Delusions: Definition, Types, and Treatments

In the era of the internet trend of saying ‘’delulu is the solulu”, which is a GenZ way of saying being delusional is the solution to coping with all your life problems, let’s find out what this popular term means. A delusion, simply defined, is a person’s unshakable belief in something that is not true. People who experience delusions have difficulty distinguishing what is real and what is only a figment of their imagination. People who have these false beliefs cannot let go of them even if they are given evidence against those beliefs.

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According to the DSM-5, delusions refer to “fixed beliefs that are not amenable to change in light of conflicting evidence.” They are a common symptom of psychotic disorders such as schizophrenia, delusional disorder, and schizoaffective disorder. People can also experience it if they have other psychiatric disorders, such as – major depressive disorder with psychotic features and manic episodes in bipolar disorder. Dementia, Parkinson’s disease and Post-partum psychosis can also include experiences of delusions.

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What Causes Delusions?

As mentioned before, delusions commonly accompany several mental disorders. However, they can be triggered by a variety of other reasons, such as disturbed sleep patterns, extremely stressful circumstances, brain injuries or tumours, and alcohol or drug addiction. The following theories of the origin of delusions have been suggested by scholars:

1. Genetic and Biological Theory: Research suggests that people who have a family history of psychotic disorders such as schizophrenia are more likely to develop delusions. They have also been associated with the abnormal activity of neurotransmitters in the brain such as dopamine.
2. Impaired Cognitive Functioning: Researchers have also theorised that dysfunctional cognitive processing can also lead to delusions. People who think about themselves, others, and their surroundings in distorted ways are more at risk of being delusional. Such people are quick to jump to conclusions, can’t read people and social settings accurately, and are likely to assume that others view them with negative intentions.
3. Defensive Delusions: This theory posits that delusions are a form of defence mechanism to preserve a positive image of the self by attributing any negative occurrences to outside circumstances.
4. Culture and Religion-based Delusions: Delusions with a spiritual, magical, or religious character are very common in psychotic disorders. This majorly depends on the culture one belongs to, and the stories and myths that one believes in as part of that culture.
5. Low Socioeconomic status: Belonging to the lower socioeconomic strata of society brings a high level of psychological distress and stress. Thus, delusion-like experiences are often reported in this section of the population.
6. Hearing or sight Impairment: Research suggests that people whose hearing is impaired are at an increased risk of developing schizophrenia and delusions. The explanation is that auditory or visual impairments can cause misinterpretations of the environment, leading to people falsely perceiving their surroundings as threatening.

What are the Types of Delusions?

Delusions are categorised into various types based on the themes of content. Some of these types are listed below:

• Bizarre Delusions – Delusions are deemed bizarre if they are impossible, not understandable, and not based on ordinary life experiences. An example of a bizarre delusion is an individual’s belief that a stranger has removed all their internal organs and replaced them with someone else’s organs without leaving any scars on their body.
• Persecutory Type of Delusion – If an individual has persecutory delusions, they believe that they are going to be harmed, harassed, lied to, cheated on, poisoned or drugged, or conspired against by other individuals, groups, or institutions.
• Erotomanic Type – Also known as erotic or love delusions, these refer to the belief of an individual that someone, usually a famous individual or a celebrity, is in love with them. People with this delusion may try to obsessively contact the other individual.
• Jealous Type – The central theme of this subtype is that one’s partner or spouse is being unfaithful or disloyal to them.
• Capgras delusion – This refers to the belief that one’s family members or loved ones have been replaced by an imposter.
• Delusion of Control – This subtype involves the central belief that one’s thoughts, behaviours, and actions are being controlled by an external entity. This entity may be another individual such as a boss or manager, an institution such as the government, or even an undefined force.
• Grandiose Delusions – This subtype is characterised by an exaggerated or inflated sense of self. The individual believes that they have exceptional fame, wealth, abilities, beauty, skills etc.
• Somatic delusions – These involve an individual’s preoccupation with their physical health, bodily functions, and sensations.
• Nihilistic Delusions – This subtype involves the primary belief that some major catastrophe or destructive event is going to occur shortly and the world will come to an end.
• Referential Delusions – People with referential delusions believe that certain gestures, comments, and environmental cues are directed at them. For example, a person may strongly be convinced that a poster, a song, or an advertisement has a direct reference to or a hidden meaning for them.

Treatments

Treatment for delusions depends on the cause of their development. Usually, a combination of medication and psychotherapy is helpful. Medications involve antipsychotic drugs and antidepressants. Whereas Cognitive Behavioural Therapy is the preferred form of therapy. It can help the person learn to recognize and change thought patterns and behaviours that lead to troublesome experiences. Another effective treatment is Acceptance and commitment therapy (ACT), which helps people accept their beliefs and live with delusions, despite others not having these same beliefs.