Delusional Disorder

What is delusional disorder?

People who have a delusional disorder have false beliefs about what is going on. These false beliefs, called delusions, involve situations that could occur in real life, such as being followed, having a sexual partner cheat on you, or having AIDS. The delusions last for at least a month and are not caused by drugs (illegal or prescribed) or by a medical illness.

Apart from these delusions, people with this disorder may act normally. They are able to function at work and school, unless their false beliefs are directly related to work or school. However, relationships with friends and family are usually affected by the delusions.

There are several types of delusional disorders, and it is possible for you to have more than one type. These include:

• erotomanic type: delusions that another person, usually someone important, is in love with you
• grandiose type: delusions about being very great, powerful, talented, or knowledgeable, or about having a special relationship with someone famous or powerful
• jealous type: delusions that a sexual partner is cheating on you
• persecutory type: delusions that you or someone close to you is being wrongly treated in some way (being cheated, drugged, or followed, for example)
• somatic type: delusions about having some physical defect or medical problem

Delusional disorder is a very rare condition. It usually starts after the age of 30 and occurs equally in men and women.

What is the cause?

The cause of this disorder is not known. It may be caused by a change in how brain cells work and communicate with each other. It is known that the disorder is more common among people who have a close relative (a parent or brother or sister) with schizophrenia and that the disorder can be triggered by stress.

What are the symptoms?

The symptoms of delusional disorder may include:

• delusions (false beliefs about situations that could occur in real life)
• occasional feelings of being depressed (feeling very sad or down), frustrated, irritable, and angry

How is it diagnosed?

Consult your healthcare provider or a psychiatrist if you have symptoms of delusional disorder. Sometimes it is hard for people with mental illness to recognize that they are not well. Take the advice of friends or family members if they tell you that you need help.

The healthcare provider will ask about your symptoms, relationships, drug and alcohol use, and any medical illnesses. He or she may also want to speak with your family members and friends. The provider may do a physical exam and order some lab tests to rule out medical conditions. You may be given psychological tests.

After the provider makes a diagnosis, he or she will discuss a treatment plan with you and answer any questions you may have.

How is it treated?

Medicine is the most common form of treatment for delusional disorder. However, getting the right medicine with the fewest side effects may take trial and error. Be sure to work with your provider to get the best medicine for you.

You may need to be hospitalized if your symptoms are severe and you are a danger to yourself or to other people.

How long do the effects last?

Because this is such a rare condition, there is limited research on what treatments work best and how long the effects last. Without treatment, delusional disorder can be a lifelong illness. When treated, you may get better in a few months.

How can I take care of myself?

The following may help you deal with your illness:

• Learn as much as you can about your illness, its symptoms, and how it is treated. Most libraries and bookstores have books on mental illness.
• Get support. Talk with family and friends. Consider joining a support group in your area.
• Learn to manage stress. Ask for help at home and work when the load is too great to handle. Find ways to relax, for example take up a hobby, listen to music, watch movies, take walks. Try deep breathing exercises when you feel stressed.
• Take care of your physical health. Try to get at least 7 to 9 hours of sleep each night. Eat a healthy diet. Limit caffeine. If you smoke, quit. Avoid alcohol and drugs, because they can make your symptoms worse. Exercise according to your healthcare provider's instructions.
• Check your medicines. Follow exactly the directions for prescribed medicine. Contact your healthcare provider if the medicines don't seem to be working.
• Contact your healthcare provider or therapist if you have any questions or your symptoms seem to be getting worse.

For more information, contact the National Alliance for the Mentally Ill (NAMI) at 1-800-950-NAMI, or http://www.nami.org, or Mental Health America at 1-800-969-NMHA, or http://www.NMHA.org.