Delusion

A delusion is a false belief that is maintained despite overwhelming evidence to the contrary. Beliefs associated with religion or with widespread social norms within a particular culture are not considered delusions, and beliefs based upon incomplete or incorrect information also do not qualify as delusions.

Understanding Delusions

Delusions can include a wide variety of false beliefs, but they frequently involve elements of magic, conspiracy, or power. For example, a person might suffer from the delusion that the pope is trying to kill them, that fairies regularly steal their socks, or that they are the deposed leader of France.

There are four main types of delusions: bizarre, non-bizarre, mood-congruent, and mood-neutral. Bizarre delusions are those that are considered highly implausible or very odd. An example of a bizarre delusion would be the belief that aliens removed a person’s internal organs without leaving any marks or scars. Non-bizarre delusions, such as the belief that the President of the United States has contacted an individual to ask for their input about an important matter, may be possible but are still highly unlikely

Mood-congruent delusions are directly related to a person’s current mood. For example, a person with depression may believe everybody hates them, while an individual experiencing a period of mania may believe they are famous. Mood-neutral delusions, on the other hand, are not related to a person’s emotional state.

Within these broad categories, delusions typically fall under one of the following more specific categories:

• Persecutory delusions are beliefs centered around the idea that one is being targeted, persecuted, or harassed by another individual or group. An example of a persecutory delusion would be the belief that one is being spied on by the CIA.
• Referential delusions are beliefs that general stimuli are referencing a specific individual, such as the idea that a TV newscaster is sending secret messages directly to an individual through their newscast.
• Somatic delusions are preoccupied with physical experience, health, and organ function. An example of a somatic delusion is the belief that bugs have been planted under an individual’s skin.
• Religious delusions have a religious or spiritual theme, such as the belief that an individual was specifically chosen by a god for some great purpose. Religious beliefs considered within the norm for a particular religion or culture are not considered to be delusions, however.
• Delusions of control are beliefs that other people are capable of controlling one’s mind, thoughts, or actions.
• Grandiose delusions are beliefs that one has exceptional powers or abilities or is otherwise special in some way—an incarnation of a god, for example.
• Nihilistic delusions are centered around the idea that a major catastrophe will occur, or that something (the self, a body part, or the world) will be destroyed.
• An erotomanic delusion is a person’s conviction that another individual is in love with them.
• A Truman show delusion is rare, but it has been documented. This type of delusion is the belief that one’s life has been staged around a TV show (such as in the movie The Truman Show).

What Causes Delusions?

Schizophrenia, dementia, and some brain injuries can cause delusions. Chronic substance abuse may lead to both delusions and hallucinations. When there are no other symptoms, or when the cause of the delusion is unclear, a person may be diagnosed with a delusional disorder. To qualify for this diagnosis according to the DSM-IV, a person must not have a mood disorder and must not be experiencing hallucinations or flattened affect. While people with delusional disorders may not necessarily hallucinate, they may experience auditory or tactile stimulation related to the delusion.

Treatment for Delusions

Therapy and in some cases medications (including antipsychotic and antianxiety medications) can treat a diagnosed delusional disorder. However, treatment is difficult without the cooperation of the person experiencing the delusion, and some people with delusions can be quite adamant that their delusions are real.

Delusions and Culture

Mental health practitioners treating delusions must be extremely sensitive to cultural and religious context. Beliefs that might seem quite strange are often commonplace in certain societies. For example, the belief that a totem has magical powers or that a man died for the sins of all humanity may seem delusional to some individuals, but these are normal–and often normative–beliefs in some cultures. Improper treatment for beliefs that are not actual delusions can be harmful and unethical.

References:

1. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5^th ed.). Arlington, VA: American Psychiatric Publishing.
2. Colman, A. M. (2006). Oxford dictionary of psychology. New York, NY: Oxford University Press.
3. Delusion. (n.d.). Stanford encyclopedia of philosophy. Retrieved from http://plato.stanford.edu/entries/delusion
4. Four types of delusions and extensive list of themes. (2015, April 29.). Mental Health Daily. Retrieved from http://mentalhealthdaily.com/2015/04/29/types-of-delusions-extensive-list-of-themes

Last Updated: 11-30-2016