Religious Delusions in Bipolar Disorder

Table of ContentsView AllTable of ContentsWhat Are Religious Delusions?Mental Illness and Increased ReligiosityCultural Effects on Religious DelusionsImpact of Religion and Religious Delusions

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Table of Contents

What Are Religious Delusions?

Mental Illness and Increased Religiosity

Cultural Effects on Religious Delusions

Impact of Religion and Religious Delusions

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Religious delusions are a type of delusion with religious content. Although there are no clear guidelines to differentiate normal religious beliefs from pathological ones, a belief is generally only considered delusional if it is idiosyncratic, grandiose, and not an accepted part of a particular culture or subculture.

Researchers note that there is no consensus on where the boundary between religious belief and psychopathology lies.

At a GlanceReligious delusions can occur in bipolar disorder and other mental health conditions. However, it is important for doctors and therapists to distinguish between normal religiosity and delusional beliefs. Positive religious or spiritual coping can have a beneficial impact on the course of a person’s illness, while delusions can lead to worse outcomes. Keep reading to learn more about what constitutes a religious delusion and how it differs from normal spiritual beliefs.

At a Glance

Religious delusions can occur in bipolar disorder and other mental health conditions. However, it is important for doctors and therapists to distinguish between normal religiosity and delusional beliefs. Positive religious or spiritual coping can have a beneficial impact on the course of a person’s illness, while delusions can lead to worse outcomes. Keep reading to learn more about what constitutes a religious delusion and how it differs from normal spiritual beliefs.

Delusionsare defined as false beliefs that are firmly held and conflict with reality. Different types include paranoid or persecutory delusions, delusions of reference, delusions of grandeur, delusional jealousy, and others.

Two of these, in particular, may express themselves in a religious context. Here are a few examples:

Religious Paranoid Delusions

“Demons are watching me, following me, waiting to punish me if I do anything they don’t like,” or “If I put on my shoes, God will set them on fire to punish me, so I have to go barefoot all the time.” Auditory hallucinations, such as, “The voices keep telling me there are devils in my room,” are often combined with religious paranoia.

Religious Delusions of Grandeur

“God has exalted me above you, normal people. He tells me I don’t need help, don’t need medicine. I’m going to heaven, and all of you are going to go to hell,” or “I am Christ reborn.”

Prevalence estimates vary considerably, with between 1.1% and 80% of people who have delusions reporting some type of religious content.One study found that approximately 38% of people with bipolar disorder experience religious delusions.

It isn’t uncommon for people to experience increased religiosity due to a mental health condition. A heightened focus on religion isn’t necessarily unique to bipolar disorder. It is also associated withschizophrenia,schizophreniform disorder,schizoaffective disorder, and other psychotic disorders.

The increased religiosity may take many forms—some more subtle than others, and not all are indicative of psychosis. Here are some examples (using hypothetical patients):

Terri’s doctor may provide an immediate diagnosis of having religious delusions. But in the cases of Janie and Ed, a psychiatrist might feel such a diagnosis would be premature. And in Jerry’s case, at this point, his beliefs appear to be supportive rather than problematic.

As psychiatristHarold G. Koenig, professor of psychiatry and behavioral sciences at Duke University, wrote in a review of the literature on the subject, “While about one-third of psychoses have religious delusions, not all religious experiences are psychotic.”

Koenig found that some spiritual approaches may benefit the patient—as in Jerry’s case. When religious delusions aren’t immediately obvious, the treating clinician needs to examine the patient’s religious beliefs and behaviors carefully, Koenig concluded.

Cultural variables may play a role in how religious delusions are expressed. However, more research is needed to better understand how a person’s religious background might impact how delusions occur.

One meta-analysis of 55 studies examined the relationship between religious delusions (RD) and religious hallucinations (RH) in countries around the world.

A 2021 review found that the specific content in religious delusions is more connected to a person’s immediate social and family environment rather than their cultural background.

Delusions versus Hallucinations: What Are the Differences?

Religious and spiritual beliefs can be a positive coping mechanism for people with bipolar disorder that can lead to better well-being and outcomes.One study found that suicide was less common in bipolar people who were religious.

Conversely, having religious delusions has been found to be associated with a more serious course of illness and poorer outcomes. Research has shown that patients with religious delusions had more severe psychotic symptoms, a longer history of illness, and poorer functioning prior to the onset of a psychotic episode.

You can see why, then, it’s essential for clinicians to be aware of these differences.

Doctors ought to include a patient’s beliefs in evaluating the patient as a whole and use care in distinguishing between strong religious beliefs and delusions.

Keep in Mind

Despite the conflicting research on whether a country’s culture affects the incidence of religious delusions, it is certainly an area of interest for further study. More research is needed to better understand how to differentiate between normal religiosity and delusional religious beliefs.

If there’s one thing that researchers do agree on, it’s that those who treat people with psychoses need to be sensitive to a patient’s non-delusional religious beliefs, both in distinguishing them from delusions and in evaluating how helpful they are potentially to the patient.

Religious Abuse: Spotting the Signs and How to Cope

12 SourcesVerywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Sofou N, Giannakopoulos O, Arampatzi Ε, Konstantakopoulos G.Religious delusions: Definition, diagnosis and clinical implications.Psychiatriki. 2021;32(3):224-231. doi:10.22365/jpsych.2021.014Ouwehand E, Zock H, Muthert H.Religious or spiritual experiences and bipolar disorder: a case study from the perspective of dialogical self theory.Religions. 2020;11(10):527. doi:10.3390/rel11100527Abdel Hamid AAL, Nasreldin M, Gohar SM, Saleh AA, Tarek M.Sexual and religious obsessions in relation to suicidal ideation in bipolar disorder.Suicide Life Threat Behav. 2019;49(6):1552-1559. doi:10.1111/sltb.12540National Institute of Mental Health.Bipolar disorder.Harvard Health Publishing.Delusional disorder.Cook CC.Religious psychopathology: The prevalence of religious content of delusions and hallucinations in mental disorder.Int J Soc Psychiatry. 2015;61(4):404-25. doi:10.1177/0020764015573089Grover S, Hazari N, Aneja J, Chakrabarti S, Avasthi A.Influence of religion and supernatural beliefs on clinical manifestation and treatment practices in patients with bipolar disorder.Nord J Psychiatry. 2016;70(6):442-449. doi:10.3109/08039488.2016.1151930Grover S, Davuluri T, Chakrabarti S.Religion, spirituality, and schizophrenia: A review.Indian J Psychol Med. 2014;36(2):119-24. doi:10.4103/0253-7176.130962Iyassu R, Jolley S, Bebbington P, et al.Psychological characteristics of religious delusions.Soc Psychiatry Psychiatr Epidemiol. 2014;49(7):1051-61. doi:10.1007/s00127-013-0811-yKoenig HG.Religion, spirituality, and psychotic disorders.Revista de Psiquiatria Clínica.2007;34(1):40-48. doi:10.1590/S0101-60832007000700013Lucchetti G, Koenig HG, Lucchetti ALG.Spirituality, religiousness, and mental health: A review of the current scientific evidence.World J Clin Cases. 2021;9(26):7620-7631. doi:10.12998/wjcc.v9.i26.7620Caribé AC, Studart P, Bezerra-Filho S, et al. Is religiosity a protective factor against suicidal behavior in bipolar I outpatients?J Affect Disord. 2015;186:156-161. doi:10.1016/j.jad.2015.07.024

12 Sources

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Sofou N, Giannakopoulos O, Arampatzi Ε, Konstantakopoulos G.Religious delusions: Definition, diagnosis and clinical implications.Psychiatriki. 2021;32(3):224-231. doi:10.22365/jpsych.2021.014Ouwehand E, Zock H, Muthert H.Religious or spiritual experiences and bipolar disorder: a case study from the perspective of dialogical self theory.Religions. 2020;11(10):527. doi:10.3390/rel11100527Abdel Hamid AAL, Nasreldin M, Gohar SM, Saleh AA, Tarek M.Sexual and religious obsessions in relation to suicidal ideation in bipolar disorder.Suicide Life Threat Behav. 2019;49(6):1552-1559. doi:10.1111/sltb.12540National Institute of Mental Health.Bipolar disorder.Harvard Health Publishing.Delusional disorder.Cook CC.Religious psychopathology: The prevalence of religious content of delusions and hallucinations in mental disorder.Int J Soc Psychiatry. 2015;61(4):404-25. doi:10.1177/0020764015573089Grover S, Hazari N, Aneja J, Chakrabarti S, Avasthi A.Influence of religion and supernatural beliefs on clinical manifestation and treatment practices in patients with bipolar disorder.Nord J Psychiatry. 2016;70(6):442-449. doi:10.3109/08039488.2016.1151930Grover S, Davuluri T, Chakrabarti S.Religion, spirituality, and schizophrenia: A review.Indian J Psychol Med. 2014;36(2):119-24. doi:10.4103/0253-7176.130962Iyassu R, Jolley S, Bebbington P, et al.Psychological characteristics of religious delusions.Soc Psychiatry Psychiatr Epidemiol. 2014;49(7):1051-61. doi:10.1007/s00127-013-0811-yKoenig HG.Religion, spirituality, and psychotic disorders.Revista de Psiquiatria Clínica.2007;34(1):40-48. doi:10.1590/S0101-60832007000700013Lucchetti G, Koenig HG, Lucchetti ALG.Spirituality, religiousness, and mental health: A review of the current scientific evidence.World J Clin Cases. 2021;9(26):7620-7631. doi:10.12998/wjcc.v9.i26.7620Caribé AC, Studart P, Bezerra-Filho S, et al. Is religiosity a protective factor against suicidal behavior in bipolar I outpatients?J Affect Disord. 2015;186:156-161. doi:10.1016/j.jad.2015.07.024

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Sofou N, Giannakopoulos O, Arampatzi Ε, Konstantakopoulos G.Religious delusions: Definition, diagnosis and clinical implications.Psychiatriki. 2021;32(3):224-231. doi:10.22365/jpsych.2021.014Ouwehand E, Zock H, Muthert H.Religious or spiritual experiences and bipolar disorder: a case study from the perspective of dialogical self theory.Religions. 2020;11(10):527. doi:10.3390/rel11100527Abdel Hamid AAL, Nasreldin M, Gohar SM, Saleh AA, Tarek M.Sexual and religious obsessions in relation to suicidal ideation in bipolar disorder.Suicide Life Threat Behav. 2019;49(6):1552-1559. doi:10.1111/sltb.12540National Institute of Mental Health.Bipolar disorder.Harvard Health Publishing.Delusional disorder.Cook CC.Religious psychopathology: The prevalence of religious content of delusions and hallucinations in mental disorder.Int J Soc Psychiatry. 2015;61(4):404-25. doi:10.1177/0020764015573089Grover S, Hazari N, Aneja J, Chakrabarti S, Avasthi A.Influence of religion and supernatural beliefs on clinical manifestation and treatment practices in patients with bipolar disorder.Nord J Psychiatry. 2016;70(6):442-449. doi:10.3109/08039488.2016.1151930Grover S, Davuluri T, Chakrabarti S.Religion, spirituality, and schizophrenia: A review.Indian J Psychol Med. 2014;36(2):119-24. doi:10.4103/0253-7176.130962Iyassu R, Jolley S, Bebbington P, et al.Psychological characteristics of religious delusions.Soc Psychiatry Psychiatr Epidemiol. 2014;49(7):1051-61. doi:10.1007/s00127-013-0811-yKoenig HG.Religion, spirituality, and psychotic disorders.Revista de Psiquiatria Clínica.2007;34(1):40-48. doi:10.1590/S0101-60832007000700013Lucchetti G, Koenig HG, Lucchetti ALG.Spirituality, religiousness, and mental health: A review of the current scientific evidence.World J Clin Cases. 2021;9(26):7620-7631. doi:10.12998/wjcc.v9.i26.7620Caribé AC, Studart P, Bezerra-Filho S, et al. Is religiosity a protective factor against suicidal behavior in bipolar I outpatients?J Affect Disord. 2015;186:156-161. doi:10.1016/j.jad.2015.07.024

Sofou N, Giannakopoulos O, Arampatzi Ε, Konstantakopoulos G.Religious delusions: Definition, diagnosis and clinical implications.Psychiatriki. 2021;32(3):224-231. doi:10.22365/jpsych.2021.014

Ouwehand E, Zock H, Muthert H.Religious or spiritual experiences and bipolar disorder: a case study from the perspective of dialogical self theory.Religions. 2020;11(10):527. doi:10.3390/rel11100527

Abdel Hamid AAL, Nasreldin M, Gohar SM, Saleh AA, Tarek M.Sexual and religious obsessions in relation to suicidal ideation in bipolar disorder.Suicide Life Threat Behav. 2019;49(6):1552-1559. doi:10.1111/sltb.12540

National Institute of Mental Health.Bipolar disorder.

Harvard Health Publishing.Delusional disorder.

Cook CC.Religious psychopathology: The prevalence of religious content of delusions and hallucinations in mental disorder.Int J Soc Psychiatry. 2015;61(4):404-25. doi:10.1177/0020764015573089

Grover S, Hazari N, Aneja J, Chakrabarti S, Avasthi A.Influence of religion and supernatural beliefs on clinical manifestation and treatment practices in patients with bipolar disorder.Nord J Psychiatry. 2016;70(6):442-449. doi:10.3109/08039488.2016.1151930

Grover S, Davuluri T, Chakrabarti S.Religion, spirituality, and schizophrenia: A review.Indian J Psychol Med. 2014;36(2):119-24. doi:10.4103/0253-7176.130962

Iyassu R, Jolley S, Bebbington P, et al.Psychological characteristics of religious delusions.Soc Psychiatry Psychiatr Epidemiol. 2014;49(7):1051-61. doi:10.1007/s00127-013-0811-y

Koenig HG.Religion, spirituality, and psychotic disorders.Revista de Psiquiatria Clínica.2007;34(1):40-48. doi:10.1590/S0101-60832007000700013

Lucchetti G, Koenig HG, Lucchetti ALG.Spirituality, religiousness, and mental health: A review of the current scientific evidence.World J Clin Cases. 2021;9(26):7620-7631. doi:10.12998/wjcc.v9.i26.7620

Caribé AC, Studart P, Bezerra-Filho S, et al. Is religiosity a protective factor against suicidal behavior in bipolar I outpatients?J Affect Disord. 2015;186:156-161. doi:10.1016/j.jad.2015.07.024

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