Delusions are irrational beliefs held by people which do not reflect reality. Delusions can be caused by sleep disturbance and extreme stress, but diseases including brain injury or tumour and alcohol or other drug addictions and some somatic illnesses can precipitate delusions. When delusions interfere with the quality of life, it can be indicative of one of several different psychological conditions including psychotic conditions such as Schizophrenia or Schizoaffective Disorder, Delusional Disorder and depressive disorders such as Major Depressive Disorder and Bipolar Disorder.
This book, Run Hide Repeat chronicles what it is like to live with a person suffering from Delusional Disorder. This is an interview with the author of the book.
The DSM5 identifies four categories of delusions:
Bizarre delusions are implausible or not understandable, and not derived from ordinary life experiences – such as an individual’s belief that a stranger has removed his or her internal organs and replaced them with someone else’s organs without leaving any wounds or scars
Non bizarre delusions involving situations that are not occurring but could occur in real life, such as being followed, poisoned, infected, loved at a distance, or deceived by spouse or lover, or having a disease.
Mood-congruent delusions are consistent with a depressive or manic state, such as delusions of guilt, worthlessness, bodily disease, or impending disaster, or delusions of superiority or fame when manic.
Mood-incongruent delusions are incongruent with the particular mood state. They may include delusions of being targeted, persecuted or controlled during a depressive episode.
If you are trying to support someone who is experiencing delusions, here are some helpful suggestions that will not harm the person.
- Be curious about what the person believes is happening with questions such as:
- Who is trying to hurt you?
- Could you think why?
- How might this happen?
- Validate anything the person says that is true.
- Do not try to convince the person that they are wrong or try to argue or rationally explain the situation. Accept that they believe the delusion and that it is real for them – “I can see why you would be worried if someone is following you.”
- Respond to the underlying feelings and encourage discussion of these rather than the content of the delusion.
- Try not to take anything that is said personally.
- Notice what helps the person feel calmer or safer and help the person work out ways to cope more effectively with stressors.
- Encourage the person to enjoy real life activities – perhaps walking, craft, building, gardening – and encourage conversation about real situations.
- There may come a point when a mental health intervention is required – if the person poses a risk to themselves or someone else. Most cities will have a mental health crisis team available or you could contact the emergency department of the local hospital for assistance.
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