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What Is a Delusion?
By
Amy Morin, LCSW

Medically reviewed by
Steven Gans, MD
Updated on February 13, 2021

Table of Contents

What Is a Delusion?

Signs

Types of Delusions

Causes

Diagnosis

VIEW ALL

What Is a Delusion?
Delusions are defined as fixed, false beliefs that conflict with reality. Despite contrary evidence, a
person in a delusional state can’t let go of these convictions.

Delusions are often reinforced by the misinterpretation of events. Many delusions also involve
some level of paranoia. For example, someone might contend that the government is controlling
our every move via radio waves despite evidence to the contrary.

Delusions are often part of psychotic disorders. They may occur along with hallucinations, which
involve perceiving something that isn’t really there, like hearing voices or feeling bugs crawling
on your skin.

Signs
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Delusions are characterized by an unshakable belief in things that are not true, and often, there
is a continued belief in the delusion despite contrary evidence. Not all delusions are the same.
Some might involve non-bizarre beliefs that could theoretically occur in real life. Others may be
bizarre, fantastical, or impossible. 

The nature of the delusional symptoms may play a central role in the diagnosis. Delusional
disorder, for example, is characterized by non-bizarre delusions that often involve the
misinterpretation of an experience or perception. In schizophrenia, the delusions may be bizarre
and not rooted in reality.

Types of Delusions
There are several different types of delusions that characterize the diagnosis of delusional
disorders. The type of disorder is determined by the theme of the delusions that are
experienced.

Erotomanic
In this type of delusion, individuals believe that a person—usually with a higher social standing—
is in love with them. An example of this type of delusion would be someone who believes an
actress loves them and that they are communicating with them via secret hand gestures during
their TV show.

Grandiose

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In grandiose delusions, individuals believe they have extraordinary talent, fame, wealth, or
power despite the lack of evidence. An instance of this type of delusion would be someone who
believes God gave them the power to save the universe and every day they complete certain
tasks that will help the planet continue on.

Persecutory
Individuals with persecutory delusions believe they are being spied on, drugged, followed,
slandered, cheated on, or somehow mistreated. An example might include someone who
believes their boss is drugging the employees by adding a substance to the water cooler that
makes people work harder. 

Jealous
With this type of delusion, individuals might believe their partners are unfaithful. For instance,
someone with this type of delusion might believe their partner is meeting their lover every time
they use the restroom in public settings—they also think that they are sending their lover secret
messages through other people (like the cashier in a grocery store).

Somatic
Individuals with somatic delusions believe that they are experiencing physical sensations or
bodily dysfunctions under the skin, or that they're suffering from a general medical condition or
defect. For instance, someone who believes there are parasites living inside their body may be
suffering from somatic delusions.

Mixed or Unspecified
When delusions don’t fall into a single category and no single theme dominates, the delusions
are considered “mixed.” Mental health professionals may refer to the disorder as “unspecified"
when delusions don’t fall into a specific category or the delusion type can’t be clearly
determined.

Causes
Researchers aren’t exactly sure what causes delusional states.It appears a variety of genetic,
biological, psychological, and environmental factors are at play.

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Psychotic disorders seem to run in families, so researchers suspect there is a genetic

component to delusions.Children born to a parent with schizophrenia, for example, may be at a
higher risk of developing delusions.

Abnormalities in the brain may also play a role.An imbalance of neurotransmitters (chemical
messengers in the brain) may increase the likelihood that an individual will develop delusions.

Trauma and stress also can trigger delusions.Meanwhile, individuals who tend to be isolated
appear more vulnerable to developing a delusional disorder as well.

Sometimes, people share delusions. This experience is most common in individuals who reside
together and have little contact with the outside world.

Related Conditions

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Delusions may be symptoms of mental health problems or brain disorders. The following are
some conditions that may involve delusions:

Brief psychotic disorder: People experience hallucinations, delusions, or disorganized

speech that may be triggered by a stressful event.Symptoms of this disorder persist for
one month or less.

Delusional disorder: People experience "non-bizarre" types of delusions and can usually
act normally and don't have markedly impaired functioning.With only an estimated 0.2% of
the population meeting the criteria, this disorder is considered a relatively rare mental
illness.

Dementia: Although estimates vary, roughly one-third of individuals with dementia may
experience delusions.Often, the delusions involve paranoia, such as thinking family
members or caretakers are stealing from them.

Mood disorders: Sometimes, individuals with mood disorders like depression or bipolar
disorder may experience delusions.
Parkinson’s disease: The prevalence varies widely but many patients with advanced
Parkinson’s disease experience hallucinations and delusions.

Postpartum psychosis: Hormonal shifts after giving birth may trigger postpartum
psychosis in some women. Some research indicates it's also linked to bipolar disorder.

Schizoaffective disorder: This disorder involves symptoms of schizophrenia as well as a

mood issue, like depression or mania.

Schizophrenia: The disorder involves “positive symptoms,” such as hallucinations or

delusions. It also involves “negative symptoms,” such as flat affect, reduced feelings of

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pleasure in everyday life, difficulty beginning and sustaining activities, and reduced
speaking.
Schizophreniform disorder: This disorder involves symptoms similar to schizophrenia but
for less than six months.

Substance/medication-induced psychotic disorder: Drug or alcohol intoxication or

withdrawal may cause some individuals to experience delusions.Symptoms are usually
brief and tend to resolve once the drug is cleared, though psychosis triggered by
amphetamines, cocaine, or PCP may persist for weeks.

Diagnosis
If a person is experiencing delusional symptoms, their doctor will begin by taking a medical
history and performing a physical exam. Lab tests may also be ordered to rule out any physical
illnesses that might be causing the symptoms.

If there is no medical condition causing the symptoms, a doctor may refer the individual to a
psychiatrist for further evaluation. Mental health professionals may use a variety of psychological
assessments to learn more about the person's symptoms. A diagnosis may then be made based
on the diagnostic criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). 

Treatment
It’s important for anyone experiencing delusions to seek professional help. This can be
especially challenging, however, since people experiencing delusions often don't think of their

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beliefs as a problem because, by definition, the person experiencing delusions believes their
experience to be fact. Consequently, it is often concerned loved ones who must bring the issue
to the attention of a healthcare professional.

In some cases, psychiatric hospitalization is required to help people with delusions become
stabilized—especially if they become a danger to themselves or others.

Treatment for delusions often includes a combination of medication and therapy.

Medication
Medications may include:

Typical, or first-generation antipsychotics: These medications are used to block

dopamine receptors in the brain. Dopamine is a neurotransmitter that is believed to be
involved in the development of delusions.
Atypical antipsychotics: These medications are used to block dopamine and also
serotonin receptors in the brain. This leads to a different side effect profile than the first-
generation antipsychotics.
Tranquilizers: Sometimes these medications are used to address anxiety, agitation, or
sleep issues common in people with delusional disorders.
Antidepressants: These medications may be used to treat depression if someone with a
delusion is experiencing a mood issue.

Therapy
Therapy may include cognitive behavioral therapy (CBT),which helps an individual learn to
recognize and change unhelpful thoughts and behaviors. Family therapy is often part of the
treatment as well. Through therapy, family members can learn how to support someone who is
experiencing delusions.

Related:
The 9 Best Online Therapy Programs
We've tried, tested and written unbiased
reviews of the best online therapy programs including Talkspace, Betterhelp, and Regain.

Coping

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Managing the environment also can help someone with delusions. For example, if someone
believes the government is spying on them through the TV, it may be best for that person to
avoid watching television. Or, if a person believes they are being followed when they go into the
community alone, it may be best to have someone go with them when they go out.

If you or a loved one are struggling with delusions, contact the Substance Abuse and Mental
Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information
on support and treatment facilities in your area.

For more mental health resources, see our National Helpline Database.

A Word From Verywell

Most disorders that involve delusions aren’t curable, but they are treatable. In fact, some people
are able to live healthy, productive lives with few symptoms. But some do struggle to work,
maintain healthy relationships, and participate in activities associated with daily living. Ask a
healthcare professional to provide help and support for you or your loved one.

Related:
How to Find the Right Therapist

Article Sources

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within
our articles. Read our editorial process to learn more about how we fact-check and keep our content
accurate, reliable, and trustworthy.

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Additional Reading

American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed.

2013. doi:10.1176/appi.books.9780890425596

Bürgy M. Study of delusional depression: Drive, dynamics, therapy. Neurol Psychiatry Brain Res.

2018;30:117-124. doi:10.1016/j.npbr.2018.08.003
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Hoenders HJR, Bartels-Velthuis AA, Vollbehr NK, Bruggeman R, Knegtering H, de Jong JTVM.
Natural medicines for psychotic disorders: A systematic review. J Nerv Ment Dis. 2018;206(2):81-
101. doi:10.1097/NMD.0000000000000782

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