder.
Are you thoughts so jumbled you are worried there might be something wrong? Disordered thinking is often related to diagnosable and treatable mental health disorders.
What is disordered thinking?
It is what it sounds like — thinking that has become disorganised and hard to follow.
If you have disordered thinking, you can’t control your thoughts or express yourself well, which can make relating with others difficult.
Symptoms of disordered thinking
Symptoms can see you:
- unable to think straight
- Feeling like your head is full of fog or sand
- struggling to concentrate
- rapidly jumping from one subject to the next
- not finishing your thoughts
- speaking in a confusing way: too fast, too many pauses, drifting off
- losing a logical order to your ideas.
Why does it matter if my thoughts are a mess?
For starters, when we can’t think well we can’t communicate well. And when we can’t communicate well, it affects our ability to cope. We can’t ask for what we need, or state how we feel, or what is upsetting us. Relating to others becomes difficult, which can leave us feeling shunned and rejected.
And in some cases disorganised thinking can be the beginning of a more serious mental health disorder like schizophrenia.
Related mental health issues
photo by: Joseph Frank
Disordered thinking is connected to severe depression, which can leave you feeling so foggy and confused it can be hard to form useful thoughts, or to speak clearly.
It can also form a part of mania, where your thinking can get too fast, and you can’t keep up with your own ideas.
But disordered thinking is most commonly known as a symptom of schizophrenia. Here it is usually (but not always) joined by delusions (believing things are real that aren’t) and hallucinations (sensing things to be there that aren’t).
What is a thought disorder?
The term ‘thought disorder’ can be confusing. It’s called a disorder, yes. But it’s not currently a standalone diagnosis. Nor is it an actual listed, standalone disorder in the DSM-V or the ICD-10, the two most used manuals for diagnosing mental health disorders. It’s instead more of a feature of other disorders, or used as a synonym for severely disorganised thinking.
At one point, the argument was made for ‘thought disorders’ to refer to several different issues. In the 1980s, neuroscientist Nancy C. Andreasen argued that thought disorder “has often been treated as if it were unitary, but in fact it is composed of a number of different language behaviours.” She identified no less than 18 different types of thought disorders, along with a scale that attempted to measure them.
But nowadays, when psychiatrists and mental health professionals say ‘thought disorder’, they are generally just talking about disorganised thinking that is severe enough it affects the way someone speaks and presents themselves.
If it helps, see thought disorders as ‘sub disorders’, a symptom of other listed major mental health disorders.
Diagnosis in the UK
Here in the UK, if you go see your GP, you won’t come home with a diagnosis of ‘thought disorder’ but with a related diagnosis like severe depression, schizophrenia, or psychotic disorder.
The National Institute of Health and Care Excellence (NICE), which is used to diagnose in Britain, makes no mention of thought disorders. It instead offers a ‘Guide to Psychosis and Schizophrenia‘.
Formal thought disorder
This is a more exact term for thought disorder, and is again often used as a synonym for severely disorganised thinking.
By: cometstarmoon
Formal thought disorder is about the form your thoughts take, and is related to organisation and expression.
It means your thoughts are so disorganised and messy it affects the way you talk and write, and that this is not caused by a medical condition.
It’s not the same as being tired or depressed and speaking differently. Or of having a short episode of talking strangely, such as after a shock like an accident. If you have formal thought disorder, your talking is inconsistent and incoherent for no known reason, and it has been for some time.
Formal thought disorder can include things like:
- talking too fast and loud, or in a garbled manner
- strange pauses
- incoherent tangents of thought
- excessive detail
- or talking very little and in a vague way that confuses others
- using outdated, formal, or strangely elevated language
- repeating certain words again and again
- being more obsessed with the sound of words than what they mean
- making words up, or using the wrong words to explain things.
Content thought disorder
‘Content thought disorder’ is about what you think about. Your thoughts are illogic and confused. An example is having delusions. You might believe you are being persecuted by aliens, or that everyone is secretly out to get you. You might not talk about this, but you think it.
If you have schizophrenia, you could have both formal and content thought disorders.
This is confusing…
There is some irony in the fact that mental health professionals and the mental health industry has made their description and diagnosis of disorganised thinking, well… disorganised. And highly confusing.
Perhaps neuroscientist Andreasen should have been listened to when she actually identified this confusion. “Because the term “formal thought disorder” has been so misunderstood and misused, it is recommended that it no longer be used,” she suggested. She pointed out that, “Most of them are in fact disorders of communication…[that] can be better conceptualised as “disorders of thought, language, and communication.”
But the trouble is also that we simply don’t have a standard ‘normal’ for language we can compare everything to, when it is influenced by culture, amongst many other things. As a 2017 review of research around disordered thinking explains,
“Language “distortion” is a sign—in the medical sense—that is potentially measurable but currently without a universally accepted measure.”
What really matters about disordered thinking
The thing to keep in mind is mental health terms and diagnoses are not an exact science. They are just words created by mental health professionals to more easily describe groups of people with similar issues. And, as this article shows, terms and diagnoses can change with the times.
What matters is that if your thinking, or that of your loved one, means they can’t communicate, connect, and cope? Then it’s time to seek help.
Worry you have a thought disorder and want to talk to someone who is informed? We connect you to a team of highly regarded mental health experts in London. Or use our online booking platform to find a UK-wide therapist now.
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