Delusional Disorder

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KEY POINTS

• Delusional disorder is a very rare condition that causes you to have false beliefs.
• Treatment may include medicines, therapy, and learning ways to manage stress. In severe cases, you may need to be treated in the hospital.

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What is delusional disorder?

Delusional disorder is a condition that causes you to believe things that are not true. These false beliefs, called delusions, last for at least a month and are not caused by drugs (illegal or prescribed) or by a medical illness. If you have this disorder, the false beliefs involve things that could actually happen, such as having a sexual partner cheat on you or having AIDS. This disorder does not include having beliefs that could not happen in real life, such as space aliens tapping your telephone.

Delusional disorder is a very rare condition. It usually starts after the age of 30.

What is the cause?

The exact cause of this disorder is not known.

• The brain makes chemicals that affect thoughts, emotions, and actions. Without the right balance of these chemicals, there may be problems with the way you think, feel, or act. People with delusions may have too little or too much of some of these chemicals.
• Stress also plays a part. Stress and abuse may make symptoms start sooner and be more severe.
• People with this disorder may have physical changes in their brain. These changes may mean that some parts of the brain are more active or less active than in other people.

What are the symptoms?

Symptoms may include:

• Believing things that are not true, such as believing:
  • You have a special relationship with someone famous or powerful
  • Your sexual partner is cheating on you
  • You or someone close to you is being cheated, drugged, followed, or harmed in some way
  • You have some physical defect or medical problem
• Sometimes feeling very sad or down, frustrated, irritable, and angry

How is it diagnosed?

Your healthcare provider or therapist will ask about your symptoms, medical and family history, and any medicines you are taking. He will make sure you do not have a medical illness or drug or alcohol problem that could cause the symptoms. You may have tests or scans to help make a diagnosis.

A mental health professional should make the final diagnosis after talking to you and the people close to you.

How is it treated?

Medicines

Medicines are the most important part of your treatment. Several types of medicines can help. Your healthcare provider will work with you to select the best medicine. You may need to take more than one type of medicine. These medicines may cause side effects, but you and your healthcare provider will watch for them. Your healthcare provider may change how much or how often you take your medicine, or change the medicine you have been taking.

It is important to stay on your medicine to keep your symptoms under control. If you are thinking about stopping your medicine, talk to your provider first. Antipsychotics should not be stopped suddenly or without your provider's okay.

Therapy

Cognitive behavioral therapy (CBT) focuses on thinking and behavior. The therapist helps you learn how to:

• Test the reality of your thoughts
• Cope with stress
• Replace negative thoughts with positive thoughts
• Identify early warning signs that symptoms are getting worse

You may need to spend some time in a hospital if you are thinking about hurting yourself or someone else, or if you are unable to take care of yourself.

How can I take care of myself?

The following may help you deal with your 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, or take walks. Try yoga, meditation, or 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. To help prevent problems, tell your healthcare provider and pharmacist about all of the medicines, natural remedies, vitamins, and other supplements that you take. Take all medicines as directed by your provider or therapist. It is very important to take your medicine even when you are feeling and thinking well. Without the medicine, your symptoms may not improve or may get worse. Talk to your provider if you have problems taking your medicine or 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.

Get emergency care if you or a loved one has serious thoughts of suicide or self-harm, violence, or harming others. Also seek immediate help if you have chest pain or trouble breathing.

For more information, contact:

• National Alliance on Mental Illness (NAMI)
  800-950-6264
  http://www.nami.org
• Mental Health America
  800-969-6642
  http://www.mentalhealthamerica.net/