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.
