As a veteran, have you ever found yourself drifting off-topic or using too many words to describe a situation? Have friends or family mentioned you spend a long time getting to the point? If yes, you might be experiencing circumlocutory speech, a unique but common speech-based disorder that often appears in combat veterans.
According to the U.S Bureau of Labor Statistics, 25% of veterans leave service with a service-connected disability. For 9/11 veterans, this number skyrockets to 40%. A third of veterans had a rating above 30%, and 41% had a rating of 60% or higher. If you’re experiencing symptoms of disorganized speech or thought, you are not alone. It's frustrating to spend years serving your country, only to return home and find yourself unable to communicate like you previously could.
However, it's essential to recognize circumlocutory speech is diagnosable and treatable. Symptoms can cause subsequent anxiety, trauma, or depression. Circumlocutory speech will affect your VA rating as it is a symptom that speaks to the severity of your service-connected mental health condition.
What Is Circumlocutory Speech?
Circumlocutory speech is a “language disorder where the patient refers to an object, event, or person, describing its characteristics instead of using its name,” says WebMD. More informally, circumlocutory speech is when a person takes a while to “get to the point” or uses excessive wording to illustrate a thought.
Often considered similar to stereotyped or circumstantial speech, circumlocutory speech could be a speech-based marker for a larger issue such as PTSD. It could also be a symptom of a more formal thought disorder such as schizophrenia or a mood disorder, and it can also lead to other issues such as social anxiety.
Symptoms of Circumlocutory Speech
Symptoms might include sharing irrelevant details, unnecessarily long descriptions, or telling tangential stories unrelated to the subject. You might find yourself drifting off-topic or having friends and family frustrated that your stories take a long time to tell. You might overexplain a situation with extraneous details or never finish your thoughts on a topic. As a disabled veteran, you might be annoyed at your inability to tell a straightforward story like you once could.
This non-linear thought pattern might frustrate or embarrass you, causing you to not participate in social activities or prevent you from engaging appropriately at work. For many disabled veterans with circumlocutory speech, it might significantly affect everyday life, work, family, and social activities.
Causes of Circumlocutory Speech
What exactly causes this speech-based disorder? If you find yourself often losing the topic of a conversation, you might be wondering why this is occurring. For some, this type of disorganized thinking can be caused by a traumatic brain injury, another underlying mental health condition, or times of extreme stress and anxiety. Often linked to irregular brain processing in the cerebellum, disabled veterans with circumlocutory speech might display dysfunction in the cerebellum's circuitry during an MRI, often linked to irregular brain processing in the cerebellum.
Common treatments are behavioral modification, anticonvulsants, antidepressants, and anxiolytics. Group or individual therapy can help as well as lifestyle changes. Cognitive-behavioral therapy (CBT) could help you identify disorganized thinking patterns and return your speech to its normal course.
Circumlocutory Speech and the VA Rating Code
Regulated by the Department of Veterans Affairs, the VA rating code helps determine the level of compensation for service-connected disabilities. The VA bases a rating on the severity of your symptoms, and many specific service-connected health conditions have their own rating system. The VA rating code for mental health disorders gives a number from 0, 10, 30, 50, 70, or 100 under the VA’s General Rating Formula for Mental Disorders, and disabled veterans fall at all extremes of the scale.
In 2022, mental health conditions face possible regulatory changes from the VA that would “use new evaluation criteria to more accurately capture the different domains of impairment caused by mental disabilities and provide more adequate compensation for financial losses experienced by veterans with service-connected mental disorders.”
In the case of circumlocutory speech, a rating might be assessed on how severely it impacts your life. Does illogical speech affect your ability to gain or keep employment? Does circumlocutory speech reduce your ability to socialize and enjoy life? A VA rating code would assess how your symptoms and condition affect your daily living and quality of life.
If you’re wondering what rating code symptoms of circumlocutory speech might receive, a common rating is 50%. With a 50% mental health rating, you’re not completely incapacitated, but your condition affects your everyday life. Economic situations play into a 50% rating as this discombobulated speech might affect your ability to work and generate income. Disorganized thinking might lead you not to engage at work, get promoted, or interact with colleagues like you normally would. You're entitled to monthly compensation to make up for the impact this service-connected disorder has on your life.
When working through a C&P exam or compensation and pension exam, nothing is more frustrating than having a doctor not recognize your unique situation. Ensure that you’re not undermining the mental or emotional pain circumlocutory speech takes on your everyday life, and don’t be embarrassed to share specific examples of this occurring. Keep track of symptoms or examples, and be prepared to use anecdotes from friends and family on how circumlocutory speech has changed you. Be honest about the frequency of your symptoms without over-exaggerating them.