Understanding the Different Types of Delusions

Delusions are more than unusual ideas or personal biases they’re fixed, false beliefs that someone holds despite clear evidence to the contrary. These beliefs can significantly impact daily functioning and relationships.

Delusions often appear as part of mental health conditions such as schizophrenia, bipolar disorder, dementia, or delusional disorder. They can also result from brain injury, intoxication, or as a side effect of certain medical illnesses. Understanding the different types of delusions can help you recognize when professional help might be necessary.

Delusion vs. Self-Deception

Delusions differ from self-deception. Self-deception involves incorrect thoughts or feelings based on personal bias. Delusions, on the other hand, are deeply held and often interfere with a person’s ability to function.

What Is Delusional Disorder?

Delusional disorder is characterized by one or more false beliefs lasting a month or longer. These beliefs may involve ordinary situations like being followed by police or extraordinary claims, such as having organs removed without leaving scars.

The exact cause of delusional disorder is unknown, but research suggests several factors may contribute:

• Trauma or extreme stress as a coping mechanism

• Genetics, particularly family history of schizophrenia or schizotypal personality disorder

• Brain chemistry imbalances or structural changes in the brain

People with delusional disorder typically do not recognize their beliefs as irrational, even when presented with evidence to the contrary.

Types of Delusions

Delusions can involve events that might plausibly happen or beliefs that are completely “bizarre” and not grounded in reality. Common types include:

Persecutory Delusions

The most common type, persecutory delusions involve the belief that someone or something is out to harm the person. This could involve an individual, an organization, or even a machine.
Often linked to extreme paranoia, persecutory delusions are frequently accompanied by anxiety, difficulty sleeping, depression, and negative thoughts about oneself.

Erotomanic Delusions

Erotomanic delusions cause a person to believe that someone often a celebrity or high-status individual is secretly in love with them. People experiencing these delusions may think the person is sending them hidden messages.
This can sometimes lead to stalking behaviors, either in person or online.

Grandiose Delusions

People with grandiose delusions believe they have exceptional abilities, wealth, fame, or even spiritual powers. These beliefs can provide a sense of importance or belonging but may also lead to risky behavior.
Examples include believing:

• You are a famous figure or have special powers

• You can cure incurable diseases

• You are God or chosen by a higher power

Grandiose delusions are common in bipolar disorder and schizophrenia.

Jealous Delusions

This type involves the false belief that a partner is unfaithful. It differs from normal jealousy in its intensity and persistence. People may repeatedly search for “evidence” or misinterpret their partner’s behavior, sometimes resulting in extreme actions like checking personal belongings or confronting others.

Somatic Delusions

Somatic delusions center on the body. A person may believe something is wrong with them physically despite normal medical tests.
Examples include:

• Believing you have a serious illness

• Thinking your internal organs are missing or rearranged

• Believing your veins run backward

People with somatic delusions often undergo repeated medical testing but remain convinced something is wrong.

Mixed or Unspecified Delusions

Some individuals experience multiple types of delusions at once without one type being more dominant (“mixed”). Others have delusions that don’t clearly fit into any category (“unspecified”).

Common Themes in Delusions

Delusions often revolve around recurring themes rather than isolated beliefs. These include:

• Persecution: Feeling targeted or harmed by others

• Infidelity: Believing a partner is unfaithful without evidence

• Love: Believing someone, often a stranger or celebrity, is secretly in love with you

• Religion: Thinking you have god-like powers or receive direct messages from God

• Grandiosity: Feeling superior or possessing extraordinary abilities

• Guilt/Unworthiness: Believing you’ve committed an unpardonable sin or deserve eternal punishment

• Negation/Nihilistic: Believing you or the world no longer exist, or that parts of your body are missing

Themes of guilt, unworthiness, or negation are especially common in people with depression and can increase the risk of self-harm.

Delusions vs. Hallucinations

Delusions are false beliefs, while hallucinations are false sensory experiences (such as hearing voices or seeing things that aren’t there). They often occur together but are distinct phenomena.

When to Seek Help

Delusions can seriously disrupt relationships, work, and safety. If you or someone you know is experiencing delusions:

• Consult a mental health professional or primary care provider

• Avoid confrontation; instead, encourage supportive evaluation

• Seek immediate help if the person is at risk of harming themselves or others

The Bottom Line

Delusions are fixed, false beliefs that can occur in mental health conditions or due to medical issues. They vary widely from paranoia to grandiosity to false beliefs about one’s body but all can profoundly affect a person’s life. Recognizing their types and themes is the first step in getting help.

If you found this article informative, share it or subscribe to our newsletter for more mental health insights