Logorrhea, also known as polyphrasia, is a concomitant of neurological and psychological disorders. However, the compulsive need to communicate nonstop also occurs as a result of overindulgence in alcohol and caffeine or other drugs. In addition, the term names a nonpathological, conspicuous behavior.
What is logorrhea?
Logorrhea refers to an increased urge to talk. Colloquially, the term translates as talkativeness, speech diarrhea, or pathological talkativeness. Manic, paranoid and schizophrenic clinical pictures often show this kind of uncontrolled speech flow. But logorrhea is also among the symptoms of incipient dementia or drug addiction. In addition, it is known as a possible consequence of organic damage to the brain in the frontal area or the so-called Wernicke’s aphasia, for example after a stroke, in which patients are no longer able to recognize the meaning of words.
Causes
The most common cause of logorrhea is considered to be bipolar affective disorder – also known as manic-depressive illness. Sufferers suffer from enormous mood swings, periods of depression alternating with long periods of mania. Experts believe that bipolar affective disorder is triggered by genetic and neurobiological factors. However, the causes of the disease have not yet been fully elucidated. In the manic phases, which are characterized by disproportionately elevated mood or even excessive irritability, by exaggerated self-confidence and aimless drive, there may be an inhibitory and distant urge to talk, logorrhea.
Symptoms, complaints, and signs
Endless, uninhibited monologues with loss of self-control, often peppered with foul language and insults, are the typical symptoms of manic logorrhea. Frequent repetitions and constant change of topics characterize the rapid and rampant flow of speech without periods or commas. In most cases, the monologue is delivered at an inappropriate volume and with great emphasis. Others do not get a chance to speak and feel run over. During the seizure, no normal communication with the affected person is possible. Medicine distinguishes between different degrees of severity of logorrhea. In extreme cases, what is said remains completely incomprehensible. The thoughts expressed then show no coherence at all. The flood of ideas in the head leads to confusion of thought. “Flight of ideas” is what the experts call this.
Diagnosis and course of the disease
In the case of pronounced logorrhea, a neurologist and psychiatrist should be consulted in any case. However, the treatment of mania turns out to be markedly difficult. Since in many cases patients experience a real increase in their drive and self-esteem, they themselves see no need to undergo therapy. Thus, admission and treatment may become necessary against their will. For the most part, sufferers are treated throughout their lives with medication to stabilize their mood and with psychotherapy. In the acute manic phase, highly potent neuroleptics or even antipsychotics, such as olanzapine, are recommended. Lithium treatment is considered helpful as long-term prevention, especially for recurrent manic episodes. After the manic episode has subsided, therapy should be used to help individuals cope with the psychological and social consequences of the episode and to change behaviors related to the manic-depressive illness.
Complications
Logorrhea causes severe psychological and social discomfort. As a rule, in this disease, the patient’s quality of life is considerably reduced and there are significant limitations and discomforts in the patient’s daily life. The affected person loses all self-control and can no longer orientate and concentrate. Insults and verbal abuse occur. Especially people who are not familiar with this disease can perceive it as an attack, so that injuries or an argument may occur. The social contacts of the affected person also suffer extremely from the disease, because the affected person talks extremely much. Not infrequently, the talking also takes place at a high and, above all, inappropriate volume, so that other people can feel harassed.Similarly, patients can not absorb information content. Treatment of this disease is carried out by a psychologist. As a rule, in severe cases, treatment can also take place in a closed clinic. Therapies and medications are used in this process. However, it is not uncommon for antipsychotics to show side effects, so that those affected usually appear tired and listless. As a rule, it is not possible to generally predict whether the course of the disease will be positive. The success of the treatment also depends heavily on the patient’s will.
When should one go to the doctor?
If people show behavioral abnormalities, the clarification and support of a physician is needed. If an occurrence occurs that is perceived to be off the norm in direct comparison to fellow humans, a physician should be informed of the observations. Since logorrhea often lacks insight into the disease on the part of the affected person, a visit to the doctor often has to be initiated by close relatives. Close consultation with a physician is necessary so that the right steps can be taken to begin treatment. In addition, the relationship of trust with the ill person should be established so that medical care is accepted and can take place. Loss of self-control is an important indication of a present illness. People who talk and communicate without stopping need medical as well as therapeutic help. Talking at a high volume, the use of vulgar expressions and an aggressive demeanor as soon as the affected person is interrupted are considered worrisome. A visit to the doctor is advisable if the sufferer cannot be persuaded to remain silent either independently or at the request of the persons present. Compulsive behavioral traits or a manic demeanor must be investigated and treated. If there is a loss of the feeling of fatigue, talking without periods, and hectic behavior, a visit to the doctor is necessary.
Treatment and therapy
The World Health Organization (WHO) lists bipolar disorder among the ten medical conditions that cause permanent disability worldwide. However, only ten to 15 percent of patients receive medical treatment. In the large remainder, the illness remains undiagnosed, is misdiagnosed or diagnosed too late. The first symptoms of bipolar disorder usually appear between the ages of twenty and thirty. In rare cases, the first episodes of illness can occur in adolescents. The first episode is usually a depressive episode, which means that bipolar disorder usually goes undetected until the first appearance of a manic episode. Most patients initially experience approximately four episodes in ten years, with the intervening periods being completely asymptomatic in most cases. As the disease progresses, the number of episodes increases and the intervening periods are now also no longer symptom-free. In old age, the frequency of episodes mostly decreases again. However, a relatively large proportion of patients with bipolar disorder do not reach old age. This is because the risk of suicide is dangerously high. “One in four affected persons attempts to take their own life at least once during the course of the illness,” according to a letter from the German Society for Bipolar Disorders (DGBS).
Outlook and prognosis
Logorrhea represents a concomitant condition of a present situation. Logorrhea is not a disease in its own right, so it does not have its own prognosis. Rather, the overall health condition is considered for the prospect of recovery. It is a symptom of logorrhea that is present because of a temporary mental condition or because of a mental disorder. If the affected person is in an alcoholic state, usually after a few hours there is freedom from symptoms. As soon as the toxins are removed from the organism, a continuous improvement of health begins. The same development can be observed in people who have consumed drugs or are in a highly euphoric state due to various experiences. Here, too, a spontaneous healing usually appears within a few hours. If the affected person suffers from schizophrenia or a paranoid disorder, the prognosis is considerably worse. Both disorders are permanent disorders that require action.In long-term therapy, various symptoms can be minimized, but recovery does not occur according to the current medical status. If a disease of the memory activity is present, a cure is also not to be expected in the normal case. In the case of dementia, a continuous decline in the functional activity of the memory is to be expected. No cure is currently possible.
Prevention
Pathological loquacity thus refers in a pathological sense to a severe psychological or even organic disorder. In addition to this medical and psychological significance, however, logorrhea is also a phenomenon of our time. As such, the term has long since found its way into media and social criticism. The fact that in various media, everything is commented on non-stop, is aptly described by the term logorrhea. We text to each other constantly, on Twitter, Facebook, in the online editions of newspapers, in blogs and the talk shows on TV. “Logorrheic behavior in the media has already influenced the communication patterns of many people in recent years to such an extent that it can be described as an across-the-board phenomenon. Auditory boundaries are crossed more and more often, this creates developmental disorders in children, it disturbs men, but also women, who lose the others and themselves in this flow of speech,” is how Astrid v. Friesen, educationalist, journalist and author, assesses the phenomenon.
Aftercare
Logorrhea can lead to various complications or discomforts, so this condition must definitely be examined and treated by a doctor. Early diagnosis usually has a positive effect on the further course of the disease and can prevent further worsening of the symptoms. Most of those affected show strong insults and insults due to logorrhea. To better manage the psychological pressure, long-term support from a psychologist is recommended. With the help of behavioral therapy, those affected learn to better assess the reactions of their social environment and to be able to react to them more appropriately. Sometimes medications are used as an adjunct. However, it is not uncommon for antipsychotics to have side effects, so that those affected usually appear tired and fatigued. Dealing openly with the illness proves to be the best strategy for averting further symptoms at an early stage. As a rule, it cannot be generally predicted whether this will result in a positive course of the disease. The success of the treatment also depends strongly on the will of the patient. The further course of the disease depends very much on the exact cause, so that a general prognosis cannot usually be given. In most cases, however, the life expectancy of the affected person is not reduced by the disease.
What you can do yourself
Sufferers can do little to help themselves in everyday life, due to the lack of reflection of logorrhea, and thus find it difficult to improve their health themselves. They depend on the support of relatives as well as physicians or nurses. Lifestyle should be reviewed and optimized. Heavy consumption of caffeine or alcohol will aggravate existing symptoms. In everyday life, the intake of beverages such as cola, coffee or energy drinks can be avoided to alleviate the symptoms. The intake of alcohol should be completely refrained from. A review of regularly taken medications and their ingredients can also provide information about increased conspicuous behavior. The prescribed medication for the treatment of logorrhea should be followed according to the doctor’s instructions. Self-responsible decisions that involve interference with the treatment plan should be refrained from. It is important to have a good relationship of trust with the treating physician as well as therapist. Together, goals should be worked out in a treatment or therapy that can be actively worked on. The focus should be on improving the patient’s well-being and there should be a willingness to change. As soon as the patient of logorrhea loses control over his own behavior, relatives should be prepared to initiate compulsory admission due to their duty of care and for the protection of the affected person.
