Delusional Disorder

What is delusional disorder?

People who have a delusional disorder have false beliefs about what is going on. These false beliefs, called nonbizarre 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 thought to affect only about 3 people in 10,000. It usually starts after the age of 30 and occurs equally in men and women.

How does it occur?

Nobody knows for sure what causes delusional disorder. 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:

• nonbizarre delusions (false beliefs about situations that could occur in real life) as opposed to bizarre delusions, which involve beliefs that could not possibly be true (believing that you came from Mars, for example)
• hallucinations (seeing or hearing things that aren't actually there)
• 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 difficult for people with mental illness to recognize that they are not well. Take the advice of friends or family members if they are encouraging you to seek 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. Medicine can make a big difference in the way you feel. 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.

What can I do to help 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.
• Do not use illegal drugs or alcohol. Drugs and alcohol can make your symptoms worse. If you are taking medicine, using drugs or alcohol could be very dangerous.
• Eat a healthy diet.
• Avoid caffeine.
• Exercise regularly.
• Follow exactly the directions for prescribed medicine. Contact your healthcare provider if the medicines don't seem to be working.
• Learn to manage stress or try to avoid it. Stress can make your symptoms worse.
• Tell your provider if your symptoms seem to be getting worse or if you are having a hard time dealing with them.
• Ask your healthcare provider or therapist if there are any support groups in your area for people with delusional disorder.

For more information, contact the National Alliance for the Mentally Ill (NAMI) or the National Mental Health Association (NMHA).

• NAMI's toll-free number is 1-800-950-NAMI. NAMI's web site address is http://www.nami.org.
• NMHA's Information Center toll-free number is 1-800-969-NMHA. NMHA's web site address is http://www.NMHA.org.