Caring for Someone With Delusional Disorder

People who suffer from delusional disorder may become isolated and feel alienated from others. Relationships are strained, often leaving a person to fend for themselves. They can have depression, due to the challenges they face associated with their illness. Depending on the subtype of the disorder, it could also get them into legal issues. Caring for a person diagnosed with delusional disorder takes a degree of patience, compassion, and understanding.

Delusional disorder is not a common diagnosis and can be misunderstood. People who suffer from it cannot tell reality from illusion in certain situations though they may act perfectly adjusted other times. Delusional disorder is grouped into a category similar to schizophrenia and is considered a serious mental illness classified as psychosis. It is differentiated from schizophrenia because with delusional disorder, social functioning and erratic behavior is not as severe. A person with delusional disorder will not show signs of any other symptoms of schizophrenia (disorganized thoughts and speech, bizarre behavior, severe hallucinations) other than dysfunctionality stemming from their delusion. However, a person diagnosed with schizophrenia will display delusional thinking as part of their symptoms.

Classification of Delusions


There are two types of delusions that a person may have when diagnosed with delusional disorder. They are termed “non-bizarre” or “bizarre” and are distinguished as:

  • Non-bizarre delusions may be of situations and circumstances that are plausible such as: being stalked, a partner cheating, an illness inflicted on them, conspired against, spied on, and subversively attacked. These are called “Persecutory Delusions” and are the most common.
  • Bizarre delusions are when implausible events occur such as: believing they are a famous person and not being recognized for it, that aliens from space have removed organs from them, that people on the television are speaking directly to them.

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Tips for Caring for Someone With Delusional Disorder


  • Be aware of vocal tone. When speaking to someone who has delusional disorder, be conscious of tone and word choice. Try to come across as non-confrontational and calm, expressing concern as a form of opinion, rather than judgement. It is best to talk to your loved one about your concern when they are not in the midst of their delusion.
  • Stay neutral. Do not try and convince your loved one that their delusions are not real. This can lead to arguments, explosive behavior, and continuing conflict which in turn will isolate them further. Contrary to deny a loved one’s delusions, you might have an impulse to agree with them. Do not buy into their delusions and become part of their psychosis. You can express a thought towards their feelings of the delusion but not state that you believe in their delusion. For example: “I understand how hard this is for you,” which can validate their feelings rather than, “OK, I’m here to help you escape from the….” This can lead to further paranoia that you might be part of the conspiracy they are afraid of.
  • Give space. If a loved one is in a delusional episode, be sure to give them space and be mindful of your body movements, so they don’t create fear or become agitated. Even though it may be an instinct to want to hold or hug them, they may misinterpret this and become aggressive. Sit calmly and give them space.
  • Give help and support. Helping your loved one when they are not in a delusional episode can come in a variety of ways including going with them to doctor’s appointments, helping them with staying on track with medications, helping with chores and errands, going for walks or exercise with them, or sitting and visiting if they are feeling depressed.
  • Educate yourself. Speak to mental health professionals who understand delusional disorder to discuss how to best help manage your loved one’s illness. Ask about treatment options and medications, in addition to the benefits of care at a residential treatment facility. Discuss the different types of delusions to understand more about the diagnosis.
  • Be Encouraging. Encourage your loved one to stick with a treatment plan. Help them with choices to enlist in a treatment program or to see a therapist on a regular basis. Help them understand the benefits of staying on prescribed medication. Reassure them that they are not alone.
  • Crisis management. If your loved one is in crisis, try and get them to the hospital upon their own consent, or if not, you may need to call for involuntary measures, so they don’t hurt themselves. Be reassuring that a hospital is a safe place and that the stay will not be long. Be willing to help them through admissions. Consider hospitalization as a last option, but call 911 if you feel that they are in serious danger of hurting themselves.

Having delusional disorder has nothing to do with a person’s intelligence level, socioeconomic, or cultural background. A delusion is a belief in something where a person is completely convinced that what they are experiencing is real.