Why am I having speech problems?
January 5, 2010 11:12 AM   Subscribe

I seem to be having some speech/language problems. What could be causing them, and should I be concerned?

I know YANAD but I thought this might be worth a try.

For the last 6 months or so, I've noticed that I'm having more trouble talking. Occasionally a word or sentence will come out garbled/slurred unclear, I have more trouble finding the right word, and sometimes I end up saying a wrong similar word instead of the right one. For example, yesterday I remember saying 'wall' instead of 'edge' for no apparent reason, and I was recently on the phone with my friend and about 5 or 6 times I had trouble summoning up the right word.

This can't be chalked up to aging - I'm only 20, and should be in my prime. I'm a native English speaker. I've never had any language problems or learning disabilities. My reading, writing, and listening skills are the same as always. I don't have any health problems except for mild IBS and a possible case of depression.

What could be the cause of this and should I be worried? I keep wondering if it's really all that severe or if I'm just exaggerating something. One possible cause which worries me is Olney's Lesions, a potential form of brain damage caused by dissociative drug use. I've done DXM (a couple times in high school) and nitrous oxide (frequently in the past year) before, both dissociatives. Now I'm starting to panic that I have brain damage.

I'm really uncomfortable going to the doctor at any rate, and a potential massive rant about the consequences of drug use hardly encourages me. Any advice is appreciated.
posted by anonymous to Health & Fitness (22 answers total) 2 users marked this as a favorite
The best neurologist in the world isn't going to give you a real diagnosis over the internet, so whether you like visiting doctors or not that's the only way you're going to get an actual answer to this question.
posted by GuyZero at 11:19 AM on January 5, 2010

This could be nothing, or it could be a serious brain injury/illness. I understand that going to the doctor can be uncomfortable, but you really, really need to see a doctor, and you need to be honest about your medical history, including drugs. I promise, your doctor has heard way weirder things than using cough medicine to get high. But try to avoid freaking out about possible worst case scenarios until you've been checked out. Good luck!
posted by decathecting at 11:21 AM on January 5, 2010 [1 favorite]

Whether or not this is something serious, it will be best to find out sooner than later by seeing a doctor. Either you spend time worrying about something that's nothing, or you wait too long to address something that could be remedied/treated. Usually speech issues are associated with the brain, and I think that you are right to be thinking about going to see a doctor. Ditto to what decathecting said about disclosing full medical history, it could make a huge difference in diagnosis and treatment. I hope everything turns out well.
posted by bright knight at 11:40 AM on January 5, 2010 [1 favorite]

Well no one can diagnose this kind of issue over the internet, and I'm certainly not qualified to do such a thing. But,

For the last 6 months or so, I've noticed that I'm having more trouble talking. Occasionally a word or sentence will come out garbled/slurred unclear, I have more trouble finding the right word, and sometimes I end up saying a wrong similar word instead of the right one. For example, yesterday I remember saying 'wall' instead of 'edge' for no apparent reason, and I was recently on the phone with my friend and about 5 or 6 times I had trouble summoning up the right word.

Both of these are garden variety speech errors commonly made by fluent native speakers of any age. If they are happening more than normal that is certainly a cause for concern. But it is typically not easy for people to judge how often they (or others) make speech errors because part of our language processing faculty involves basically filtering them out. Furthermore, like most self-diagnosis, there is a significant issue of confirmation bias -- if you start noticing them and get worried, this will cause you to pay more attention when you do make errors that you notice, but not notice all the times you don't. So you should probably still get this checked out, but realize that the best-case scenario is that you are completely normal.
posted by advil at 11:45 AM on January 5, 2010

My guess is that you don't have a brain tumor, but what do I know?

I agree with advil (eponysterical!) this is a pretty normal thing. It happens to me more often when I'm stressed out and/or not getting enough sleep and/or had too much coffee. Are you getting a full 8 hours? Do you lose your words more often in the evening, or first thing in the morning?

I can't for the life of me speak coherently for the first or last hour of the day. And frankly, things are touch and go for the entire second half of Fridays.

Between now and when you see a neurologist, start keeping track of these incidents. Correlate them with what's going on in your life at the time. I'm betting you'll find a consistency.
posted by ErikaB at 11:53 AM on January 5, 2010

Are you sleep-deprived?
posted by mai at 11:54 AM on January 5, 2010

If it's any consolation, my friend and I (both 20, no drug use, in good health etc.) recently discovered that we've both started having your problem in the last year or so. I'll start to speak and the words will come out in the wrong order and I'll have to start over. Sometimes it'll take me a few tries to say a word. Generally, we both complained of feeling less eloquent.

Obviously this is anecdotal and you should probably talk to a doctor if it's a problem every time you talk or every day or whatever, but with my friend and I, I think it's simply that we don't normally have problems speaking so we notice our (relatively rare) mistakes more. Or perhaps we all three coincidentally have the same brain disorder.
posted by MadamM at 11:57 AM on January 5, 2010

Oh yeah, I meant to mention that we've both been more sleep deprived and stressed over the period we've been having the problem than at more or less any other time in our lives.
posted by MadamM at 11:58 AM on January 5, 2010

I will join the chorus saying you should go see a doctor.

I wanted to add that I have shared many an embarassing thing with various doctors, including risky/stupid/possibly illegal behavior and have never been subject to a rant. In my experience doctors have a)heard things that will curl your hair and b)have good poker faces. In the main, they know that if they get all judgey/ranty it will just get in the way of treating you. (Of course, there are judgey/ranty doctors, because doctors are humans and humans come with a wide range of types...)

So go, be as honest as possible and don't worry about rants. If you don't have good chemistry with one particular doctor, definitely find one who works for you.
posted by agatha_magatha at 11:59 AM on January 5, 2010

What GuyZero said. There's no way to detect brain issues aside from imaging. (head CT, etc.) You can try asking people who aren't doctors, but we can't look inside your skull.
posted by Citrus at 12:03 PM on January 5, 2010

If you're using nitrous frequently, you're probably doing it in a party setting? Meaning, you're likely also drinking and staying up late, and all the other fun things that will disrupt one's sleep schedule and make one spacey. Try easing up on the partying for a bit, and see if you don't feel better - you may just be overdoing it.
posted by 5_13_23_42_69_666 at 12:04 PM on January 5, 2010

Much like Madam M, I'm 20, have never used drugs, native English speaker, etc and notice the same thing happens occasionally- a lot more when I'm distracted or tired. I've always chalked it up to my brain moving faster than I can talk. I often find myself thinking a few steps ahead of what I'm saying, which leads to the wrong word or completely incoherent sentences while my mouth tries to catch up with my brain. IMO, you should probably see a doctor anyways (because I don't think a group of internet strangers will be nearly the assurance you need if you think you have brain damage) but as long as it's not happening often, it seems to be pretty normal.
posted by kro at 12:07 PM on January 5, 2010

I've had a similar speech problem my entire life. When I was in elementary school, they put me in speech therapy for a year thinking it would solve the problem, but like everyone else is saying -- I'm fairly certain it has to do with the fact that the words I'm about to say are visibly scrolling through my mind and I trip over them quite frequently.

It's incredibly frustrating in and of itself, and makes you look like an idiot.. but coupled with anxiety and tension, it's completely pointless to talk at all.

Are you under more stress lately?
posted by june made him a gemini at 12:41 PM on January 5, 2010

According to the Erowid article on Olney's lesions:
"If you feel you are impaired, STOP USING NOW, and stay clean for several months before you get worried. Many people have told me that their "brain damage" cleared up after a few months."

It's probably still a good idea to see a doctor - but your problem might clear up if you lay off the drugs for a while (or, preferably, permanently).

By the way, according to the article, it seems that it's still pretty contested whether humans can get Olney's Lesions. I wouldn't jump to that as the cause of your problems.
posted by vanitas at 1:05 PM on January 5, 2010

Look, it might be nothing. It might be something as simple as getting more sleep and relaxation. Or it could be something SCARY. Just go to the doctor. You'd be surprised how understanding some of them are.
posted by christinetheslp at 1:53 PM on January 5, 2010

I frequently pull up the wrong word in speech, but I've always been that way and it's just the way my brain processes things (a bit too flexibly associative).
But a recent, sudden change in speech patterns can be a symptom of a host of problems ranging from fatigue to brain damage/illness. See a doctor. Be honest. Better to be sure.
posted by Billegible at 2:00 PM on January 5, 2010

Depression can also do this. I speak from experience. Medication put an end to it.
posted by spicynuts at 2:02 PM on January 5, 2010

For what it's worth, as far as I know brain damage from DXM occurs after "heavy, repeated use". That doesn't sound like what you've done...but more like I've done (and I am [relatively] fine).
posted by lhude sing cuccu at 2:06 PM on January 5, 2010

Unless you were eating a whole boxed of Coricidin or chugging a gallon of Robitussin for those couple of times, AFAIK the lesions are unlikely.

Seconding that this can come from the anxiety associated with depression.

(Way too much) Experience on both of these.
posted by cmoj at 2:10 PM on January 5, 2010

Look at my posting history. I'm fine now.

It is overwhelmingly likely that your perceived problems are nothing more then a vicious cycle of confirmation bias and anxiety - when you get anxious, you get tongue tied, which makes you more anxious. Throw in sleep disturbance, alcohol, or just run of the mill paraphasic errors everyone makes and you've got plenty to prime the pump.

Go see a neurologist. Believe them if they tell you you're fine. Don't google "symptoms" - you'll just find new things to obsess about (like, oh, I don't know... epilepsy? schizophrenia? multiple sclerosis? spongiform encephalitis? You'll just start picking out things with nonspecific and hard to verify symptoms). Maybe check out a forum for anxiety sufferers.
posted by elektrotechnicus at 2:20 PM on January 5, 2010

This is a common symptom of hypothyroidism, getting your T4 and T3 levels checked would be a good idea. Thyroid problems commonly appear in your early 20's so it fits. (Many times people only have one or two of the symptoms listed.) It's a simple blood test, talk to your doctor.
posted by stoneweaver at 2:56 PM on January 5, 2010


I get this a lot, and I'm only 26. I find it's worse with stress, or around when I'm having migraine issues. I recently saw a neurologist about migraines and ocular migraines and (since I now have health insurance) got an MRI and everything was fine. Of course, my brain is not yours, but even as a self-admitted hypochondriac, I imagine you are fine.

If you don't have insurance for an MRI, a neurologist clinical appointment can do some general physical tests to test your reactions, etc, because if it IS a serious problem, 99% guarantee that other symptoms would present along with it. Things like tingling or numbness, loss of balance, coordination issues, etc etc etc. Those things would be easily picked up on by a neurologist.
posted by CTORourke at 4:52 PM on January 5, 2010

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