Hi, I'm Dr. Tracey Marks
and I make mental health education videos.
Today, I'm talking about delusional disorder
and how it's different from schizophrenia.
Delusional disorder is very different from schizophrenia.
The only thing that they have in common
is the presence of delusions.
Schizophrenia is delusions plus hallucinations,
disorganized thoughts and behaviors,
and other cognitive or thinking problems.
A delusion is a fixed false belief
and despite evidence that goes against what you believe,
you still believe it,
so it's what we call a tightly held belief.
Delusions can be a part of other psychotic experiences
like mania, depression,
and substance intoxication or withdrawal.
The delusions you see in schizophrenia
tend to be bizarre in nature
whereas the delusions you get with delusional disorder
are non-bizarre and possible.
An example of a bizarre delusion is believing
that our insides are being replaced while we sleep.
A non-bizarre delusion is believing
that a famous person is in love with you.
It's probably really unlikely, but it's possible.
The main criteria for delusional disorder is that
you have a delusion that lasts at least one month.
And there are certain personality disorders
where people can experience
very short-term psychotic experiences
that last minutes to hours.
And you can see this with paranoid personality disorder
and borderline personality disorder.
You can watch more about these disorders
in my personality disorders playlist.
But those very short, transient psychotic experiences
would not be considered a delusional disorder.
There are six types of delusions in delusional disorder.
First, there's erotomanic type.
This is when you believe that someone is in love with you.
And we sometimes see this kind of delusion
in people who stalk.
They're following or contacting the person
because they believe the person wants their contact
and the person on the other end is creeped out by it
and doesn't understand why the stalker
won't just leave them alone.
Now, not every stalker is delusional, but some can be.
Next is grandiose type.
With this delusion, you believe that you have a great talent
or insight that people just haven't discovered yet
or you're on the verge of a big discovery.
You might be working on something big,
but there's something about it
that just doesn't add up enough
and that's why it's undiscovered or unrecognized,
but you'll say it's unrecognized
because the right people haven't been exposed to it.
Another way that this can look is
you believe that you're a prominent figure like Jesus
and that the person that we thought was Jesus
was just an imposter.
Religious themes often get pulled in
to the grandiose type of delusions.
The third type is somatic.
It involves delusional beliefs
about body functions or sensations
and the most common beliefs are the following:
that you emit a foul order,
you're infested by insects in your skin,
you have a parasite in your body,
or the parts of your body are not functioning.
And believe it or not, these really are the standard ones.
There's other kinds of somatic delusions people can have,
but these themes seem to repeat themselves.
And people with these delusions
end up with a lot of doctors appointments
to get the problem that they think they have evaluated.
A fourth type is jealous type and with this,
the person believes that their partner is unfaithful.
They may see minor things
like you having disheveled clothing
as evidence of the infidelity.
A fifth type is persecutory.
With this type,
the person feels that they're being conspired against,
spied on, or poisoned.
The person also may feel like someone or some entity
is holding them back from achieving a certain goal.
These last two that I just mentioned may sound very similar
to a person with paranoid personality disorder
and I talked about that disorder in this video.
The person with paranoid personality though
has a lot more going on than having these specific concerns.
And with the personality disorders,
the problems bleed across all aspects of their lives.
Also, the paranoid person is suspicious,
but not necessarily delusional.
They can at least consider
that what they're thinking may not be true.
The last type is mixed type
and this is where no specific theme predominates
and you may have features of a few of the types.
These delusional themes can be present
in illnesses that have delusions.
For example, mania can have grandiose delusions.
With psychotic depression,
people can have persecutory delusions.
Delusional disorder may not be obvious to other people
because the delusions can be compartmentalized in a way
that you can have normal functioning
in every other aspect of your life
that doesn't involve the delusion.
So if you believe Mark Zuckerberg is in love with you,
you can still go to work and take care of your family,
but where it may show up is in your attempts to contact him
or you may post pictures on your Instagram
that reveal your obsession with him.
If you have somatic delusions,
you may compulsively wash yourself several times a day
to get rid of your smell.
And people close to you know that you have this problem,
but others on the outside of your home may not.
Delusional disorder tends to remain stable over time,
meaning it can intensify and cause problems,
or it can run quietly in the background of your mind.
But a small portion of people
can go on to develop schizophrenia.
Not because it causes schizophrenia,
but it may be more of what we call
a prodrome to schizophrenia.
A prodrome is an early stage of an illness
where you can have some symptoms of a larger illness,
but not all of them.
So you have a little of this and a little of that,
but it eventually builds up to the bigger illness.
So in some people,
delusional disorder can lead up to schizophrenia,
but that's not the usual.
In my experience, delusional disorder is not as responsive
to anti-psychotic medication.
If the disorder doesn't cause a lot of dysfunction,
you may not even go to get help
or accept that you need to take something
to stop believing what you do.
And since it doesn't make you
globally psychotic and out of touch,
many people will just keep to themselves
about their beliefs to reduce conflict
and get people off their back about getting help.
So it's something people can live with without seeking help.
Sometimes the intensity of the belief can come and go
such that you get less focused on it.
Then under stress, the thoughts can ramp up again.
So that's delusional disorder.
For more information on schizophrenia, watch this video.
Sometimes the obsessions of OCD can get close to delusional.
For more on OCD, watch this video.
See you next time.