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Thinking Disorders and Substance Abuse

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What is a Thinking Disorder?

Thought disorder is a term used to describe illnesses that are associated with an impaired capacity to sustain coherent discourse and is reflected in an individual’s verbal and written communication. This mental health condition affects a person’s beliefs, thoughts and perceptions. Thinking disorders have two distinguishable components: Disordered thinking and delusional thinking. Those with disordered thinking struggle to think straight and thoughts come and go quickly. These individuals struggle to pay attention and connect their thoughts logically and reflect this through incoherent or hard to follow conversation. Individuals with schizophrenia often times experience disordered thinking. Delusional thinking occurs when someone believes something that is clearly or most likely false. For example, believing that aliens are following you. This delusion is strongly believed despite the lack of evidence and reflects the person’s abnormality of thought content. These are different than overvalued ideas which are unreasonable ideas with some level of doubt associated with it. Individuals suffering with depression, schizophrenia, delirium, psychosis, and manic depression are more likely to experience thought disorders.


This mental disorder is not actually it’s own diagnosis but rather a symptom and characteristic of other mental illnesses. Thought disorders are characterized and diagnosed by the following symptoms-

  • Confusion and disorientation
  • Flight ideas- When an individual switches from one unrelated idea to another during a conversation
  • Circumstantiality- long-winded and convoluted speech
  • Word salad-Words that are inappropriately strung together
  • Difficulty speaking
  • Blocking- When an individual chooses not to address something that is in conflict
  • Frequent interruptions in a person’s train of thought
  • Belief that a person is an entity
  • Delusions-Experience strange thoughts and have fixed illogical beliefs
  • Hallucinations- Individuals hear and see things that aren’t really there.
  • Paranoia-Someone fixates on fears and skeptical thoughts.
  • Derailment-ideas that get further and further apart from each other and from discussion.
  • Inability to follow a logical train of thought

Addiction and Substance Abuse:

Drug use and alcohol can evoke thought disorder behavior. If someone is heavily under the influence they can not think clearly and may experience things like paranoia or other mental disorder symptoms. Many substances mimic mental illnesses associated with thinking disorders. For example, individuals under the influence of hallucinogenic drugs, like LSD, will most likely experience hallucinations. Furthermore, individuals can experience characteristics of thinking disorders when withdrawing. Some mental disorders are caused from drug use and symptoms never fully go away after treatment. It is also common for someone to struggle with a substance-induced disorder and other co-occurring mental disorders. Detoxification is a necessary first step in recovery. This process rids the body of toxins and substances. This is done so medically and clinically. Once an individual struggling with substance abuse has detoxed they can then be continuously evaluated for other mental health issues.


Treatment varies depending on the type of thinking disorder and within the context that it is occurring. For example, CBT and behavioral therapy is often used for disordered thinking. Medication can be used to alleviate thinking disorders in someone with depression of anxiety. Someone with schizophrenia will also take psychotropic medications which may also improve thinking disorders. Psychotherapy is also another tool used to help better understand the root of the thinking patterns.

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