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People who suffer from delusional disorder may become isolated and feel alienated from others. Relationships are strained, often leaving a person to fend for themselves. They can have depression, due to the challenges they face associated with their illness. Depending on the subtype of the disorder, it could also get them into legal issues. Caring for a person diagnosed with delusional disorder takes a degree of patience, compassion, and understanding.
Delusional disorder is not a common diagnosis and can be misunderstood. People who suffer from it cannot tell reality from illusion in certain situations though they may act perfectly adjusted other times. Delusional disorder is grouped into a category similar to schizophrenia and is considered a serious mental illness classified as psychosis. It is differentiated from schizophrenia because with delusional disorder, social functioning and erratic behavior is not as severe. A person with delusional disorder will not show signs of any other symptoms of schizophrenia (disorganized thoughts and speech, bizarre behavior, severe hallucinations) other than dysfunctionality stemming from their delusion. However, a person diagnosed with schizophrenia will display delusional thinking as part of their symptoms.
There are two types of delusions that a person may have when diagnosed with delusional disorder. They are termed “non-bizarre” or “bizarre” and are distinguished as:
Having delusional disorder has nothing to do with a person’s intelligence level, socioeconomic, or cultural background. A delusion is a belief in something where a person is completely convinced that what they are experiencing is real.
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Try to offer empathy and focus on the emotions that the person is experiencing. Arguing facts and details may cause the person to shut down and perceive you as judging them. By offering support with no judgement that doesn’t confirm or deny the delusion, the person may feel consoled and trust that you care for them. Some things to keep in mind as you speak to the person: 1. Pay attention to the emotions of the person 2. Discuss the way you see the delusion 3. Express that you are concerned about the person 4. Offer to pursue therapy together but be strategic 5. Ask the person why they believe as they do and be open-minded 6. Avoid getting frustrated and expressing that to the person 7. Learn about Cognitive Distortions or Thinking Errors 8. Model engagement in reality testing Information for these strategies are from Tamara Hill’s article on PsychCentral, an independant mental health website with information and content overseen and created by mental health professionals. Medically reviewed by Lori Lawrenz, PsyD — Written by Morgan Mandriota on November 15, 2021
It can be difficult to watch a loved one experience symptoms of paranoia. Your support can help them cope. When someone you love experiences paranoia from a mental health condition, you might feel the urge to step in to help but might not know how. Learning about paranoia and how to talk to someone with paranoid delusions may be a good first step. “Paranoia is characterized by the intense feeling and belief that one is being threatened, targeted, and conspired against by others,” explains South Oaks Hospital medical director Youssef Hassoun, MD. Delusions are false beliefs that someone holds onto despite evidence to the contrary. Paranoid delusions refer to false beliefs about being persecuted or in danger. Paranoia is a symptom of many mental health conditions, including but not limited to: Only a health professional may be able to provide an accurate diagnosis. This is important because paranoia may also be a sign of something else, like a medication side effect. Not everyone will experience paranoia in the same way, but there are several common signs that could indicate it. Paranoia isn’t its own diagnosis. Rather, it’s a symptom of a few mental health conditions. Here are some common signs that someone may be experiencing paranoia:
It’s also important to know what paranoia isn’t. Symptoms of paranoia as a result of a mental health condition are not to be confused with paranoia related to distrust. “Distrust can be present among any of us, based on certain experiences we’ve had in the past that left us generally untrusting of others,” says Hassoun. For example, it may be natural for someone who’s been repeatedly lied to, cheated on, or scammed to have a difficult time trusting others. When considering symptom severity, Hassoun notes that psychiatrists usually take note of how it impacts the person’s ability to function every day. “In schizophrenia, for example, paranoia leads to severe functional impairment, frequently preventing individuals from being able to take care of themselves, have meaningful jobs, continue to be able to have stable relationships with others, and, at times, leading to frequent hospitalizations,” he says. Consider the following tips on what to do or how to respond to someone experiencing paranoia. Don’t deny their experience“[People living with paranoia] usually have a severe conviction of being in danger that others don’t necessarily share, and hence it’s considered delusional,” says Hassoun. This doesn’t mean that the experience isn’t real for them, though. “Challenging one’s delusions in a confrontational manner never ever helps,” he says. “On the contrary, this may alienate the person [or] lead them to be more aggressive, argumentative, and eventually agitated and possibly hostile.” Remembering paranoia isn’t a personal choice may help you support your loved one. “Partners and loved ones can help people experiencing paranoia feel seen and supported by not denying their experience or telling them their experience isn’t real,” adds Lesley Smith, a clinical social worker in Portland, Oregon with a history of working in mental health crisis intervention. She recommends finding the balance between not confirming their fears but not denying them either. For example, you can try saying something like “It sounds like you’re really scared right now.” Be kind and understandingOffering kindness and compassion can reassure them that they’re supported and going to be OK, even if they don’t feel like it at the moment. “It’s important to remember that paranoia (or any illness or symptom) does not summarize the individual,” advises Hassoun. “Don’t be afraid to shine a light on what’s beautiful in them to help them cope with intense feelings of insecurity, fear, or disappointment that they might have.” To do this, he suggests mentioning:
After a paranoia episode, Smith also suggests validating their experience and reminding them that you’re there for them. Educate yourself about paranoiaLearning about paranoia, including what it is and what it isn’t, can help you become more informed as someone trying to offer support. You can do this by: Ask what you can do to helpHassoun reminds you to simply ask: “What can I do to help?” Other questions you can ask them include:
Once you learn these answers, you can utilize them to help distract or calm down your loved one. Reassure their safetySmith notes that the most important thing to do is to help your loved one feel as safe as possible in the moment — physically, mentally, and emotionally. To do this, try comforting them through their fears or helping them access relaxation and grounding strategies. Hassoun says you can also “remind them of a similar experience that happened previously where they were suspicious of someone yet they found out that there was nothing to it and ask them if this could be the case now.” Seek professional help“Paranoia doesn’t make people dangerous, but sometimes when people are scared they do extreme things,” says Smith. “If you feel like you’re unsafe or the person you’re with is engaging in unsafe behavior, please reach out for support.” If you have already tried speaking with your loved one and feel you need further help, consider contacting their therapist or a mental health professional. They may be able to guide you on how to best support them during (and after) the episode. You could also contact the National Alliance on Mental Health to find resources for people living with paranoia and those looking to support them. Smith notes that when necessary, calling emergency services might help, too, “especially if the paranoia is leading to thoughts of hurting themselves or others.” These tips can help you support someone who lives with paranoia, but understanding and care can only do so much. Paranoia is a symptom of a mental health condition that can be managed with the help of a mental health professional. “Family members need to know they’re not the primary therapist and their role isn’t to ‘fix what’s wrong,’” reminds Hassoun. “The most important role that one could play is advocating for the well-being of their loved ones who are [experiencing] paranoia,” he adds. “[You] can have a therapeutic role by simply creating opportunities and circumstances for one to be able to cope better with these symptoms they’re having.” Supporting your loved ones when they’re experiencing symptoms of paranoia is possible. Here are some ideas of how to help someone with delusions:
Ultimately, it’s important to remember that managing their paranoia isn’t your responsibility. But your love and support can still offer them a helpful sense of comfort in times of need. Last medically reviewed on November 15, 2021
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