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Delusional disorder: when one starts believing in unreal

What is a delusional disorder?

Delusional disorder is a mental illness when people assume and start believing something, which in reality is not true. People often misunderstand the circumstances and situations and start feeling that it is deliberately done to harm them. It was earlier called as the paranoid disorder and is a type of psychosis.

Delusion as a symptom is a part of many psychotic disorders, but delusional disorder in itself is very rare. People with delusional disorder act and behave normally, except in situations, which are related to their belief and perceptions. More women are treated for delusional disorder than men.

Causes

Genetic, environmental, psychological and biological factors are supposed to be the cause of the delusional disorder. The exact cause is yet to be known.

Risk factors

Factors that could lead to the onset of delusional disorder are:

  • Heredity: People with family members suffering from delusional disorder or schizophrenia are at a higher risk of developing it.
  • Neurological issues: Abnormalities in the part of the brain responsible for perception and thinking could be one of the reasons for delusional disorder.
  • Environmental issues: Individuals with a history of substance abuse, addiction, and chronic stress are more likely to develop the delusional disorder. People who are immigrants, living alone in isolation often exhibit signs of the delusional disorder.

Symptoms and signs

The most obvious sign of delusional disorder is the presence of faulty assumptions; perceptions and thinking that are far away from reality. Some people might experience episodes of delusion. For others, it could be ongoing, with different variations in its intensity and degree. In few others, the symptoms might be corrected after a period of time. Other symptoms that might be present are:

  • Always being angry and anxious
  • Depression
  • Low mood or irritability
  • Hallucinations that are part of the delusion

The delusions can be of several types:

  • Persecutory: Individual believes that their friends, family, neighbours or secret agencies are spying on them. They always suspect that everyone is trying to harm them or kill them.
  • Jealous: They are always suspicious of their partner’s motive.
  • Grandiose: Assuming to be blessed with super powers, talent, highly qualified inventors are some of the common delusions.
  • Erotomanic: Erotomanic is the thought of someone very famous being madly in love with him or her. Claiming to be receiving secret love notes, letters, and meeting them privately and can lead to stalking.
  • Somatic: Belief that they are very sick or have a physical deformity.
  • Bizarre: Delusion, which are of bizarre beliefs, for example talking about alien attacks or communicating with the aliens.
  • Mixed: Having more than one of the above-mentioned types of delusions.

Diagnosis

Diagnosis of the delusional disorder can be difficult as most of the people do not talk about their delusions.

First, your doctor would assess you physically to diagnose any other medical illness that might be causing the symptoms.

  • Blood tests, MRI, CT scan, may be done to rule out any other medical condition. Once given a clean chit, the doctor will refer the patient to the psychiatrist department for detailed evaluation of the mental condition.
  • Based on the result of psychometric testing, observation, symptoms, behaviour and attitude of an individual, the psychiatrist can confirm the diagnosis of delusional disorder.

Treatment

Delusional disorder is treated by a personalised treatment plan consisting of individual counselling, cognitive behavioural therapy and medications.

An individual with very severe symptoms of the disorder is kept under medical observation. Hospitalisation becomes necessary to avoid the chances of self-injury or suicide.

  • Medication: Antipsychotic, antidepressants, tranquillizers, are some of the medicines that may be prescribed by the doctor.
  • Individual psychotherapy or counselling: This therapy is an attempt to help an individual realise the difference between perception and reality.
  • Family therapy: It is important to include the family members in the treatment plan of delusional disorder. It helps them to deal with someone with the delusional disorder in a more positive manner. It also enables them to cope up with the demands of such behaviour in a family.
  • Cognitive behavioural therapy: A psychiatrist tries to change the thought process and assumptions of someone with the delusional disorder, by changing the unsettling feelings and behaviours.

Prevention

There is no tested way to prevent delusional disorder. Early intervention certainly helps in curtailing further deterioration of the symptoms.

Complications

People with the delusional disorder are susceptible to other psychological disorders including depression and schizophrenia. The stress of delusional disorder starts affecting theory relationship, family, and work.  Self-harm, injury and suicidal tendencies are also reported in such individuals.

Next steps

If you know someone who has belief into delusions, help them seek a professional help.

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References

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  • Treatment for delusional disorder—Cochrane—accessed on 21 February 2017 — http://www.cochrane.org/CD009785/SCHIZ_treatments-for-delusional-disorder
  • Delusional disorder—UTAS — accessed on 21 February 2017 – http://eprints.utas.edu.au/287/5/Chapter%204%20%20Delusions.pdf
  • Delusional disorder—Cambridge– accessed on 21 February 2017 – http://assets.cambridge.org/97805215/81806/sample/9780521581806web.pdf
  • Delusional disorder—like minds taranaki– accessed on 21 February 2017 — http://www.likemindstaranaki.org.nz/taranaki-mental-health-sector/conditions-treatments/psychotic-disorder/delusional-disorder.html
  • Delusional disorder—Harvard health publications– accessed on 21 February 2017 – http://www.health.harvard.edu/diseases-and-conditions/delusional-disorder-
    http://onlinelibrary.wiley.com/doi/10.1111/j.1440-1819.2007.01694.x/full

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