Delusions and its Types

Delusion is one of the three main symptoms of psychosis.

Delusion is a condition where a person has an unbreakable and unshakable belief in something completely untrue. There is plenty of evidence to prove otherwise, however, it is difficult for a person to get rid of his firmly held belief.

There are different types of delusions:

• Erotomaniac– People suffering from erotomania believe that another person, especially someone important or famous is in love with them. They might even try to contact the person in question and stalking is quite Facebook, Instagram profiles, watching interviews of them, etc is quite common. An example of this behavior would be a person getting too excited and believing that the object of the delusion is in love with him and secretly communicating via hand gestures or looking at him while performing or giving an interview.
• The patients are usually socially withdrawn, dependent, have poor occupational functioning capabilities.
• Grandiose– People having grandiose delusions believe and have an over-inflated sense if their own worth, prestige, money, fame and power in spite of lack of evidence. They might believe that they have some great talent which could perhaps save the world and the community and can be used for the greater good. For example, a person can believe that God has given him the great power of patience and endurance to heal and save the world.
• The delusion of Jealousy – People with this type of delusion believe that their spouses or sexual partners are unfaithful and are cheating on them. This makes the people hypervigilant and control-freaks. An example of this behavior would be the person believing and suspecting his partner that every time she uses the restroom or uses her mobile for a long time, she is texting her lover or chatting with him.
• Persecutory Delusion-People with persecutory delusions believe that they (or someone close) are being mistreated, followed, being spied on or someone is trying to harm them. There are several linked factors that most people with persecutory delusions go through-
• Worry and rumination– People who experience this type of delusion are generally those who over-think and over-worry. In this manner, they tend to exaggerate things. People who experience persecutory delusions tend to spend a lot of time worrying. Several studies have found that the rate of worry in people who experience persecutory delusions are similar to the rate of worry people with anxiety disorders.
• Negative thoughts– There was a study conducted in 2012, where 301 patients with psychosis were assessed three times over the course of a year. Researchers had found that negative thoughts about oneself were one of the reasons for the persistence of persecutory delusions. It was also found that those people who were overly critical of themselves suffered from persecutory delusions more. Self-love and compassion have proved to reduce these paranoid thoughts.
• Interpersonal Sensitivity-A study found that people with persecutory delusions tend to have a higher interpersonal sensitivity, meaning that they feel vulnerable and exposed in front of others due to the fear of criticism or rejection, and/or judgment. Individuals are also more likely to interpret neutral events as potentially dangerous.
• Jumping to conclusions– A  study found that people who experience persecutory delusions have a tendency to jump to conclusions. Hence, they are in the habit of making poor decisions, and most of the time are quite impulsive. For example, the person with persecutory delusion might think that a group of people laughing, are laughing at him. The study also found that these people had poor working memory and low IQ.
• Somatic delusions– Individuals having somatic delusions believe that they have a physical defect or a medical condition. Since people with delusions, do experience hallucinations as well, somatic delusions are quite similar to tactile hallucinations where one feels there are insects crawling all over one’s skin, or there is someone touching the person, or the person is touching something or someone, which in reality does not exist.
• Mixed delusions– When delusions do not fall under one category or when people have more than one type of delusions, people are said to have mixed delusions. Mental health professionals have come up with “unspecified” delusions- those that cannot be defined and determined quite clearly. For example- people with Capgras Syndrome or Imposter Syndrome believe that people they know or recognize have been replaced by an imposter. This is not be confused with Fregoli Syndrome where a person believes that familiar people, usually persecutors are changing their appearance constantly. This occurs due to traumatic brain injury.
• Cotard Syndrome- This is also called the Walking Corpse Syndrome where the person holds the false belief that he has lost his blood, internal organs, he is dead or putrefying. This is a rare mental condition and is commonly seen in patients with dementia or schizophrenia.
• Delusional disorder- People suffering from delusional disorder find it difficult to differentiate between imagination and reality. However, they do experience “non-bizarre” delusions that involve situations that can take place in real life for about a month or more. It was formally known as a paranoid disorder. For example- being followed, being conspired against, etc. Delusions generally involve misinterpretations of reality. In actuality, their so-called beliefs are either untrue or are highly exaggerated.

It is a bit challenging to point out whether a person had the delusional disorder as they can continue to socialize with others and function quite normally. Unlike individuals with schizophrenia, people diagnosed with delusional disorder may otherwise behave quite normally.

Hence, it is quite difficult to understand whether a person has delusional disorder or not, as there are no outward symptoms as such, apart from their usual false beliefs.  However, sometimes people get so preoccupied with their delusions and even experience hallucinations that their lives get disrupted.

Although delusions are or can be symptoms of more serious psychotic disorders like schizophrenia, the disorder itself is quite rare. Based on case registries and case series, an estimated 0.05-0.2% of people are affected by this disorder. It is more common in males. One may have symptoms from adolescents or late adulthood, but it generally occurs late in life.