Delusional disorder, previously known as the paranoid disorder, is a type of serious mental illness, also known as psychotic disorder. A person with the delusional disorder will not be able to differentiate between what’s real and what they are imagining.
As the name suggests, delusions are the major symptoms of this disorder. They are very strong beliefs in something that is not true or is nowhere close to reality. However, that does not mean that they are completely unreal.
Delusional disorder, previously called paranoid disorder, is a type of serious mental illness called a psychotic disorder. People who have it can’t tell what’s real from what is imagined. However, it does not mean that they are fully unrealistic. The delusional disorder involves a person having that are not bizarre, that could happen in real life, such as being poisoned, followed, conspired against, deceived or observed from a distance. They generally involve mistaken experiences or perceptions, which in reality, are either not true or are very much exaggerated.
To the contrary, a bizarre delusion is something that can never happen in reality, such as being abducted by aliens or having your thoughts play on the television or being cloned. A person who thinks such thoughts may be considered to be delusional with bizarre-type delusions.
Delusional people can often continue to function and socialize normally apart from when they have delusional episodes. They do not usually behave in a bizarre manner or prominently odd.
It is unlike people suffering from other psychotic disorders, who may also have delusions as one of the symptoms of their delusion. However, in some cases, delusional people can become preoccupied with their delusions which may disrupt their lives.
Even though delusions may be a symptom of other common conditions such as schizophrenia, delusional disorder is very rare. It often happens to a person in their middle to late life and is a bit more common in women than in men.
Types Of Delusions In Delusional Disorders
Delusional types are based entirely on the main theme of the delusion. Let’s take a closer look at each type here.
Delusion Of Grandeur/Grandiose
A person with this type has a very high sense of power, worth, identity or knowledge. They tend to believe that they have a great talent or have made an important discovery. For instance, they may believe that they are exceptionally talented, have a special relationship with an important or famous person or own extravagant riches.
Somatic Delusional Disorder
A person with this type believes that they have a medical problem or a physical defect. It often leads them to several consultations with doctors, surgeries, depression and suicide as well. Some people also tend to develop tactile hallucinations and get the sensation of parasites or insects crawling over their skin. This condition is called monosymptomatic hypochondriacal psychosis and is a part of somatic delusional disorder.
This person believes that their spouse or significant other(SO) is unfaithful. These doubts may not be found and can severely impair the relationship. The person generally tends to go to extreme lengths so as to find any evidence of their partner’s alleged affairs and may also hire a private detective for this task. Studies show that this condition is found more in men than in women. It is also known as pathological jealousy or morbid jealousy.
Erotomaniac Or Delusion Of Love
A person with this type believes that someone is in love with them and might try to contact them. It so happens that it is someone who is a famous personality or important to them. It can lead to stalking behaviour in them, jealousy and rage. This condition is always known as De Clerambault’s Syndrome.
This type of delusion is the most common form. A person with this type believes that they or someone who’s close to them is being mistreated, or someone is planning to harm them or spying on them. The person also fears that they are being staked, obstructed, poisoned, or spied upon. They tend to go to legal authority and make complaints. Further, they might also retaliate violently against the persecution.
A person of this type has two or more types of the aforementioned delusions.
Induced Delusional Disorder Or Folie a’ Deux
It is a rare form of delusion where two people who are in a close relationship are completely isolated from others both physically and culturally. The couple also shares the same delusional system. For example, persecution or grandeur disorder. One of the partners may be the dominant personality which influences the other into adopting the delusion. In such a case, the psychosis mainly affects the dominant person while the other person recovers quickly from all the delusions once they separate themselves from the dominant.
Symptoms Of Delusional Disorder
Some symptoms are very obvious while some are related to the delusion.
- The obvious ones are referred to as non-bizarre delusions.
- Angry, irritable or low mood
- Hallucinations (hearing, seeing, or feeling things that are not really there). For example, someone who believes they smell a bad odour or have an odour problem.
Causes And Risk Factors For Delusional Disorder
Just like other psychotic disorders, the exact cause of the delusional disorder is not known yet. However, researchers are looking at the role of biological, environmental, genetic, or psychological factors. Let’s take a closer look at each of these causes and how they might lead to delusional disorder.
Researchers are monitoring how delusional disorders may take place when a few parts of the brain are not normal. Abnormal brain regions which control thinking and perception may be associated with delusional symptoms.
Studies show that stress can trigger this disorder, along with alcohol and drug abuse. People who isolate themselves, such as people with poor sight and hearing or immigrants tend to be more likely to have this disorder.
The fact that delusional disorder is more common in people who have family members with delusional disorder or schizophrenia suggests there might be a genetic factor involved. Just like with other mental disorders, it is probable for a child to develop a delusional disorder that is present in their parents.
Diagnosis Of Delusional Disorder
If you are showing symptoms of delusional disorder, your doctor will most likely give you a physical exam and medical history. Although there are no lab tests as such to diagnose a delusional disorder, your doctor may use diagnostic tests, such as to rule out physical illness, imaging studies or blood tests as the cause of symptoms. They include:
- Alzheimer’s disease
- Obsessive-compulsive disorder (OCD)
- Other schizophrenia spectrum disorders
In case the doctor does not find any physical reason for the symptoms, they may refer you to a psychologist or a psychiatrist, health care professionals who are trained to diagnose and treat mental conditions. They will take help of interview and assessment tools to examine you for any psychotic disorder.
The therapist will base the diagnosis on the person’s symptoms and their observations as to how the person behaves along with their attitude. Thereafter, they will conclude if the symptoms lead to a disorder.
Diagnosis of delusional disorder is made when the doctor observes the following:
- The person has one or more delusions which last a month or more.
- The person has never before been diagnosed with schizophrenia. And, if they have any hallucinations, they are related to what they are hallucinating.
- Their life, in general, is not affected apart from the delusions and its effects. Other behaviour is not bizarre or odd.
- Major or manic depressive episodes, it happened, have been for a short while when compared with the delusions.
- They do not have a mental disorder, medical condition, or medication to blame.
Complications Of Delusional Disorder
A person with delusional disorder may become depressed, mostly as a result of the difficulties they face that are linked with delusions.
Acting on the delusions can lead the person to become violent or get into legal problems. For example, a person with erotomanic delusion stalks the object of delusion which can get them arrested.
Further, people with this disorder tend to alienate themselves from other people, particularly if their delusions hinder their relationships.
Outlook For People With Delusional Disorder
The outlook usually varies depending on the person, their circumstances, type of delusional disorder. Further, a person who supports them or if they have the willingness to stick with the treatment.
Delusional disorder is essentially a chronic or ongoing condition, but when treated properly, a lot of people will start to find relief from their symptoms. While some people recover completely, others have a short period of intense activity of delusional belief with episodes or periods of remission.
Unfortunately, a lot of people with the delusional disorder do not seek help. It is difficult for a person with a mental disorder to realize that they are not well or healthy. Else, they may consider their symptoms to be a cause of the environment or their surroundings. They might also be very embarrassed or afraid to ask for help and get treatment.
Without proper treatment, a person could suffer from the condition throughout their entire life.
Treatment Of Delusional Disorder
The treatment for this condition mainly involves medication and psychotherapy. Psychotherapy is a form of counselling. However, the condition is very resistant to treatment with only medication. People whose symptoms are severe or are at risk of hurting others or themselves may require to be in the hospital until their condition is stabilized.
Psychotherapy is the basic treatment for delusional disorder. It ensures a safe environment for the patient to discuss and talk about what they are facing (symptoms). Further, it encourages healthy and better functional behaviours and attitudes.
A lot of psychosocial treatments prove to be helpful with psychological and behavioural problems linked with delusional disorder. Through therapy, the patient will be able to learn to control their symptoms, figure out warning signs of relapse, and also develop a relapse prevention plan. These treatments include:
- Individual psychotherapy helps the person in recognizing and correcting the underlying thinking of theirs, which has become distorted.
- Cognitive-Behavioural Therapy (CBT) helps the patient learn to recognize and change their thought patterns and behaviours, which result in troublesome feelings.
- Family therapy can help the patient and their family deal with the patient more effectively. Also, it enables them to contribute to the patient’s betterment.
- The primary medications that are utilized to treat the delusional disorder are known as antipsychotics.
- Traditional antipsychotics, that are also known as neuroleptics have been used to treat mental disorders since the late 1950s. These medicines block dopamine receptors in the parson’s brain. Dopamine is a neurotransmitter believed to add to the development of delusions.
- Newer medications are called atypical antipsychotic drugs and appear to be effective in treating the symptoms of delusional disorder. They block serotonin and dopamine receptors in the brain. Serotonin is another neurotransmitter believed to be involved in delusional disorder.
- Other medications that may be used include antidepressants and tranquillizers. Antidepressants may be used to cure depression, which is a common symptom in people with delusional disorder. Tranquilisers may be used if the person has an extreme level of anxiety or sleeping problems.
Prevention Of Delusional Disorder
There is no way to stop the delusional disorder from occurring. However, early diagnosis and treatment can help in decreasing the complications in the patient’s life, their family and friends.
Delusional disorder is a chronic condition. If anyone close to you seems a bit off than usual or are going through any mental challenges, you should help them address it and get the right treatment. Given the current scenario, not many are aware of this condition and tend to ignore seeking help as a result. But it is important to keep a tap on the symptoms and reach out for help whenever needed.
If it is not taken seriously, delusion can cause the victim to act anti-social and result in doing violent and illegal actions because of their delusions. Keeping them