woman distressed by delusional disorder

Delusional Disorder is Distressing For Everybody

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Does Someone You Know Have Delusional Disorder?

This is a very interesting disorder. It causes individuals who have Delusional Disorder (DD) great distress. Frequently the people in their support system are distraught because they are not sure how they can help. In this case, there is usually one strongly held delusion (e.g., infestation of insects). Other than that, the individual would not normally stand out as unusual. The delusion is always “nonbizarre”-they are within the realm of possibility, yet incorrect. If you heard people with DD discuss their delusions, they might sound very reasonable and you might believe them.

“I believe in looking reality straight in the eye and denying it.” Garrison Keillor

They may experience tactile or olfactory hallucinations. Their hallucinations would be associated with the delusion. For example, if an individual believed he had an infestation of insects, he might also feel “things” crawling on his skin. Depending on the delusion, there may be some impairment of functioning socially and/or vocationally, or there may be extensive disruption of his life.

John,  a  30-year-old  male,  believed  the  IRS  was  following   him everywhere he went and trying to make his life miserable. He was married and had worked six years as a dockworker. John was so earnest and convincing that I almost believed him. Other than his delusion and the resulting anxiety, he was functioning quite well. I was able to work with him on controlling his anxiety. However, he was unwilling to consider the possibility, no matter how compelling the evidence, that his persecution  by the IRS was a delusion.

Note: All identifying information on my client “John” was changed to protect his/her   confidentiality.

There are six common subtypes:

Erotomanic Type

In this subtype. subjects believe that  another person (usually someone famous or on a higher status) is in love with them. In some instances they have never met the object of their delusion. They often go to great lengths to contact their “beloved,” and this can create problems with the criminal justice system.

Grandiose Type

In this subtype, subjects believe they are special in some way. For example, they may believe they have unusual talent, ability, insight.  are  more important than they actually are, or have a special relationship with an important person (e.g., Bill Clinton, Aretha Franklin, Billy Graham).

Jealous Type

These individuals believe that their significant others are being unfaithful. This belief is based on frivolous evidence (e.g., spouse is a little late coming home, disarrayed sheets). The spouse is generally confronted with the “evidence”. They then try to limit and control the spouse’s freedom. They will not listen to reasonable explanations.

Persecutory Type

This is a belief by individuals that they are, in some way, being persecuted by someone or something. They frequently seek to remedy the situation through the court system. These individuals are often angry and resentful. You will note that my client John’s delusion belongs to this subtype (or the IRS was actually persecuting him-stranger things have happened).

Somatic Type

In this subtype, individuals believe there is a problem with their bodies. This may be a foul odor, an infestation of insects or parasites; parts of the body are not functioning or are misshapen and ugly.

Mixed Type or Unspecified Type

The delusion cannot be determined or it does not fit one of the subtypes.

The most common subtype is Persecutory. Delusional disorder is relatively rare, occurring in only about 0.03% of the general population. The onset is usually midlife or later.

Do you or someone you know suffer from delusions? Find out with this test!

Delusional disorder is relatively rare, occurring in only about 0.03% of the general population. The onset is usually midlife or later.
These are the personality and belief patterns one can expect to see in a person with Delusional Disorder. Mark each “True” or “False” depending on whether the person exhibits that characteristic or not.

Do You Know Someone Delusional?

1. Has beliefs such as being followed, persecuted, poisoned, loved at a distance, deceived by a spouse or lover, or has a disease. (These beliefs must not be supported by objective evidence. Duration of beliefs must be at least one month.)
2. Must not meet the guidelines for another disorder (e.g., schizophrenia-see below).

Schizophrenia Symptoms:
• Delusions
• Hallucinations
• Disorganized speech (i.e., incoherence)
• Grossly disorganized or catatonic behavior
• Negative symptoms (i.e., lack of effect, shows no emotion)
Note: The delusions are more bizarre and unbelievable than those experienced in a personality disorder. (DSM IV, 1996, p. 285)

Schizophrenia is a very serious psychotic diagnosis. lt usually appears by early adulthood. Delusions would be more bizarre than one would have with Delusional Disorder. Instead of believing he was being tormented by the IRS, if John were schizophrenic, he might believe aliens had infiltrated the IRS and that is why they were being so aggravating. Dear Reader, now that I think about it, that explanation might not be so bizarre after all.
3. Behavior is not odd or bizarre other than in association with the delusion.
4. Not experiencing depression or mania unless duration is brief relative to the delusion. (Mania-possible changes in behavior and mood-high energy level, able to function with very little sleep, high self-confidence, increased sexual activity, risk-taking behaviors, rapid speech.)
5. Above symptoms not caused by drugs or medication.


© 2016, Dr. Dorothy McCoy. All rights reserved.