What comes to the mind of everyone thinking of someone who is delusional? Do we think of someone who has hallucinations or believes that they are the incarnation of a religious deity? While there are certainly cases out there in which individuals experience these symptoms, delusional disorder (DD) is far more different and complex than we might think. In fact, DD is divided into six categories, all of which center upon the experiencing of delusions.
So, what are these different categories, and how can one get a diagnosis? Let’s first take a deeper look at what delusional disorder is and what it might look like for different people.
Delusional Disorder Treatment Options
The good news is that treatment options are available and can be effective for those seeking help with delusional disorder. A licensed psychologist, psychiatrist, or counselor can run diagnostics and offer various treatment options. Treatments usually include therapy and medication in tandem.
- Antipsychotic medications have been shown to at least partially help those with delusional disorder.
- The most common forms of therapy for DD are individual psychotherapy, Cognitive Behavioral Therapy (CBT), and family therapy.
- Although DD is usually a chronic issue, therapy might not be long-term, depending on how the individual progresses.
About Delusional Disorder
Delusional disorder was once paranoid disorder. Paranoid disorder is now paranoid personality disorder and, along with schizophrenia, it is not part of a DD diagnosis. Specialists still see it as a type of psychosis in which a person experiences strong and unshakable perceptions that are not true to their external reality. However, the delusions they experience are situations that could occur in real life. These situations tend to go through extreme exaggeration or high misinterpretation.
Many with delusional disorder are able to socialize with others when they are not experiencing delusions. Also, they often come across as being relatively non-eccentric or bizarre in terms of behavior. Delusional disorder can, however, become disruptive and take away from the person’s quality-of-life. DD can represent one of the following six categories, each with their own unique set of symptoms.
Symptoms of Delusional Disorder
The two common, overarching symptoms are a persistently low mood (characterized by anger and/or depression) and non-bizarre hallucinations that resemble to the delusion they hold. Delusions must occur for a paranoid personality disorder without co-occurring psychotic symptoms. Delusional disorder can be differentiated. So, we need to look at symptoms within the confines of each of these categories. These categories and their symptoms are as follows:
- Erotomantic: When someone believes that another person (including someone they don’t personally know, such as an actor or actress) is in love with them. This can lead to attempts to contact the object of affection, and stalking can become the result of this type of delusion.
- Grandiose: Having an elevated sense of self-worth, talent, identity, power, or knowledge.
- Jealous: In this category, the delusions revolve around jealousy, especially regarding a significant other. The person with DD might believe that their partner is trying to hide an affair from them.
- Persecutory: Those with this type of delusion tend to think that they are being victimized, spied on, or that someone is plotting to harm them. They tend to make frequent legal complaints to authorities and will sometimes pin the blame on someone they know.
- Somatic: Those with somatic DD tend to believe that they have a serious physical health problem that requires medical attention. They will make frequent calls and appointments with their doctors but present with none of the physical issues that they report.
- Mixed: Some individuals with delusional disorder present symptoms from at least two of the above categories.
Causes of Delusional Disorder
As of right now, we do not know the exact cause(s) of delusional disorder. However, it is a general belief that genetics, biological factors, and psychological/environmental factors can all contribute to the presence of DD.
In terms of genetics, those with family histories of DD or schizophrenia are that much more likely to have DD, suggesting a genetic factor. In fact, recent studies suggest that schizophrenia and delusions could link to paranoid personality disorder due to the presence of paranoid personality disorder.
Biologically, scientists are still studying how brain abnormalities might cause delusions. As for psychological/environmental factors, substance abuse and stress are two potential triggers for DD. Those with diminished sight and/or hearing, as well as immigrants, seem to be more at-risk for DD. Additionally, the elderly and prison inmates tend to have elevated populations of those with DD.
Other Issues Related to Delusional Disorder
Delusional disorder is difficult to treat. This is because, oftentimes, the person with DD does not believe that anything is wrong with them, even when they are not experiencing their delusions.
This means that there are likely many individuals who have not sought treatment for DD. So we cannot only guess at how widespread DD might be.
Delusional Disorder in Popular Media
One of the eeriest (albeit Hollywood-ized) examples of a type of delusional disorder is in Stephen King’s novel-to-film, Misery. In the story, a famous author named Paul Sheldon gets into an accident while driving during a blizzard. He ends up in the home of a woman whose name is Annie Wilkes. At first, she appears to take care of the bed-ridden author.
However, as time goes on, Sheldon finds that Annie is holding him hostage and forces him to finish a manuscript he is working on. Annie says that she is his number one fan and that she loves him. She has a particularly unhealthy obsession with Sheldon’s romance novels and seems to believe in their reality.
Annie Wilkes is an extreme case. But every case of delusional disorder is different. Although, unfortunately, those like Annie who believe there is nothing the matter will not seek help.
If someone we love are experiencing symptoms of delusional disorder, we should know that there is no shame in reaching out for help. Our reality shouldn’t have to be debilitating and a struggle that we face entirely on our own can be successful for us.