Disorientation & Confused Thinking in Adults: Signs and Treatment
Disorientation and confusion are altered states of mind that can arise from a variety of causes. For instance, while disorientation in elderly adults can sometimes signal delirium, it could also simply be a symptom of brain fog.
Commonly, lifestyle factors and significant life changes, such as loss or illness, can be to blame for disorientation in adults. However, this cognitive symptom also often stems from stress and underlying mental health conditions.1,2
Disorientation and confusion can be extremely stressful for those who experience it and their loved ones. Symptoms can impact daily life and prevent people from engaging in their normal work and social activities. Therefore, it’s important to identify any potential underlying causes.
A mental health professional can help you pinpoint the causes of your disorientation and figure out ways to restore clarity. This page can also work as a useful guide for understanding disorientation in adults, as it explores:
- What disorientation is and other cognitive symptoms
- The different factors that can cause disorientation
- Types of support for disorientation and confusion
- Where to find professional support
What Is Disorientation?
Disorientation can mean different things to different people. For some, it may describe feeling slightly “off,” confused, or disconnected from the present moment – such as detachment from daily life or discord with the future or sense of purpose. For others, it can describe a more serious state of delirium or be accompanied by other symptoms like memory loss or difficulty concentrating.
With this variation in mind, the following sections cover a few different ways disorientation can show up.
Delirium
Sudden confusion (or delirium) is a significant change in someone’s consciousness and cognition, where they can no longer focus or shift their attention as they could before. Delirium is not yet fully understood, but we know that it is a manifestation of stress on the central nervous system.1
Delirium is most common in elderly people and can signal more serious health conditions. Yet, while disorientation can be an early sign of dementia, dementia develops more slowly than delirium. Therefore, someone’s symptoms would be more consistent and permanent, rather than sudden and transient.1
If you’re worried about a loved one who seems disoriented, they may be delirious if they have the following symptoms:1
- Increased agitation or increased sleepiness
- Hallucinations and delusions
- Occasionally combative or uncooperative behaviors
- Emotional instability
- Changes to their sleep-wake cycle
- Inappropriate or unsafe behavior
- Disorganized thinking, whether that’s problems with memory or language
With delirium mainly impacting elderly people, younger adults experiencing disorientation should consider other explanations for their symptoms. Medical advice in these situations may be important if symptoms are persistent.
Brain Fog and Disorientation
Disorientation is also a symptom within the broad category of “brain fog,” which can involve difficulty concentrating, fatigue, and memory problems.2 Therefore, someone could simultaneously have brain fog and disorientation, including problems with memory and other cognitive issues.
For instance, symptoms of brain fog-related disorientation could include:2
- Struggling to recall information or translate thoughts into words
- Becoming easily distracted
- Dissociating from yourself or the world
- Difficulty concentrating
- Having slow or sluggish thoughts
- Being persistently mentally fatigued
- Feeling as though one’s mind is “blank”
- Becoming overwhelmed by routine or mundane tasks
Other cognitive issues aside from brain fog that could cause similar symptoms include intrusive and racing thoughts, overthinking, and indecisiveness. These may also be caused by a wide range of emotional and lifestyle factors.
Substance-Induced Confusion
People may experience disorientation or confusion under the influence of drugs, alcohol, or prescription medications. It could also be that withdrawing from a substance induces a state of confusion.
In these cases, people may feel dizzy, mentally fatigued, and as though they can no longer think with their normal level of clarity.
Cognitive Dissonance
Major life disruptions can cause a great deal of disorientation, whether these disruptions are in our relationships, work lives, personal identities, or senses of meaning.
Cognitive dissonance is when we hold two conflicting realities. Therefore, when our lives have been uprooted or significantly changed, this dissonance can be between the old version of our lives that no longer exists and our new circumstances.5
Though these moments offer an opportunity to reinvent ourselves, they can be incredibly disorienting. We may be unsure of what daily life and the future will look like and have to take small steps to build our new lives.5 However, this sort of disorientation isn’t as physical as the other types we’ve described so far; it’s more of a disorientation from our mental reality.
A strong sense of cohesion with our reality, roles in life, and identities is crucial for feeling secure and oriented. When this is off kilter, we may feel disoriented in everyday moments, such as when shopping, travelling to work, or in conversations with friends. In other words, there might be moments of confusion in which our brains are “catching up” to our new situation.
Causes of Disorientation and Confusion
As disorientation can appear in several ways, what are its causes?
In elderly people, delirium can be caused by things like medication side effects, substance intoxication or withdrawal, infection, pain, or even simple conditions like constipation.1 If any of these factors could be a cause of delirium in yourself or someone you know, seeking medical advice may be necessary to ensure safety and reduce symptoms.
However, mental health factors can also be a significant contributory factor in disorientation, which we cover next.
Mental Health and Confusion
People can experience disorientation, as well as other brain fog symptoms, if they have anxiety. As well as causing a persistent state of stress, things like rumination and worry divert the brain’s resources away from day-to-day tasks, making people feel forgetful, distracted, or confused.2
Anxiety can take us away from the present moment, whether we’re worrying about the future or the past. Therefore, emotional regulation strategies may help with disorientation as a result of anxiety, as they can bring people into the here-and-now and a more grounded state. Learning to regulate emotions like fear, sadness, and anger enables us to let things pass more easily and reduces built-up stress.
Disorientation may also occur when somebody is experiencing psychosis. This condition involves symptoms like delusions, hallucinations, and disorganized thoughts and behaviors. People with psychosis may seem disoriented, paranoid, or hold bizarre beliefs. Plus, because of distractions caused by hallucinations, they may speak in non-linear ways.3
Additionally, while confusion isn’t a commonly mentioned symptom of depression, the condition can significantly change our ability to think. This is because depression can impair our memory, attention, information processing, and decision-making skills. Further, it can make it much harder to take all the necessary steps to get something done. So, while confusion may not be listed as a common symptom of depression, these factors can converge and cause someone to feel disoriented.4
Finally, while disorientation may be a symptom of mental health conditions, it can also be a result of stress. Stress-induced confusion occurs because chronic stress keeps our nervous systems on high alert. When we’re operating in this kind of “survival mode,” our brains may struggle to focus on minor tasks and engage in activities that require logical thinking.2
Other Causes of Disorientation
If someone is experiencing disorientation alongside other symptoms of brain fog, there are a few other potential causes. For instance, symptoms could be caused by fibromyalgia, COVID-19, chemotherapy, pregnancy, a vitamin deficiency, or a side effect of medication.2 Additionally, medications known to sometimes cause brain fog include certain antidepressants, painkillers, benzodiazepines, antihistamines, and sleep aids.2
There are also potential contributory lifestyle factors, such as poor sleep and stress (as mentioned above), which can put people at increased risk of brain fog symptoms. Even things like eating a heavy meal or experiencing jet lag could cause temporary brain fog.2
If you’re unsure of whether your disorientation is the result of mental health symptoms or lifestyle factors, it may help to take a self-test.
Support for Confused Thinking and Disorientation
The first step toward getting the right adult cognitive health support is determining the cause of your symptoms. Whether it’s stress, a response to medication, or an underlying mental health condition, the cause will determine the appropriate treatment approach.
We cover a few strategies for managing disorientation below, but to ensure you’re taking the right approach, it may be important to consult a medical or mental health professional.
Coping With Confused Thinking
Depending on the cause of your symptoms, there are different things you can do to manage them. For instance, it may be changing your medication, getting more sleep, or exercising more frequently. There are also certain foods known to promote brain health, such as healthy oils, nuts and seeds, fruits and vegetables, and fatty fish.2
While you employ different changes to reduce your symptoms, let your work and loved ones know what’s happening. For instance, a manager at work may give you an extension on a project, allowing you to reduce stress. Further, many people living with brain fog feel guilt or shame for not being able to function “normally.” Therefore, having friends and family to support you could help alleviate these feelings.2
Therapy for Disorientation
If your symptoms are connected with mental health or stress, you could seek out cognitive behavioral therapy (CBT) for disorientation and confusion.
CBT focuses on the thoughts and behaviors that worsen stress and mental health issues. Therefore, a large part of CBT is targeting “cognitive distortions,” which are the automatic and unhelpful thoughts that worsen things like anxiety and low self-esteem.6
In order to reduce your disorientation, a CBT practitioner may investigate any cognitive distortions you may have. For example: black-and-white thinking, catastrophizing, using “should” and “must” statements, and assuming the thoughts of other people (mind reading).6
Over time, challenging and reshaping these automatic ways of thinking can help reduce emotional distress and build psychological flexibility. Though it may not reduce your disorientation (or other brain fog symptoms) right away, it can improve your mental health and confusion over time.6
However, if your disorientation comes from a big life event, such as a significant loss, illness, or the breakdown of a relationship, you’ll likely benefit from a different kind of therapy. Humanistic and existential counseling approaches take a different approach to CBT.
Instead of giving directional guidance to challenge your thoughts and behaviors, humanistic and existential approaches provide a space for you to process what’s happened. For example, practitioners can help you examine what matters to you, rediscover your sense of meaning, and come to terms with your new circumstances. Though disorientation can indicate a breakdown of our previous life, it is also the space from which we can reimagine and redefine ourselves.5
Mission Connection: Get Support for Cognitive Symptoms Today
Disorientation in adults can be frustrating and frightening, and can even impact our ability to function in everyday life. If this cognitive symptom is affecting your ability to live a full, meaningful life, Mission Connection can help.
Whether your disorientation is caused by mental health conditions such as anxiety and depression, a significant life change, or something else, our treatments can be personalized to your needs. Our centers are located across the US, but we also offer flexible online options, ensuring that you can access support that suits your schedule and lifestyle.
If you feel that your cognitive symptoms could be helped with therapy, reach out to us here at Mission Connection to ask any questions and learn how we can help.
References
- Ramírez Echeverría, M. de L., Paul, M., & Schoo, C. (2022). Delirium. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK470399/
- Psychology Today. (n.d.). Brain Fog https://www.psychologytoday.com/us/basics/brain-fog
- Calabrese, J., & Al Khalili, Y. (2023). Psychosis. Nih.gov; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK546579/
- Cartreine, J. (2016, May 6). More than sad: Depression affects your ability to think. Harvard Health. https://www.health.harvard.edu/blog/sad-depression-affects-ability-think-201605069551
- Psychology Today. (2025). When Things Fall Apart: The Hidden Freedom in Disorientation. https://www.psychologytoday.com/us/blog/the-heart-of-healing/202503/when-things-fall-apart-the-hidden-freedom-in-disorientation
- Guy-Evans, O. (2022, November 3). 13 Cognitive Distortions Identified in CBT. Simply Psychology. https://www.simplypsychology.org/cognitive-distortions-in-cbt.html
