Bipolar Disorder Delusions

 Delusions are beliefs that aren’t based on reality. During a delusion, you might believe that you’re close friends with a famous musician you’ve never met or that you’re leading the country’s space program. Learn about Psychotherapy

Having delusions can be a condition of its own, called delusional disorder. They also can occur during the manic or depressive episodes of bipolar disorder. Sometimes, delusions happen together with hallucinations.

Believing in things that aren’t true can distance you from the real world and leave you feeling distressed. The inability to let go of an untrue belief could affect your work, relationships, and other parts of your life. However, there are effective treatments available.

There are several different types of delusions. Grandiose and paranoid delusions are the most common in bipolar disorder. Guilt is more common during depressive bipolar episodes.

Grandiose

People with grandiose delusions believe that they’re more powerful, rich, smart, or talented than they really are. They think that they have accomplished greater things than they have done. Sometimes grandiose delusions involve religious beliefs.

Paranoid or persecutory

Someone with paranoid or persecutory delusions thinks that other people are trying to hurt them, despite having no proof that this is happening. They may feel so threatened that they repeatedly call the police seeking help.

Jealousy

A person with this type of delusion believes that their romantic partner is cheating on them. In reality, there’s no evidence that their partner is being unfaithful.

Guilt

This is when someone believes they’re responsible for committing a crime or causing a terrible event, such as a natural disaster. Again, there’s no evidence that they had involvement in the event.

Erotomanic

This type of delusion causes a person to believe that someone is in love with them who isn’t. Often the object of their affection is someone famous.

Somatic

Someone with a somatic delusion believes that there’s something wrong with their body. For example, they believe that they have cancer or another disease, when they’re actually healthy.

Mixed

A person with mixed delusions has two or more of the delusions listed above.

Below are a few examples of what someone might say or believe with each type of delusion. In every case, there’s no evidence to back up their claims.

Grandiose

“I’ve discovered the cure for cancer.”

“I have millions of dollars in the bank.”

“I’m the new Pope.”

Paranoid or persecutory

“The government has planted a chip in my brain, and now they’re monitoring my every move.”

“The person in the car parked outside my home has been following me and is trying to kidnap me.”

“My co-worker puts poison in my coffee every morning. They want to kill me.”

Jealousy

“I need to check my partner’s emails every day to see who they’ve been talking to.”

“My spouse was 5 minutes late tonight. They must be cheating on me.”

“I waited outside my partner’s office for 2 hours to see where they went and who they were with.”

Guilt

“I gave my roommate a cup of tea, and she died of cancer. I’m responsible for her death, and I must be punished.”

“I wished for rain so that I wouldn’t have to go to work. The hurricane that blew through my city was my fault.”

Erotomanic

“The anchor on the evening news is sending secret messages straight into my brain.”

“I’ve written hundreds of letters to J. Lo. I wait for her in her hotel lobby after every concert.”

“My congressman is in love with me. The restraining order he filed against me is proof of his love.”

Somatic

“Parasites have crawled into my skin and are laying their eggs inside my intestines.”

“The left side of my face looks different than the right side. I’m disfigured and ugly.”

“I’ve been to 20 different doctors, but none of them will admit that something is wrong with me.”

Doctors don’t know exactly why some people develop delusions. These false beliefs are a feature of psychotic episodes in some people with bipolar disorder.

Genes may be at least partly responsible for delusions. You’re more likely to have them if one or more of your family members do, too.

Delusions may have something to do with brain chemicals called neurotransmitters, which send messages from one nerve cell to another. An imbalance in these chemicals can prevent the correct messages from getting through.

A few other factors cause people with bipolar disorder to have delusions. These include:

  • stress
  • drug and alcohol use
  • poor vision and hearing
  • loneliness

Your doctor will evaluate your symptoms to figure out which treatment might work best for you. If your doctor determines that you’re a danger to yourself or to others, you may need to stay in a hospital for a period of time.

Treatment for bipolar delusions often combines medication with talk therapy.

Talk therapy can help you identify and work through the thoughts that have become distorted. You can meet one on one with the therapist or together with your partner or other family members.

Antipsychotic drugs are the most common medications used to treat delusions. These drugs block the effects of the chemical dopamine in your brain. Dopamine is involved in triggering delusions.

When someone is having delusions, you instinct may be to reason with them or challenge the false belief. But the more you try to talk them out of it, the more difficult it will become to dissuade them.

Instead, try these strategies:

  • Listen calmly as your loved one talks about their concern.
  • Assure them that they’re safe and that you’ll help protect them from any harm.
  • Offer other possible reasons for what is happening. For example, you might say, “I understand that you think the car parked outside your home is the CIA monitoring your movements. Why are they following you? Is it possible that the person who owns the car is simply visiting one of your neighbors?”
  • Try to distract the person or direct them to another activity.

If your friends and family often tell you that your beliefs are untrue, see a mental healthcare provider. An exam can help pinpoint the reasons for your delusions. Your doctor will suggest treatments to help you manage false beliefs.

Delusions can be a symptom of both manic and depressive episodes in people with bipolar disorder. These false beliefs can be very distressing to anyone who experiences them.

If you’re concerned about delusions in yourself or a loved one, seek help from your primary care provider, a psychologist, or a psychiatrist. They can help you diagnose the condition and set up a treatment plan.

Next: What are personality disorders?

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