Living with Delusional Disorder

Delusional disorder is a type of psychosis in which a person can’t tell the difference between what is real and what is imagined. When you have this disorder, you have an unshakable belief that events that could occur in real life have happened, even though they haven’t. Living with this disorder can cause you to feel angry, irritated or misunderstood, but you may not recognize that you have a psychiatric problem. Treatment is possible when you recognize that your beliefs are delusions.

Delusional disorder is classified as a psychotic disorder. If you have it, you may have trouble recognizing the difference between delusions and reality. The delusions that you are experiencing are usually considered non-bizarre, which means they are things that could actually happen. You might think that someone is following you or watching you, for instance, or that someone you love is trying to poison you.

People who are not close friends or family members may not notice that anything is wrong, and probably don’t think that you appear in any way to be odd. There’s a good chance you’re able to function normally in your day-to-day life, although the people closest to you may dispute some of the things that you believe to be reality.

Types of Delusions You May Experience


When you live with delusional disorder, different aspects of reality may be distorted. There are several different types of delusions you may experience, and they are almost always things that could actually happen.

  • Erotomaniac. You believe that someone is in love with you, possibly a famous or otherwise important person. Your belief may be so strong that you try to contact this person, or may stalk them.
  • Grandiose. You believe you have exceptional worth or talent.
  • Jealous. You are convinced your partner or spouse is unfaithful.
  • Persecutory. You believe that you or those you love are being spied on or treated badly, and you may complain to law enforcement about neighbors or others whom you think mean to do you harm.
  • Somatic. You believe you have a medical condition or physical defect.
  • Mixed Type. You may have multiple types of delusions that fit into two or more other categories.

Possible Negative Effects of a Delusional Disorder


Some people who have a delusional disorder may never seek the attention of medical professionals, because they don’t think of their delusions as problematic. Although it appears there are approximately 30 people with this disorder for every 100,000, the true prevalence of delusional disorder may be greatly underestimated. When people with this disorder don’t recognize that there is a problem, they have no reason to seek treatment.

An untreated delusional disorder can eventually lead to negative effects such as:

  • Conflict in romantic relationships
  • Frequent anger toward others
  • Increased irritability
  • Legal problems if you act on delusions
  • Isolation
  • Substance use disorder

Diagnosing Delusional Disorder


If you are experiencing symptoms of delusional disorder, talk to your doctor. He or she will do a complete physical exam and may run some blood tests or imaging studies to rule out other possible causes. Once it has been determined that there is no physical reason for these symptoms, you’ll probably be referred to a psychiatrist.

A psychiatrist will use special interview and assessment tools in order to evaluate you when they are trying to diagnose a psychotic disorder. Along with symptoms reported, the doctor will pay attention to their own observations of your behavior and may also interview family members. A diagnosis of delusional disorder is made if you have had non-bizarre delusions for at least one month but you don’t have symptoms of other psychotic disorders.

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Treating Delusional Disorder


Treatment strategies for this disorder are tailored to the individual. One of the most effective forms of treatment for delusional disorder is psychotherapy. Successful treatment depends on being able to develop a trusting relationship with the therapist as well as establishing treatment goals that are acceptable to the patient.

Medication may be helpful in treating delusional disorder. Choices include conventional antipsychotics and atypical antipsychotics medications. Sedatives and antidepressants may also be used to treat symptoms of anxiety.

A residential treatment environment may be helpful, particularly if you are experiencing a lot of anxiety, fearfulness or an urge to harm yourself. At a residential treatment facility, you will be in a safe environment where you can focus on learning new coping skills such as relaxation techniques.

Delusional disorder is usually an ongoing condition, but with treatment and support from family and friends you can obtain relief from your symptoms.