Confusion: Causes, Symptoms, and Treatment

Confusion is a feeling many people experience at some point in their lives. Most of the time, it’s nothing to worry about.

However, there are times when feeling confused should be taken seriously and could suggest an underlying issue. 

If you find you are feeling more confused than normal, don’t ignore it.

Make note of your symptoms, their frequency and discuss them with a doctor or your primary care provider. 

In this article, we’ll discuss the symptoms of confusion and possible causes.

We’ll also highlight when confusion is a cause for concern and what you can do about it, or if you should see a medical professional.

What is Confusion?

Confusion is a sudden change in a person’s mental state.

Confusion may cause people to feel disoriented or have difficulty paying attention and is often the result of stress, anxiety, or fatigue.

A state of confusion can also be caused by certain medical conditions, such as severe infections, a stroke, Alzheimer’s disease, or dementia. 

In some cases, confusion can become dangerous if it makes someone more susceptible to accidents or injury.

It is important to be aware of the risks involved with confusion and know when to contact a medical provider.

Symptoms

The symptoms associated with feeling confused may appear very suddenly or they could develop over a longer period.

Whether it is you or someone else experiencing confusion, some common symptoms to look for include:

• Difficulty focusing
• Feeling disoriented
• Trouble with decision making
• Memory problems
• A lack of awareness
• Abnormal or incoherent speech

In some cases, people who are confused can also act strangely or show unusual behavior.

Sudden confusion may cause people to experience:

• Frustration
• Aggression
• Sudden changes in emotion or mood swings
• Uncertainty or anxiety

Causes

There are many factors that can contribute to a state of confusion, some more serious than others.

Sudden confusion can be a sign that something is not right. 

Dehydration

Drinking water and staying hydrated allows our bodies to function properly.

Severe dehydration can cause decreased energy levels and cognitive performance.

When a person is dehydrated, daily functioning and performance can be inhibited, and lower electrolyte levels may result in weakness or fatigue, as well as feelings of confusion.

Head Injury or Concussion

If you or someone you know has recently received a head injury or concussion, this can result in a number of issues, including confusion.

Head injuries can alter the brain’s function and may require immediate medical attention depending on the severity.

For many, concussion symptoms will go away within a few days, but others can have more prolonged symptoms that last weeks or months.

Blood Sugar Problems

Changes in blood sugar levels can cause confusion, especially in older adults, and people with diabetes are much more susceptible to blood sugar-related confusion. 

Other symptoms of hypoglycemia (low blood sugar) include: 

• Feeling shaky
• Sweating
• Racing pulse
• Feeling dizzy or lightheaded 

Additional symptoms of hyperglycemia (high blood sugar) include:

• Feeling tired
• Feeling thirsty
• Having difficulty breathing
• Abdominal pain
• Nausea and vomiting

If you experience sudden confusion, it is important to check your blood sugar levels and see if they are within a normal range.

Infection

While infection can cause anyone to develop feelings of confusion, elderly people are more at risk.

Infection can occur anywhere in the body, but the most common areas that an infection will cause symptoms of confusion are the lungs, brain, and urinary tract.

Depending on where the infection stems from, it can cause the body to release chemicals that can alter brain function.

It can also lead to a sudden drop in blood pressure which can reduce blood flow to the brain, or, in some cases, cause inflammation of the brain tissue leading to confusion. 

If you suspect that confusion is caused by an infection, seek medical attention immediately so that the infection can be treated.

Lack of Oxygen

When the body does not receive enough oxygen, brain function suffers.

A lack of oxygen could result from an asthma attack or other medical conditions involving the lungs and heart. 

If sudden confusion occurs in the setting of difficulty breathing, it could be that the brain is not receiving enough oxygen and you may need to seek immediate medical assistance.

Neurological Disorders

The most common mental health disorders to cause confusing disorientation are dementia and delirium.

Dementia develops over a longer period of time whereas delirium can appear very rapidly.

Delirium is often due to drug or medication use but can also be caused by other medical conditions.

These may require immediate treatment depending on the cause.  

Some other mental health disorders that can cause confusion include:

• Depression with psychosis
• Schizophrenia
• Bipolar disorder

Stroke

Confusion is one of the most common symptoms of a stroke and can occur both during and after an attack.

Confusion in a stroke is caused by reduced blood flow to the brain which results in a lack of oxygen that impedes function. 

Some other symptoms of stroke include:

• Numbness or weakness in the face, arm, or leg, especially on one side of the body
• Trouble speaking or understanding speech
• Difficulty seeing in one or both eyes
• Dizziness, loss of balance, or lack of coordination
• Severe headache

If you or someone you know is showing signs of a stroke, seek emergency medical attention immediately.

Seizures

Seizures are generally accompanied by loss of consciousness and involuntary movements, and may be followed by a period of feeling sleepy or confused. 

There are a variety of reasons a person might have a seizure, including brain injury, stroke, Alzheimer’s disease, and epilepsy.

While some seizures are mild and last only a few seconds, others can be more severe and last for minutes or even hours. 

If you witness someone having a seizure, stay calm and call for medical help.

Aging

As people age, they may start to experience mild forgetfulness.

Having troubles with memory will often cause slight confusion––however, mild forgetfulness is a normal part of aging and is usually not a cause for concern. 

If memory issues start to impair daily activities, or confusion becomes progressively worse, it can sometimes be a sign of a more serious problem, such as dementia. 

If you are concerned about confusion in an elderly loved one, speak to your healthcare provider.

They will be able to rule out any underlying causes and help you develop a plan to manage the confusion. 

Alcohol or Drug Use

The use of drugs and alcohol, especially in excessive amounts, can alter a person’s mental state.

This can create problems with speech, making decisions, as well as balance and coordination.

Confusion is an established stage of intoxication after a person’s blood alcohol content (BAC) has reached a level of 0.18-0.30%.

It is typical for a person to feel disoriented at this stage.

This is often accompanied by symptoms of dizziness, memory loss, and an increased pain threshold.

But if you feel sudden and unexpected confusion after ingesting alcohol or drugs, call a doctor or poison control center right away––feelings of confusion should not occur if drug and/or alcohol intake is minimal.

Be aware of the potential for confusion when using alcohol or drugs so that you can take steps to protect yourself and others. 

Certain Medications

When prescribed medications, particularly new medications, be aware of common side effects.

Inform your healthcare provider of any new side effects.

Sudden or severe confusion may be cause enough to try a different medication, just be sure to do so under your doctor’s supervision.

Diagnosis

To understand the cause of confusion, doctors will often need to talk with a patient and go over their personal and family history. 

Often, a patient will be asked to perform simple tasks to test attention, memory, and cognitive ability.

These could include solving basic math problems or spelling. 

Doctors may also require additional testing based on existing symptoms, such as:

• Physical examination
• Blood test
• Urine test
• MRI
• CT scan
• Chest X-ray

These tests can help medical providers identify the cause of confusion and determine how to treat it.

Treatment

Confusion can be a normal reaction to unexpected, stressful, or overwhelming events. It can also be a symptom of an underlying medical condition.

Regardless of the cause, there are several treatments that can help to reduce confusion and improve cognitive function.

Home Remedies

While confusion can be frustrating and even scary, there are many steps that you can take at home that will help to improve the symptoms of short-term confusion. 

When a person is confused, it’s best to maintain a calm, quiet, and peaceful environment.

Remind the confused person of the date and their location and talk with them about the day’s events.

This can help to reduce any agitation or stress that the person may be feeling and improve their concentration. 

If confusion is caused by dehydration, symptoms can be relieved by drinking water.

Similarly, if you are experiencing low levels of blood sugar, confusion can be reduced by drinking beverages or eating foods with high amounts of sugar.

Medical Care

If you are experiencing confusion that interferes with your daily life or lasts for more than a few days, it is important to see your doctor or healthcare provider for an evaluation.

There are many possible treatments for confusion, ranging from lifestyle changes to medication.

In some cases, therapy can provide guidance and support to help patients make sense of their feelings and thoughts. 

Prevention

Mild confusion can often be remedied by changing daily habits.

Depending on the cause, some things you can do to prevent confusion include:

• Getting enough rest
• Drinking plenty of fluids
• Maintaining a balanced diet
• Managing stress 
• Keeping track of blood sugar levels
• Taking daily medications as prescribed
• Eliminating drug or alcohol consumption

When to See a Medical Provider

Contact your medical provider or, in the case of emergency, call 911 if you notice sudden confusion or confusion accompanied by any abnormal symptoms.

Concerning symptoms include: 

• Cold or clammy skin
• Dizziness or feeling faint
• Accelerated heartbeat
• Fever
• Headache
• Slow or rapid breathing
• Uncontrolled shivering

Call 911 or your local emergency number immediately if:

• Confusion has come on suddenly in someone with diabetes
• Confusion came on after a head injury
• The person becomes unconscious at any time

Are you or someone you know experiencing symptoms of confusion? You can get affordable primary care with the K Health app.

Download K Health to check your symptoms, explore conditions and treatments, and if needed text with a healthcare provider in minutes. 

K Health’s AI-powered app is based on 20 years of clinical data.