Therapeutic Response to Delusions

Instructor: Emily Cummins
Delusions refer to firmly held but false beliefs about reality. In this lesson, we'll talk about some of the causes of delusions and some of the therapeutic methods that aim to treat delusions.


Have you ever thought you saw something that wasn't there? If so, this was probably a shadow or light playing tricks on you. It probably wasn't a delusion, which can be a symptom of various, serious mental disorders. In this lesson, we'll talk about the different treatments that mental health professionals might use to help patients with delusions.

First, we should define delusions. Delusions refer to beliefs that have no basis in reality. They are firmly held beliefs about the world that a delusional person clings to, but which are not real. A delusion can be something like believing you are the president, which is a grandiose delusion. They could also be somatic, meaning you believe something is wrong with your body, like you have a serious injury, when in reality nothing is wrong. Delusions of paranoia happen when we think someone is after us, following us, or out to get us, even when they are not. Erotomanic delusions are those that involve believing someone, often a very important or very famous person, is in love with you.

Causes of Delusions

Delusions are brought on by some type of psychosis, which is a mental state in which our thoughts and emotions are very detached from reality. Psychoses can be caused by a number of different things. Diseases like Parkinson's and Huntington's, which are diseases of the brain, can bring about delusions. Sometimes, external factors like drug abuse or severe lack of sleep can cause delusions.

Delusional disorder is considered a form of psychosis and it is characterized by the presence of delusions, but, otherwise, the patient tends to appear relatively normal. In other words, day to day life of patients with delusional disorder is not always that disrupted. Delusions can also be caused by schizophrenia, which is a mental illness that affects how someone thinks and feels. Schizophrenia disrupts how we perceive reality and it can involve delusions.


What can be done for people who experience delusions? Well, the treatment depends on what is causing the delusion. Let's talk about some of the therapeutic approaches that can help alleviate delusions. Psychotherapy is one method for treating delusions. Psychotherapy is a method in psychology where a trained professional tries to help a patient change behavior without drugs, often through counseling. In the case of a disorder or condition causing delusions, a therapist will try and challenge a patient's delusions in a constructive way. It is important that a counselor not challenge a patient's delusions too aggressively at first. It is key to remember that a patient truly believes his or her delusions are real.

Antipsychotic medication can also be used to treat delusions. Conventional antipsychotics are drugs that have been around for a long time. These work by blocking dopamine receptors in the brain. Psychiatrists think that dopamine might be involved in the tendency to develop delusions. Atypical antipsychotics are a newer group of drugs that block dopamine and serotonin receptors, also thought to be involved in delusions. These drugs typically have fewer side effects than conventional antipsychotics. Sometimes, antidepressants are needed, as depression is common in people with psychotic disorders. These medications can have side effects, though, so it is important to carefully monitor patients taking them.

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