Delusions are considered inaccurate beliefs held by an individual, (typically with

a mental illness), regardless of logical evidence disproving the belief. A delusion

differs from a belief that is held based on insufficient information or perceptual
feedback. An example of a non-deluded belief was when scientists initially
thought that the Earth was the center of the solar system in the 4th century BCE.

As they gained new scientific insight into space with new technology (16th
century), they updated their previously held false belief. Based on the
accumulated scientific knowledge, we all now know that the Sun is in fact the
center of the solar system. Someone that still believes [with conviction] that the
Earth is the center of the solar system, despite significant evidence to the contrary,
would be deluded in their thought.

Although a majority of delusions manifest as a result of excess dopaminergic

activity, it is difficult to pinpoint the specific neurochemical abnormalities
responsible for every delusion. In addition to positive symptoms of
schizophrenia, delusions may occur in cases of psychotic depression, bipolar
disorder, personality disorders, as well as those who abuse illicit drugs.

What are delusions?

In the earliest days of psychology, diagnostic criteria for delusions were

developed by Karl Jaspers. Jaspers wrote an essay called General
Psychopathology in 1910 that discussed delusions and various aspects of
jealousy. He had specific criteria that included three key descriptors including:
certainty (conviction), incorrigibility (unchangeable), and impossibility of content
(implausible).

1. Certainty: Individuals that hold delusions are certain in their beliefs; they
believe with 100% conviction that they are real, despite significant logical
evidence to the contrary.
2. Incorrigibility: Those with delusions will not update their false beliefs
even if presented with overwhelming logical evidence suggesting that the
opposite is true. Despite scientific evidence to suggest that their way of
thinking is flawed, they arent able to escape their deluded perception.
3. Impossibility: The delusion that a person holds is not only untrue, but
generally impossible or highly implausible to be true. Some of the delusions
may not only seem like an obvious impossibility, but they may seem highly
bizarre.

4 General Types of Delusions

There are many different, specific types of delusions that people may experience.
According to the DSM-V, there are four specific classifications for delusions.

1. Bizarre delusions: These types of delusions are considered extremely odd,

highly implausible, and inappropriate based on the persons culture and life
experiences. An example of a bizarre delusion would be the belief that an
alien performed surgery and replaced all of their blood with Kool-Aid without
leaving a scar.
2. Non-bizarre delusions: These are considered delusions that theoretically
are possible, but still unlikely based on circumstances. An example of a non-
bizarre delusion would be that an individual believes they are being secretly
video-taped and phone-tapped by the F.B.I. as part of an investigation.
3. Mood-congruent delusions: These are considered delusions that directly
stem from a persons mood (e.g. depression or mania). A person with severe
depression may believe that strangers hate seeing him. A person with mania
however may believe that they are a celebrity and should be recognized by
TMZ or that by thinking happy thoughts, the sun will come out on a cloudy
day.
4. Mood-neutral delusions: A mood-neutral delusion is a false belief that
isnt directly related to a persons emotional state. In other words, the delusion
doesnt stem from depressive or manic thoughts. An example of a mood-
 neutral delusion would be the false belief that your neighbor can project and
insert thoughts into your head.

Specific Themes of Delusions

In addition to there being 4 general diagnostic types of delusions for a DSM-V

diagnosis, there are also more specific themes of delusions. These themes range
from: control (e.g. another person is able to control your brain) to grandeur (e.g.
believing that you are God) to mind reading (e.g. others can read your mind).
Some themes are more common than others.

Delusions of control: This is defined as a false belief that an external being,

group, or energy is capable of controlling a persons thoughts, ultimately
influencing their emotions and behavior. Those experiencing delusions of control
may believe that a group of people is forcing them to drive around the block three
times, move their right arm up and down, or kick a fire hydrant.
Thought broadcasting: This is the false belief that a persons thoughts can
be heard by others as if they are audible to everyone in their environment.
Thought insertion: This is the false belief that others are inserting specific
thoughts into the persons head. A person may believe that they are being
forced to think about the Mayan calendar by a religious group.
Thought withdrawal: This is the false idea that people are able to intercept
and remove a persons thoughts. A person may believe that their thoughts are
being stolen from their brain by others.
Capgras delusions: This is a type of delusion in which a person believes that
someone they know (e.g. a family member or friend) has been replaced by an
impostor with an identical appearance. This specific delusional theme often
occurs among those that have been formally diagnosed with paranoid
schizophrenia, dementia, or those that have endured a brain injury.
Clinical lycanthropy: This is another rare delusional theme in which a person
believes they can morph from human into an animal. An example would be
someone thinking that they were blessed with a special superhuman ability,
allowing them to transform into a wolf. Keep in mind that this is one of the rarer
delusional themes on this list.
Cotard delusions: These can be described as delusions in which a person believes
they are already dead. A person with Cotard delusions may deny that they exist
and some of these individuals may simultaneously experience delusions of
immortality. Cotard delusions were named in honor of Jules Cotard, a
neurologist who discovered this condition in the 1880s. The DSM does not
include Cotard delusions in its specific diagnostic criteria.
Erotomania: Another delusional theme is that of erotomania in which an
individual believes that a celebrity is in love with them. For example, a person
may watch the Yankees and believe that Derek Jeter is their soulmate and sending
signs of love only to them. Those with erotomania often attempt to contact the
celebrity with gifts, letters, emails, and phone calls despite no reciprocation from
the celebrity. In extreme cases, the individual may resort to becoming a stalker.
Fregoli delusions: These are considered extremely rare delusions in which a
person believes that different people are all just a single person that is capable of
morphing his/her appearance as a disguise. Some have speculated that these
delusions are most associated with brain lesions or damage. If you experienced
this delusion, you would think that everyone you see at the store is actually the
same entity just morphing into different people.
Delusions of guilt or sin (self-accusation): This type of delusions involve feeling
guilty or remorseful for no valid reason. An example would be someone that
believes they were responsible for a war in another country or hurricane damage
in another state. In this case, the person believes that they deserve to be punished
for their sins and place full blame on themselves. A person may see a crime on
the news and believe that they were involved and to blame, despite the fact that
they had never committed a crime.
Delusions of grandeur: Those experiencing grandiose delusions believe that they
are a deity, have special powers (e.g. they can fly), rare abilities, or hidden
talents. Some people with delusions of grandeur may believe that they are an
incarnation of a god (e.g. Jesus Christ), a famous musician, or professional sports
player. People experiencing this delusional theme believe that they should be
praised for their talents and achievements, and therefore should be publically
recognized.
Delusions of immortality: Some people may experience the delusion that they
are immortal. Up to half of individuals experiencing Cotard delusions (the belief
that they are already dead) also believe that they are immortal. Although this is a
relatively uncommon delusional theme, it often occurs among individuals with
nihilistic delusions.
Internet delusions: Since the boom of the internet in the 2000s, there have been
delusional themes in which people believed they were being controlled by the
Internet. As more individuals connect to the world-wide-web in coming years,
expect the number of cases of internet-based delusions to increase. An example
could be that someone believes that Google is controlling their brain and
behaviors.
Delusions of jealousy: Those experiencing delusions of jealousy often believe
that their significant other is having an affair, which leads to feelings of jealousy.
Those that experience delusions of jealousy often have struggled with problems of
preexisting pathological jealousy. Many people experiencing delusional jealousy
repeatedly collect evidence in attempt to justify their delusions of infidelity.
Eventually the individual with this delusion will confront their partner and present
them with the accumulated evidence despite the fact that it shows nothing.
Delusions of mind being read: Some people experience false beliefs that another
person or other people can read their mind and knows exactly what theyre
thinking. This is different from delusions of control like thought broadcasting in
that the individual doesnt think that their thoughts are being perceived auditorily.
An example could be that you walk into a library and think that the librarian can
read your mind.
Nihilistic delusions: This is a false belief associated with the nonexistence of the
self, specific body parts, or the world. Another variation of a nihilistic delusion
could be that the self, body parts, and/or the world will be destroyed in the near
future (e.g. the world will end). These are often considered synonymous with
Cotard syndrome.
Delusions of persecution: Persecutory delusions occur when a person falsely
believes they are being conspired against by others, sometimes in attempt to
achieve a goal. An example would be if you thought your brother was trying to
poison you by putting chemicals in your food that affected your ability to function
at work.
Another example would be that the government is spying on them (e.g. tapping
their phone lines) because they were wrongfully identified as a terrorist. Those
with persecutory delusions often describe to others that all events they experience
are in some way related to them being persecuted.

Attacked: People wrongfully believe that others are blatantly attacking

them as a person.
Cheated: Some individuals believe that they are being cheated out of
opportunities.
Conspired against: Some people believe that their neighbors or work
colleagues are conspiring to get them fired from their job or to get them to
move out of state.
Followed: It is very common for those with persecutory delusions to
believe that they are being followed by other people (e.g. government spies).
Harassment: Certain people believe that others are harassing them and/or
going out of their way to make life difficult.
Obstructed: Individuals think that others are trying to prevent them from
achieving a certain goal.
Poisoned: A specific type of a persecutory delusion that people experience
is that of poisoning. They may believe that a restaurant chef has put a
poisonous substance in their salad in attempt to make them sick.
Spied upon: Other individuals believe that they are being spied upon by
government officials (e.g. the C.I.A.).
Delusions of poverty: Some people believe that they are extremely poor and
struggling financially, regardless of their current financial status. This isnt quite
as common of a delusion compared to others on this list, but it was more common
in early days when those experiencing mental illness failed to get government aid.
Religious delusions: These are considered delusions that have a religious or
spiritual basis. It is common for religious delusions to be connected to delusions
of grandeur (e.g. a person believes they were chosen by a deity to become
famous). These may also be connected to delusions of control (e.g. that a God is
hearing their thoughts), and delusions of guilt or sin (e.g. that they should go to
Hell for a tornado that occurred in Kansas). It should be noted that beliefs that
are considered the norm for a particular religion or culture are not regarded as
delusions.
Reduplicative paramnesia: Those with this delusional theme believe that a
specific place or location has been replicated and exists in multiple locations
simultaneously. Sometimes an individual with this delusional theme may believe
that a place has been relocated or transferred to another place. This is a condition
that is most often associated with brain injury.
Delusions of reference: An individual may believe that seemingly normal,
insignificant events or occurrences have significant meaning. An example would
be finding a penny on the ground and believing that it is a sign that the person is
guaranteed to win the lottery. Another example would be watching a TV show
and thinking that the host of the show has included specific messages just for
them (e.g. seeing the color blue and believing it was preplanned because its the
persons favorite color).
Somatic delusions: A somatic delusion is a false belief that relates to a persons
body (functioning, sensations, etc.) and/or physical appearance. An example
would be someone thinking that they are carrying a rare virus or that mites have
burrowed under their skin and are eating their intestines.
Truman Show delusions: This is a delusional theme in which a person believes
their entire life is staged on a reality show (e.g. The Truman Show). Those with
the condition may experience a sense of grandiosity, but often times a
simultaneous sense of persecution. This is another relatively rare delusional
theme to experience, but one that has been documented.
How are themes of delusions classified?
The above delusional themes are classified based on one of the four types of
delusions. The majority of the aforementioned themes fit into a theme of
bizarre delusions or non-bizarre delusions. Should a person experience an
emotional state as in bipolar disorder in which they are manic or depressive, and
the delusion is related to their mood, it would be an example of a mood-congruent
delusion. Delusions that arent related to any emotional state are considered
mood-neutral.

Bizarre delusions
Delusions of control
Nihilistic delusions
Thought broadcasting
Thought insertion
Thought withdrawal
Non-bizarre delusions
Delusions of persecution
Delusions of guilt or sin
Delusions of grandeur
Delusions of jealousy
Delusions of mind being read
Religious delusions
Somatic delusions

Causes of Delusions (List)

It is often difficult to pinpoint the specific causes of delusions for every person.
Some people may have a mental illness (e.g. schizophrenia) that causes the
delusions, while others may experience delusions as a result of drug abuse. It is
important to realize that two individuals may experience the same delusional
themes, but the root cause may differ.

Alcohol: Those that are heavy drinkers may be prone to experiencing

delusions while intoxicated. Individuals that have struggled with alcoholism
may experience delusions during alcohol withdrawal. Generally alcohol-
 induced delusions are temporary and subside as long as the individual
completes a detoxification and remains sober.
Bipolar disorder: There is evidence that those with bipolar disorder may
be more susceptible to experiencing delusions than average. It is speculated
that those with bipolar disorder are more likely to experience mood-congruent
delusions or false beliefs directly related to their depressive or
manic/hypomanic state.
Brain injury: Research has demonstrated that individuals with brain
injuries, particularly to the frontal lobe and right hemisphere is capable of
causing delusions. Brain injuries can lead to cognitive impairment, which
overtaxes the non-injured regions. This overcompensation among non-injured
regions (particularly the left hemisphere) can be a direct cause of delusions.
Bullying: While getting bullied doesnt always cause delusions, those that
get bullied experience profound changes in brain functioning if they are
unable to cope. Extensive bullying causes changes in brain activity, which
can lead to mental illness and in some cases, psychotic symptoms such as
delusions. Children who are bullied are significantly more likely to
experience delusions as teenagers than others. Kids that are bullied
experience delusions at a two-fold rate compared to others.
Cognitive impairment: Those who are cognitively impaired are also more
likely to experience deluded thinking. Poor cognition can lead to
dysfunctional and distorted perceptions of environment, circumstances, and
the self, making delusions more likely to occur.
Culture: Some cultures may be more likely to experience delusions than
others. There is also evidence that certain cultures are more prone to specific
delusional themes than others. In the West, people are more likely to
experience delusions of guilt or sin, whereas in the Middle East, individuals
are more likely to experience persecutory delusions.
Depression: Those experiencing severe depression may become so
depressed, that they experience delusions. When a person experiences
delusions from depression, it may be related to neurochemical changes, a
medication that the individual is taking, social isolation, and/or neurological
 changes as a result of long-term depression. Delusions are more common
among those with psychotic forms of depression. In cases of depression, the
delusions may have a depressive theme and thus be mood-congruent.
Drugs: Many cases of drug-induced psychosis have been documented as a
result of illicit stimulatory drug abuse (e.g. cocaine). While many delusions
are experienced as a result of stimulant psychosis, delusions can also be
experienced as a result of general drug-induced psychosis from non-
stimulants like LSD. Delusions are also commonly experienced upon
discontinuation of illicit drugs.
Genetics: There is evidence that those with certain genetics are more
prone to experiencing delusions than others. Those with close [first-degree]
relatives that have been diagnosed with schizophrenia, delusional disorder, or
have experienced delusions are more likely to experience delusions
themselves. Exact genetics causing the delusions may differ based on the
individual.
HVA levels: There is some evidence that levels of HVA (a dopamine
metabolite) may cause delusions in some individuals. Currently more
research is warranted to back-up the initial findings that speculate HVA may
be a causal factor. Compared to individuals without delusions, those with
abnormal levels of HVA were more likely to experience delusions of
persecution and jealousy.
Social isolation: Those that isolate themselves from society for extended
periods of time are more likely to experience delusions. Social isolation is
capable of changing regional activity in the brain, activating/deactivating
certain genes (epigenetics), and altering neurotransmission. Extensive social
isolation alone may be a direct cause of delusions.
Medications: Those that are taking pharmaceutical drugs, especially those
that affect the brain are more likely to experience delusions. These
pharmaceuticals alter neurotransmitter activity and receptor activation.
Particularly those that are taking high doses of ADHD
medications (like dopamine reuptake inhibitors) may experience delusions
directly as a result of excess dopamine.
 Neurotransmitter dysfunction: Those that have a neurotransmitter or
receptor imbalance may be more likely to experience delusions. It is thought
that high levels of dopamine in certain brain regions may directly cause
delusions. This is why individuals with excess dopamine are given
antipsychotics to reduce dopamine levels, thus decreasing the delusions.
Personality disorders: A preexisting personality disorder or temperament
may make a person more likely to experience delusions. Environmental and
genetic influences are thought to sculpt the personality, and may also make an
individual more likely to experience delusions. Influence of a persons
personality is thought to be high in regards to causing delusions.
Psychosis: Those that have experienced psychotic episodes, particularly
those that were organic (e.g. non-drug induced) are likely to also experience
delusions. Psychosis is commonly associated with schizophrenia and is
thought to be a result of dopamine dysfunction and stemming from genetic
abnormalities.
Schizophrenia: People with schizophrenia are likely to experience
delusions. Delusions are considered a hallmark positive symptom of this
disease (the other being hallucinations). The specific types of delusions
experienced may differ based on the specific type of schizophrenia.
Sensory deficits: Those with delusions are thought to often have sensory
deficits such as: poor hearing, poor vision, or a combination of both. Sensory
deficits are known to alter brain functioning, perhaps in ways that make an
individual more prone to delusions. The sensory deficits may also lead to
excess stress, which is another influential factor.
Stress: Excessive stress is known to cause delusions. Stress increases
stimulatory neurotransmitters and may actually kill brain cells if we arent
able to calm down. While a little stress every once in a while isnt bad,
harboring chronic stress and anxiety can alter the brain, making us more
susceptible to deluded thinking.
Trauma: Those that have been through a traumatic experience may end up
dealing with delusions as a result. Trauma triggers off a high stress response
and alters the way we think and our neurotransmission. Not being able to turn
 off the fight-or-flight response can lead to a cascade of changes such as sleep
deprivation, poor diet, etc. which influence delusions.
Withdrawal: Those going through drug withdrawal may experience
delusions. Particularly those that have taken a drug at high doses and are
tapering too quickly may be more prone to delusions. It is also common for
those that have taken drugs affecting dopamine levels to cause delusions upon
withdrawal (e.g. Adderall withdrawal).

Treatment for Delusions

Not all cases of delusions require pharmaceutical treatment, some may just require
an abstinence from illicit drugs. That said, many people benefit from taking
medications to keep their delusions at bay, particularly those that are caused from
a mental illness or neurotransmitter dysfunction.

Antipsychotics: The most commonly administered treatment for delusions

is that of antipsychotics. Atypical antipsychotics are generally preferred
compared to older typical ones due to the fact that they are effective and
have less severe side effects. Antipsychotics work by blocking dopamine
receptors, thus inhibiting dopaminergic activity and decreasing delusions.
Psychotherapy: In addition to antipsychotics, those suffering from
delusions often benefit most from psychotherapy. This helps restructure their
thinking and distinguish reality from their false perceptions. While therapy
isnt an overnight success, it is a great long-term option for those suffering
from delusions. With therapy, individuals are able to learn various coping
techniques and may be able to alter their behavioral responses when a
delusional thought occurs.

Have you ever experienced delusions?

If youve ever experienced delusions, feel free to share your experience in the
comments section below. Discuss the specific type of delusion(s) that you
experienced as well as the more specific theme. To help others understand your
situation, you may also want to include what you believe caused you to
experience the delusion (e.g. mental illness, drug abuse, withdrawal, etc.).

Many people have experienced delusions at some point throughout their lives.
Those that experience chronic delusions as is the case with schizophrenia often
require pharmaceutical intervention to get them under control. How long did your
delusional state last and how did you cope with the delusions?