What Makes Someone Delusional?
A firmly held irrational belief which is maintained even when evidence to the contrary is considered is termed as delusional.
Delusions may be of primary onset where they seem to appear from nowhere, or they may have secondary onset where they are used to explain another abnormal experience. Delusions are considered to be complete, but there are also partial delusions. Partial delusions are where the person may have some doubts about their delusions from the beginning or where they begin to doubt them during treatment.
Delusional mood refers to the mood from which a delusion arises. There is an emotional reaction when an individual experiences a delusion for the first time. Sometimes a person may attribute meaning to a perception in what is known as delusional perception.
Delusional memory refers to attaching new meanings to past memories.
Occasionally delusions may be shared, particularly where one person lives with another. This is known as a 'folie a deux'.
Many different types of delusion are recognised with regards to various themes and some notable ones are as follows:
Delusions of reference - this is where the person believes that particular people, objects or events are associated with them (e.g. commentary they hear on the TV) relates specifically to them and is either a message to them or a message informing others about them.
Delusions of persecution - these usually concern the belief that an organisation or individual is attempting to undermine the person or inflict some sort of wrongdoing on them.
Delusions of grandeur - these refer to erroneous beliefs that the individual is of great importance (e.g. of royal descent, extremely intelligent or wealthy, or having an extraordinary talent).
Delusions of jealousy - these are more common in men and usually involve doubts about a partner's fidelity. They can culminate in aggressive behaviour towards the person thought to be unfaithful. The person may examine clothing and follow their partner to try and uncover evidence of indiscretions. Even where evidence cannot be found to support their delusion, they will continue to look for it.
Delusions of control - this is where someone believes that an outside agency has control over their thoughts and behaviours. This is sometimes called delusions of mind being read.
Delusions of possession of thoughts - these are most usually associated with schizophrenia. They include delusions of thought insertion whereby the individual believes that someone is implanting thoughts into them, delusions of thought withdrawal where an individual believes that their thoughts are being extracted from their minds, and delusions of thought broadcasting where the person believes that their thoughts are being made available to others through telepathy, radio waves or some other means.
Delusions of guilt and worthlessness - these are associated with beliefs such as a minor misdemeanour will bring about shame on the person's family. They are more likely to be present in depressive disorders.
Delusions of religion - these should be distinguished from normal religious beliefs held by members of a particular religious group. They are not as common in Western society as they were when religion played a greater role in everyday life.
Delusions of nihilism - these are often associated with depressive disorders. It is where the individual believes that something terrible is going to happen or has happened which involves death or non-existence. Common themes include the world is about to end.
Cotard's delusion - this is a form of nihilistic delusion where the individual believes that they are dead. It is sometimes called 'walking corpse syndrome'.
Delusions of hypochondria - also called somatic delusions, these are beliefs that a person has some form of physical illness even though all the evidence presented to them suggests otherwise.
Sexual delusions - these involve themes about love and sex and are also sometimes classed as erotomania. They involve misplaced beliefs that someone is sexually attracted to or in love with the individual. Typically the focus of the delusion is someone who is inaccessible and with whom they have had no previous contact. They may attempt to contact the person through phone calls, emails or letters and sometimes may resort to stalking them.
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