What Are Delusions?

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Causes

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Treatment

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Delusions are fixed, false beliefs that conflict with reality. If a person is in a delusional state, they can’t let go of their untrue convictions despite contrary evidence.

Delusions are common symptoms of somepsychotic disorders. They may occur along with hallucinations, which involve perceiving something that isn’t really there, like hearing voices or feeling bugs crawling on your skin.

Delusions vs. HallucinationsWhile they both involve distortions of reality, there aredifferences between delusions and hallucinations. For instance, delusional thinking means that the person’s cognitive process is distorted (their thoughts are distorted). In hallucinations, the distortion exists in the senses, such as in their sense of hearing or touch.

Delusions vs. Hallucinations

While they both involve distortions of reality, there aredifferences between delusions and hallucinations. For instance, delusional thinking means that the person’s cognitive process is distorted (their thoughts are distorted). In hallucinations, the distortion exists in the senses, such as in their sense of hearing or touch.

Signs of Delusional Thinking

It’s also important to recognize that not all delusions are the same. Some delusions might involve non-bizarre beliefs that could theoretically occur in real life, such as believing that your spouse is cheating on you. Other delusions are bizarre, fantastical, or impossible, like thinking that you are responsible for the fate of the world.

Types of Delusions

Several different types of delusions can characterize the diagnosis of a delusional disorder. The disorder is diagnosed asdelusional disorderand includes a specifierwithXYZ type.For example, if you have grandiose delusions, your diagnosis would be “delusional disorder, grandiose type.”

Erotomanic Delusions

Grandiose Delusions

In grandiose delusions, individuals believe that they have extraordinary talent, fame, wealth, or power despite a lack of evidence. An example of this type of delusional thinking would be someone who believes God gave them the power to save the universe and completes certain tasks every day that will help the planet continue.

Persecutory Delusions

Jealous Delusions

Individuals with jealous delusions might believe that their partners are unfaithful. For instance, someone with this type of delusion might believe their partner is meeting their lover every time they use the restroom in public settings—they also think that they are sending their lover secret messages through other people (like the cashier in a grocery store).

Somatic Delusions

Individuals withsomatic delusionsbelieve that they are experiencing physical sensations or bodily dysfunctions under the skin or that they’re suffering from a general medical condition or defect. For instance, someone who believes there are parasites living inside their body could be suffering from somatic delusions.

Morgellons Disease: Is It a Real or Delusional Condition?

Mixed or Unspecified Delusions

When delusional beliefs don’t fall into a single category, and no single theme dominates, the delusions are considered “mixed.” Mental health professionals may refer to the disorder as “unspecified” when delusions don’t fall into a specific category or the delusion type can’t be clearly determined.

What to Know About Fregoli Delusion

Causes of Delusions

Researchers aren’t exactly sure what causes delusional behavior and states.It appears that various genetic, biological, psychological, and environmental factors may be at play.

Conditions With Delusional Symptoms

Delusions may be symptoms of a mental health issue or brain disorder. The following are a few conditions that are associated with delusional thoughts or behaviors:

Diagnosis of Delusions

If no medical condition is instigating the symptoms, the healthcare provider may refer the individual to a psychiatrist for further evaluation. Mental health professionals can use a variety of psychological assessments to learn more about the person’s symptoms. A diagnosis may then be made based on the criteria in theDiagnostic and Statistical Manual of Mental Disorders(DSM-5-TR).

Treatment for Delusions

It’s essential for anyone experiencing delusional thinking to seek professional help. This can be incredibly challenging, however, since people experiencing delusions often don’t think of their beliefs as a problem.

By definition, a person who is having delusions believes their experience to be fact. Consequently, it is often concerned loved ones who must bring the issue to the attention of a healthcare professional.

Treatment for delusions often includes a combination of medication and therapy.

Medication

Medications that may be used to help treat delusional thought processes and their resulting behaviors may include:

Therapy

Therapy for delusions may includecognitive behavioral therapy (CBT).CBT helps an individual with delusional beliefs learn to recognize and change unhelpful thoughts and behaviors.

Family therapyis often part of the treatment for delusions as well. Through this type of therapy, family members can learn how to support their loved one who is experiencing delusional thoughts or behavior patterns.

In some cases,psychiatric hospitalizationmay be required to help the person with delusions become stabilized—especially if they become a danger to themselves or others.

Coping With Delusions

If you or a loved one are struggling with delusions, contact theSubstance Abuse and Mental Health Services Administration (SAMHSA) National Helplineat 1-800-662-4357 for information on support and treatment facilities in your area.For more mental health resources, see ourNational Helpline Database.

If you or a loved one are struggling with delusions, contact theSubstance Abuse and Mental Health Services Administration (SAMHSA) National Helplineat 1-800-662-4357 for information on support and treatment facilities in your area.

For more mental health resources, see ourNational Helpline Database.

Final Thoughts

Most disorders that involve delusions are treatable. This enables people with these delusional beliefs to live healthy, productive lives with relatively few symptoms.

Others with delusions do struggle to work, maintain healthy relationships, or participate in activities associated with daily living. If you or a loved one are experiencing issues as a result of delusional thinking, a healthcare professional can provide the help and support you need.

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16 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.

Eterović M, Kozarić-Kovačić D.Cognitive impairments may mimic delusions.Med Hypotheses. 2015;85(6):870-873. doi:10.1016/j.mehy.2015.09.021Cermolacce M, Sass L, Parnas J.What is bizarre in bizarre delusions? A critical review.Schizophr Bull. 2010;36(4):667‐679. doi:10.1093/schbul/sbq001American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, Text Revision (DSM-5-TR); 2022. doi:10.1176/appi.books.9780890425787González-Rodríguez A, Esteve M, Álvarez A, et al.What we know and still need to know about gender aspects of delusional disorder: A narrative review of recent work.J Psychiatry Brain Sci. 2019;4:e190009. doi:10.20900/jpbs.20190009Pepper EJ, Pathmanathan S, Mcilrae S, Rehman FU, Cardno AG.Associations between risk factors for schizophrenia and concordance in four monozygotic twin samples.Am J Med Genet B Neuropsychiatr Genet. 2018;177(5):503-510. doi:10.1002/ajmg.b.32640Joyce EM.Organic psychosis: The pathobiology and treatment of delusions.CNS Neurosci Ther. 2018;24(7):598-603. doi:10.1111/cns.12973Nygaard M, Sonne C, Carlsson J.Secondary psychotic features in refugees diagnosed with post-traumatic stress disorder: A retrospective cohort study.BMC Psychiatry. 2017;17(1):5. doi:10.1186/s12888-016-1166-1MedlinePlus.Brief psychotic disorder.Qian W, Fischer CE, Churchill NW, Kumar S, Rajji T, Schweizer TA.Delusions in Alzheimer disease are associated with decreased default mode network functional connectivity.Am J Geriatr Psychiatry. 2019;27(10):1060-1068. doi:10.1016/j.jagp.2019.03.020Taddei RN, Cankaya S, Dhaliwal S, Chaudhuri KR.Management of psychosis in Parkinson’s disease: Emphasizing clinical subtypes and pathophysiological mechanisms of the condition.Parkinsons Dis. 2017;2017:3256542. doi:10.1155/2017/3256542Wesseloo R, Kamperman AM, Munk-Olsen T, Pop VJ, Kushner SA, Bergink V.Risk of postpartum relapse in bipolar disorder and postpartum psychosis: A systematic review and meta-analysis.Am J Psychiatry. 2016;173(2):117-127. doi:10.1176/appi.ajp.2015.15010124MedlinePlus.Schizoaffective disorder.National Institute of Mental Health.Schizophrenia.Knapp B, Tito E, Espiridion ED.Delusional parasitosis in a patient with alcohol-induced psychotic disorder.Cureus. 2019;11(3):e4344. doi:10.7759/cureus.4344Skelton M, Khokhar WA, Thacker SP.Treatments for delusional disorder. Cochrane Schizophrenia Group, ed.Cochrane Database of Systematic Reviews. 2015;2015(5). doi:10.1002/14651858.CD009785.pub2Mehl S, Werner D, Lincoln TM.Corrigendum: Does cognitive behavior therapy for psychosis (CBTp) show a sustainable effect on delusions? A meta-analysis.Front Psychol. 2019;10:1868. doi:10.3389/fpsyg.2015.01450

Eterović M, Kozarić-Kovačić D.Cognitive impairments may mimic delusions.Med Hypotheses. 2015;85(6):870-873. doi:10.1016/j.mehy.2015.09.021

Cermolacce M, Sass L, Parnas J.What is bizarre in bizarre delusions? A critical review.Schizophr Bull. 2010;36(4):667‐679. doi:10.1093/schbul/sbq001

American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, Text Revision (DSM-5-TR); 2022. doi:10.1176/appi.books.9780890425787

González-Rodríguez A, Esteve M, Álvarez A, et al.What we know and still need to know about gender aspects of delusional disorder: A narrative review of recent work.J Psychiatry Brain Sci. 2019;4:e190009. doi:10.20900/jpbs.20190009

Pepper EJ, Pathmanathan S, Mcilrae S, Rehman FU, Cardno AG.Associations between risk factors for schizophrenia and concordance in four monozygotic twin samples.Am J Med Genet B Neuropsychiatr Genet. 2018;177(5):503-510. doi:10.1002/ajmg.b.32640

Joyce EM.Organic psychosis: The pathobiology and treatment of delusions.CNS Neurosci Ther. 2018;24(7):598-603. doi:10.1111/cns.12973

Nygaard M, Sonne C, Carlsson J.Secondary psychotic features in refugees diagnosed with post-traumatic stress disorder: A retrospective cohort study.BMC Psychiatry. 2017;17(1):5. doi:10.1186/s12888-016-1166-1

MedlinePlus.Brief psychotic disorder.

Qian W, Fischer CE, Churchill NW, Kumar S, Rajji T, Schweizer TA.Delusions in Alzheimer disease are associated with decreased default mode network functional connectivity.Am J Geriatr Psychiatry. 2019;27(10):1060-1068. doi:10.1016/j.jagp.2019.03.020

Taddei RN, Cankaya S, Dhaliwal S, Chaudhuri KR.Management of psychosis in Parkinson’s disease: Emphasizing clinical subtypes and pathophysiological mechanisms of the condition.Parkinsons Dis. 2017;2017:3256542. doi:10.1155/2017/3256542

Wesseloo R, Kamperman AM, Munk-Olsen T, Pop VJ, Kushner SA, Bergink V.Risk of postpartum relapse in bipolar disorder and postpartum psychosis: A systematic review and meta-analysis.Am J Psychiatry. 2016;173(2):117-127. doi:10.1176/appi.ajp.2015.15010124

MedlinePlus.Schizoaffective disorder.

National Institute of Mental Health.Schizophrenia.

Knapp B, Tito E, Espiridion ED.Delusional parasitosis in a patient with alcohol-induced psychotic disorder.Cureus. 2019;11(3):e4344. doi:10.7759/cureus.4344

Skelton M, Khokhar WA, Thacker SP.Treatments for delusional disorder. Cochrane Schizophrenia Group, ed.Cochrane Database of Systematic Reviews. 2015;2015(5). doi:10.1002/14651858.CD009785.pub2

Mehl S, Werner D, Lincoln TM.Corrigendum: Does cognitive behavior therapy for psychosis (CBTp) show a sustainable effect on delusions? A meta-analysis.Front Psychol. 2019;10:1868. doi:10.3389/fpsyg.2015.01450

Bürgy M.Study of delusional depression: Drive, dynamics, therapy.Neurol Psychiatry Brain Res. 2018;30:117-124. doi:10.1016/j.npbr.2018.08.003

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