The Definition of Delusion

Identifying, treating, and coping with delusions

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In This Article

Delusions are defined as beliefs that conflict with reality. Despite contrary evidence, individuals with delusions can’t let go of their convictions. Delusions are often reinforced by the misinterpretation of events.

Most delusions involve some level of paranoia. For example, someone might contend that the government is controlling our every move via radio waves.

Causes

Researchers aren’t exactly sure what causes some individuals to develop delusions. It appears a variety of genetic, biological, psychological, and environmental factors are at play.

Psychotic disorders seem to run in families, so researchers suspect there is a genetic component to delusions. Children born to a parent with schizophrenia, for example, may be at a higher risk of developing delusions.

Abnormalities in the brain may also play a role. An imbalance of neurotransmitters (chemical messengers in the brain) may increase the likelihood that an individual will develop delusions.

Trauma and stress may also trigger delusions. Individuals who tend to be isolated appear more vulnerable to developing delusional disorder as well.

Associated Conditions

Delusions are often part of psychotic disorders. They may occur along with hallucinations. Hallucinations involve perceiving something that isn’t really there, like hearing voices or feeling bugs crawling on your skin.

Delusions may be symptoms of mental health problems or brain disorders. The following are some conditions that may involve delusions.

  • Delusional Disorder. Individuals with delusional disorder experience delusions without any hallucinations. They also don’t exhibit any significant mood symptoms or markedly impaired functioning. With an estimated .2 percent of the population meeting the criteria, it’s considered a rare mental illness.
  • Brief Psychotic Disorder. Individuals with a brief psychotic disorder experience hallucinations, delusions, or disorganized speech. Their symptoms persist for one month or less.
  • Schizophrenia. Schizophrenia involves “positive symptoms,” such as hallucinations or delusions. It also involves “negative symptoms,” such as flat affects, reduced feelings of pleasure in everyday life, difficulty beginning and sustaining activities, and reduced speaking.
  • Schizophreniform Disorder. Individuals with schizophreniform disorder experience similar symptoms to schizophrenia for less than six months.
  • Schizoaffective Disorder. Schizoaffective disorder involves symptoms of schizophrenia as well as a mood issue, like depression or mania.
  • Delusional Symptoms in Partner of Individual With Delusional Disorder. Sometimes, people share delusions. This is most common in individuals who reside together and have little contact with the outside world.
  • Substance/Medication-Induced Psychotic Disorder. Drug or alcohol intoxication or withdrawal may cause some individuals to experience delusions. Symptoms are usually brief and tend to resolve once the drug is cleared. Psychosis triggered by amphetamines, cocaine, or PCP may persist for weeks.
  • Mood disorders. Sometimes, individuals with depression or bipolar disorder may experience delusions.
  • Postpartum psychosis. Hormonal shifts after giving birth may trigger postpartum psychosis in some women. Some research indicates it is linked to bipolar disorder.
  • Dementia. Roughly one-third of individuals with dementia experience delusions. Often, the delusions involve paranoia, such as thinking family members or caretakers are stealing from them.
  • Parkinson’s Disease. Approximately 50 percent of individuals with Parkinson’s Disease experience hallucinations and delusions.

Types of Delusions

Delusions usually involve a specific theme.

Erotomanic

In this type of delusion, an individual believes that a person (usually of higher social standing) is in love with him or her. An example of this would be a man who believes an actress loves him and thinks she’s communicating with him via secret signal hand gestures in her TV show.

Grandiose

In grandiose delusions, an individual believes he or she has great talent, fame, wealth, or power despite the lack of evidence. An instance of this would be a woman who believes a god gave her the power to save the universe and every day she completes certain tasks that will help the planet continue on.

Persecutory

An individual with persecutory delusions believes he or she is being spied on, drugged, followed, slandered, cheated on, or somehow mistreated. For instance, a woman who believes her boss is drugging the employees by adding a substance to the water cooler has persecutory delusions. She thinks the drug makes people work harder. 

Jealous

An individual might believe his or her partner is unfaithful. For instance, a man believes his partner is meeting her lover every time she uses the restroom in public settings—he also thinks she is sending her lover secret messages through other people (like the cashier in a grocery store).

Somatic

An individual believes that he or she is experiencing physical sensations or bodily dysfunctions under the skin, or is suffering from a general medical condition or defect. For instance, a man believes there are parasites living inside his body.

Mixed or Unspecified

When delusions don’t fall into a single category and no single theme dominates, the delusions are considered “mixed.”

If an individual’s delusions don’t fall into a specific category or the delusion type can’t be clearly determined, mental health professionals may refer to them as “unspecified.”

Coping and Treatment

It’s important for anyone experiencing delusions to seek professional help. Usually, the individual experiencing a delusion, however, doesn’t see her or his belief as a problem (since by definition, the person experiencing delusions believes the delusion to be fact). Usually, concerned loved ones must bring the issue to the attention of a healthcare professional.

In some cases, psychiatric hospitalization is required to help a person with delusions to become stabilized. Hospital admission may be necessary if an individual becomes a danger to himself/herself or someone else.

Treatment for delusions often includes a combination of medication and therapy. Medications may include:

  • anti-psychotics—used to block dopamine receptors in the brain (Dopamine is a neurotransmitter that is believed to be involved in the development of delusions.)
  • atypical antipsychotics—used to block dopamine and serotonin receptors in the brain (Atypical antipsychotics are often used when an individual has delusional disorder.)
  • tranquilizers—may be used to address anxiety, agitation, or sleep issues
  • antidepressants—may be used to treat depression if someone with a delusion is experiencing a mood issue

Therapy

Therapy may include cognitive-behavioral therapy. It can help an individual learn to recognize and change unhelpful thoughts and behaviors. Family therapy is often part of treatment as well. Family members may learn how to support someone who is experiencing delusions and may learn strategies for helping that individual live their best life.

Managing the environment can help someone with delusions. If someone believes the government is spying on them through the TV, it may be best for that individual to avoid watching television. Or, if someone believes he’s being followed when he goes into the community alone, it may be best to have someone go with him.

There is some research that suggests certain supplements may help reduce delusions. Some studies have found omega-3 fatty acids to be helpful in reducing the symptoms of psychosis. Other studies have found B vitamins to show promise in reducing psychosis.

Before starting any type of alternative treatment, speak with a physician about the potential risks, side effects, and medication interactions.

A Word From Verywell

Most disorders that involve delusions aren’t curable, but they are treatable. Some individuals with delusions are able to live healthy, productive lives with few symptoms. Others struggle to work, maintain healthy relationships, and undergo activities of daily living. It is best to speak with a healthcare professional about your delusions, or, if you have a loved one experiencing them, to do your best to work with a healthcare professional to provide your loved one with help.

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Article Sources

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  • Bürgy M. Study of Delusional Depression: Drive, Dynamics, Therapy. Neurology, Psychiatry and Brain Research. 2018;30:117-124. DOI: 10.1016/j.npbr.2018.08.003

  • Hoenders HJR, Bartels-Velthuis AA, Vollbehr NK, Bruggeman R, Knegtering H, de Jong JTVM. Natural Medicines for Psychotic Disorders: A Systematic Review. J Nerv Ment Dis. 2018;206(2):81-101. DOI: 10.1097/NMD.0000000000000782