Understanding delusional disorder, false and impossible beliefs

Delusional disorder is a psychosis whereby irrational, false beliefs persist.  Typically these over-the-top thoughts are related to grandiose, jealous, somatic, erotomaniac or persecutory behaviour. An example would be the ongoing belief that one is being followed or surveilled, despite a lack of evidence and no real reason to have the suspicion. Living with delusional disorder can considerably complicate a person’s ability to maintain a happy life and harmonious relationships with their peers.

While an exact cause of delusional disorder is unknown, medical researchers narrow the most consistent causes to genetic as well as environmental and psychological factors. While the latter is usually drug or alcohol abuse, genetic factors are substantiated by a pattern of delusional disorders commonly found occurring among family members. This suggests that genes are involved, and it is also supported by the fact that the majority of mental disorders are passed on from parents to children (the tendency toward mental illness is generally passed).

Paranoid individual concerned others watching him
A paranoid individual, fearful of  constant surveillance

Dealing with mental illness in friends and relatives is complicated and emotional. All too often the conditions seem to emerge without warning. One of the best ways to support and prepare for a neurological decline in our loved ones is through thorough research on disorders in the family. It’s best to extensively study the causes, symptoms and available treatments for the disorders themselves. Writing disabilities or psychological disorders related to anxiety, for example,  are discussed frequently in the mainstream, but delusional disorders?  Not so much.  This, in turn, makes it harder to research and ultimately prepare for.

Types of Delusional Disorder & Their Symptoms

For the purposes of study, treatment and analysis, delusional disorder has been categorized into several subtypes. It’s worth noting that some individuals can exhibit two or more different subtypes simultaneously throughout their daily lives. Below is a brief list of the different kinds of delusions, in no particular order.

  • Erotomanic Delusional Disorder involves the belief that a person is in love with the individual suffering the delusion. This can be triggered by a misinterpretation of an everyday interaction. Quite often, it can lead to stalking, unwanted contact or other illegal behavior.
  •  Persecutory Delusional Disorder involves the irrational belief that the individual is being plotted against, continually maligned in secret or generally mistreated by their peers. People suffering this particular delusion often repeatedly file lawsuits or complaints to the authorities for their imagined persecution.Self Importance personality disorder icon
  • Grandiose Delusional Disorder involves a sense of intellect, power or social standing disproportionate to the individual’s actual accomplishments. Typically it results in socially unproductive behaviors such as condescension or racism. Common cases involve individuals convinced they’ve made an important discovery, or have a unique talent deeming them irreplaceable to society.
  •  Somatic Delusional Disorder involves a persistent preoccupation with the individual’s own bodily functions or physical attributes. People with this delusion are typically convinced they are suffering an undetectable physical malady such as parasitism, or are the only ones noticing a deformity in their bodies for some reason. This usually results in their repeatedly setting appointments with medical professionals for general check-ups, and a degree of frustration at being given a clean bill of health.
  •  Jealous Delusional Disorder involves the belief that

the individual’s spouse or significant other is unfaithful. This is usually based on spurious evidence and the individual’s own interpretation of imagined inferences in everyday interactions. It causes a high risk of aggressive behavior (and even violence) toward the individual’s partner, as well as to those around them.

Delusional Disorder in The MainstreamDonald Trump Delusional

Current events have invigorated commentary on delusional disorders (specifically grandiose delusional disorder) within both the medical and political communities

Delusional disorders haven’t historically been front and center during discussions of mental health the way anxiety disorders and depression have, but politics of the past two years have had a significant part in raising public awareness about Delusional behavior. At a Yale conference in 2017, a group of psychiatric experts diagnosed President Trump with a number of delusional disorders based on his meeting their respective sets of criteria.

According to a number of psychiatrists, professors and medical professionals who spoke at the conference, these disorders are a serious impediment to the president’s ability to discharge the powers and duties of his office. They went on to cite his perceived “ongoing war” with the press and media in general, as well as his willingness to forego the advice of his top intelligence officials in matters of diplomacy.  They said he frequently insisted that his personal business sense makes him uniquely qualified to ignore the input of qualified professionals. In a 2015 Bill O’Reilly interview, the president said “There’s nobody bigger or better at the military than I am.”

In light of his handling of the United States presidency, thousands of medical professionals across the country are convinced President Trump is suffering from a delusional disorder with paranoid and grandiose features. And while their findings drew criticism for breaking the so-called Goldwater Rule, many professionals asserted that “psychiatric interview is the least statistically reliable way of making a diagnosis.”

There have also been illegitimate diagnoses of delusional disorder made in the mainstream as recently as last year. During the Brett Kavanaugh imbroglio of October 2018, attorney and conservative pundit Joe DiGenova claimed the Supreme Court nominee’s accuser was “delusional” with nothing but tears to corroborate her story. This statement quickly fell apart, given Dr. Christine Blasey Ford – a professor of psychology at Palo Alto University and a research psychologist at Stanford University’s School of Medicine – did not meet any of the criteria for diagnosis or exhibit any of the symptoms during her testimony before Congress.

Are There Any Known Treatments For Delusional Disorder?

Because long-standing delusions and their accompanying behaviors are essentially the only symptoms of delusional disorder, they can be hard to identify early on. Subtypes of delusional disorder are often mistaken for less serious psychological disorders, especially in adolescents. For instance, somatic delusional disorder can be mistaken for body or gender dysmorphia; persecutory delusional disorder can be mistaken for a mild phase of martyr complex and so on. Some parents assume that bouts of dysmorphia, victim mentality or delusions of grandeur are normal in the course of adolescent life.

Grandiose person

As of this writing, delusional disorder is generally considered difficult to treat. Aside from cognitive behavioral therapy (CBT) and specialized psychotherapy, conventional antipsychotics such as chlorpromazine and fluphenazine have been commonly prescribed by psychiatrists since the 1950s. Atypical neuroleptics, such as cannabidiol and isolated terpenes, currently have the growing interest of medical researchers and psychiatric professionals. In many cases, sedatives and antidepressants are also prescribed to treat the mood- or anxiety-suppressant symptoms that occur as a result of specific delusional disorders.

Additional research and study will be needed to understand the root causes of delusional disorder. With a greater wealth of knowledge, the psychiatric community may be able to identify the disorder much earlier on – as well as understand how exactly it is passed on between family members.