Persecutory Delusions: What They Are, Causes, Diagnosis and Examples
Have you ever had an irrational fear of being persecuted? If so, you might be experiencing persecutory delusions. This is a type of delusion that involves the person believing that they are being threatened by some outside force. These delusions can take many forms and present with different symptoms. In this blog post we will discuss what these types of delusions are, how to diagnose them, and provide examples to help illustrate our points!
Persecutory delusions can result in a variety of symptoms, including:
- fearing ordinary situations
- feeling threatened for no cause
- believing that others are talking about them
- thinking people on the television or radio are sending messages only for them
- believing that people on the street are talking about them
- fearing being harmed or poisoned by others
- feeling as if someone is trying to poison their food.
Examples of persecutory delusions
A person suffering from persecutory delusions might say things like:
“I’m being followed by the police.”
“The people on TV are talking about me and trying to get in touch with me.”
“People at work are plotting against me, sabotaging my equipment so I get fired. This is why they keep coming up with new rules for everything!”
“The mailman is calling my name and saying things about me to other people.”
“The people in the restaurant are trying to poison my food because they don’t like me. I can tell by their looks.”
“I keep hearing a voice telling me that I’m going to be killed by someone.”
Persecutory delusions may involve the person believing that others want to harm them, take advantage of them or generally make life difficult for no reason at all.
There are a number of different ways persecutory delusions might present. Some examples include:
erotomanic – believing someone loves them when it’s not true, such as a celebrity or politician who the person may have never met
grandiose – delusions involving exaggerated beliefs about one’s abilities, status or identity
jealous – delusions that someone is interested in stealing a person’s partner for no good reason
litigious – the belief that others are conspiring to get them into legal trouble when it isn’t true.
persecutory type (paranoid) – delusions where the person believes that others are trying to harm them.
inferential – the person is suspicious of what others might think or want, and figures that they must be plotting against him/her
mixed – a combination of any above types.
The DSM-V describes persecutory delusions as: “A false belief based on incorrect inference about external reality that is firmly sustained despite what almost everyone else believes and despite what constitutes incontrovertible and obvious proof or evidence to the contrary.”
Difference between paranoid and persecutory delusions
Paranoia and persecutory delusions are two distinct types of thought processes, even though they are linked.
Paranoia is a mental disorder that involves intense feelings of suspicion, fear and persecution. People with paranoid disorders tend to have preoccupations regarding certain topics or generally suspicious personalities about them (e.g., they might think people are always out to get them).
Persecutory delusions are more about the person having persistent thoughts that they are being persecuted, even when it doesn’t make sense. They may feel certain people are out to get them, or they might even believe that a group of people such as the government is targeting them.
Persecutory delusions often involve somatic complaints and fears about interpersonal relationships (e.g., believing their partner doesn’t love them).
The difference between paranoia and persecutory delusions can be thought of as the difference between a person thinking other people don’t like them versus having persistent thoughts that they are being targeted for persecution.
Persecutory delusions causes and risk factors
Persecutory delusions can occur in a variety of mental diseases, such as schizophrenia, schizoaffective disorder, and others.
Schizophrenia is a chronic mental health condition. People with schizophrenia experience changes in their perception, mood and behavior that affect how they see the world around them. This makes it hard for people to communicate or interact socially with others.
The disorder may make you unable to distinguish between what’s real and unreal, which can cause delusions (beliefs that aren’t true).
People with schizoaffective disorder have a combination of schizophrenia and mood disorders such as depression or bipolar disorder. They may experience delusions during both their psychotic periods (when they lose touch with reality) and depressive/bipolar episodes.
Bipolar disorder is a mental health condition that involves periods of high and low mood.
When you have bipolar depression, you experience symptoms such as sadness, hopelessness, guilt or irritability. You may also find it hard to function in your daily life due to feeling tired all the time or being unable to concentrate on things. People with bipolar disorder also experience psychotic symptoms.
Persecutory delusions are more common in people with mental health problems than those without, but it is possible to develop them at any age.
People who have experienced trauma or neglect as children may be particularly vulnerable to developing persecutory delusions later on. This could be due the negative coping mechanisms they learn to deal with these difficult situations.
For example, a child might think their parents never loved them because they were neglected or abused. They may also develop negative ideas about themselves and the world around them as a result of being in such an environment for so long (e.g., “I’m useless,” or, “The world is dangerous”).
Major depressive disorder with psychotic features
Persecutory delusions can also occur in depression, more specifically in depressive disorders with psychotic features.
People with depression can have persistent negative thoughts about themselves, the world around them and their future. These may become more intense due to other symptoms of depression such as having low energy or changes in appetite.
A person may have false beliefs that cannot be attributed to a mental illness, a medical condition, or drug in rare circumstances.
People with delusional disorder have a strong belief in something untrue that can’t be explained by another condition. They may also have hallucinations, particularly of the person who they think is persecuting them.
It’s not clear what causes it but there are certain risk factors for developing this type of delusion:
- Being older than 50 years old
- Having a family history of mental health problems
- Being unmarried or living alone.
People with delusional disorder are not usually violent towards others, but they can be extremely disruptive to their lives and the lives of people around them. They may also become suicidal if they feel that there is no other way out of these thoughts which makes it even more serious.
Diagnosing the cause of persecutory delusions
Doctors may use the following tests to determine the source of persecutory beliefs:
- Physical examination
- Blood tests
- Psychological evaluations. These include questionnaires and cognitive testing to determine the presence of symptoms such as delusions, hallucinations, mood changes or thoughts about self-harm. Your mental state may also be assessed through your ability to communicate effectively with those around you and carry out everyday tasks. This is usually done by a psychiatrist or psychologist.
A diagnosis of persecutory delusions usually requires that you have had these thoughts for at least one month and be able to identify at least one trigger factor, such as an incident in the past involving persecution.
Persecutory delusions treatment
Treatment will vary depending on the underlying cause and severity of your condition. It generally entails the following:
Antidepressants: Medication such as selective serotonin reuptake inhibitors (SSRIs) can be used to treat persecutory delusions.
Cognitive behavior therapy: A type of psychotherapy that addresses how you think and behave, cognitive-behavioral therapy is effective in treating paranoia and other psychotic disorders, according to the University of California at Berkeley.
Exposure therapy: Exposure therapy is used to treat persecutory delusions in patients with psychotic disorders such as schizophrenia and bipolar disorder. This type of therapy involves repeatedly confronting your fears or situations that make you anxious, according to the National Alliance on Mental Illness (NAMI).
Medication for anxiety: These can reduce obsessive thoughts about persecution, but must be used with caution.
Mental health care: This can include medication, talk therapy and peer support programs.
How to help someone with persecutory delusions
If your loved one suffers from persecutory delusions, you may be unsure how to help.
Here are some ways you may assist:
- Listen: Be patient, empathetic and understanding.
- Offer support: Let your loved one know that you are there for them when they need it most. Encourage treatment, but do not pressure or nag someone to seek help if they aren’t ready yet.
- Help with daily activities: Offer assistance so your loved one can participate in routine activities, such as paying bills or grocery shopping.
- Offer reassurance: Reassure your loved one that they are safe and nothing bad will happen to them if you are around. Be careful not to overdo this however, since it can seem patronizing.
Conclusion: Persecutory delusions can be difficult to live with, and these symptoms may vary depending on the severity of your condition. Treatment will depend on what is causing them and how severe they are; most involve some form of therapy or medication. If you believe someone in your life suffers from persecutory delusions, try providing support without pressuring them to seek treatment if they aren’t ready yet. Listen, offer reassurance and help out when possible so that they feel comfortable participating in their daily activities again!