Delusional Disorder

December 26, 2023

3 min read

Most of us have encountered delusion in some form or another in our lives. You may have even heard the term thrown around to describe someone who believes something untrue or out there.

A delusion is an unchanging fixed belief, meaning that evidence to the contrary will not dissolve the delusion. While you may think that there are many people who believe things that aren’t true, in the context of delusional disorder, the definition can be very serious and even dangerous.

Below, we’ll clarify the waters of delusional disorder, explaining what exactly it is, how it manifests, potential causes and risk factors, along with treatment options.

What is Delusional Disorder?

Delusional disorder, formerly known as paranoid disorder, is a psychotic disorder. People with this serious mental disorder have trouble differentiating reality from their imagination.

The main symptoms of delusional disorder are delusions. A delusion is a false belief or one that isn’t based on reality. Someone experiencing a delusion can’t be convinced that their belief is untrue in the same way that someone without delusional disorder can.

Delusions can be bizarre or not bizarre. Delusions that aren’t bizarre aren’t based on reality, but they could be realistic. For example, someone may think they’re being followed, spied on, or being deceived. These kinds of delusions could be everyday kind of things that could realistically happen or be happening and they are generally a result of mistaken experiences. Non-bizarre delusions may even have a kernel of truth, but be extremely exaggerated.

A bizarre delusion is something that would never happen in reality. Examples of bizarre delusions include believing themself or others are cloned or that they are like Truman Burbank in the movie “The Truman Show” where their reality is in fact a farce.

Diagnosis of Delusional Disorder

Delusional disorder is initially diagnosed when a person experiences at least one non-bizarre delusion that persists for a month or longer. The delusional thought cannot be explained by another physical, substance-induced, or mental health condition.

Symptoms of Delusional Disorder

Signs and symptoms of delusional disorder include:

Abnormally worried about the trustworthiness and loyalty of friends and family.
Believing benign remarks, actions, or events are sinister.
Reacting to perceived slights.
Having long-term grudges.
The feeling of being exploited.

People with delusional disorders may function relatively well in their daily lives and their delusions do not need to be bizarre. The delusions may only become obvious when they begin to create problems in their life. A relatively common delusion is the belief that a partner is being unfaithful when they are not and there’s no reason for them to believe so.

Causes

The causes of delusional disorder are not definitively known; however, there are some ideas as to how or why they develop.

Experts believe that delusional disorder develops in some cases from a preexisting paranoid personality disorder. Paranoid personality disorder and delusional disorder share some similar characteristics, like having an unwarranted lack of trust and suspicion for others.

Some studies suggest that this disorder develops as a way to cope with a history of trauma or extreme levels of stress.

Genetics could also be a factor in this disorder. People who have family members with schizotypal personality disorder or schizophrenia are more likely to develop delusional disorder.

Types of Delusional Disorder

Romantic: The belief that someone is in love with them.
Jealous: The belief that their partner is unfaithful.
Grandiose: The belief that they have some great knowledge, power, or talent.
Somatic: The belief that their body is very abnormal.
Thought broadcasting: The belief that others can perceive their thoughts.
Thought insertion: The belief that an external source is putting thoughts in their head.

Treatment

More research is needed to develop effective treatments. However, if you or someone you know may have delusional disorder, you should send them to a doctor for a diagnosis.

Currently, treatment includes psychological therapies like cognitive behavioral therapy (CBT) and antipsychotic medication.

General information, not medical advice

This article can't account for your health history or current treatment. Talk to a qualified clinician before you change anything about your care.

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