5. Fluctuating Symptoms: The Shape-Shifting Nature of Delirium
Perhaps one of the most puzzling facets of delirium is its fluctuating symptoms. One moment, clarity; the next, confusion reigns. It’s like watching a performance where the actor switches roles mid-scene without warning. These shifts are both fascinating and confounding.
Fluctuating symptoms are not arbitrary; they often follow a pattern. It’s been observed that symptoms may peak during late afternoon and evening, a phenomenon sometimes referred to as “sundowning.” This circadian element adds yet another layer of complexity to both diagnosis and management.
Then there’s the role of fatigue. Cognitive resources are like a battery that drains over the course of a day. For someone with delirium, the reserve is already low, making them more susceptible to fluctuations as the day wears on. The “battery theory” is just one of the many hypotheses that try to explain this phenomenon. (5)
