Delusions: what are they, types and differences with hallucinations

It is common that on some occasion, and especially under high levels of stress, we find ourselves before the firm belief that someone is watching us, that someone is following us or that someone is talking about us even if this is not truth.

However, when these ideas flood the person's mind and they are not able to see reality, we can talk about the known delusions. Throughout this article we will delve into the nature of this experience, as well as its causes, types and differences with other false beliefs.

• Related article: "The 12 most curious and shocking types of delusions"

What are delusions?

Within the field of psychopathology Delirium is understood to be a false belief or idea that the patient accepts with total conviction, despite the evidence or external evidence showing otherwise. Although it has not yet been possible to generate a fully accepted and satisfactory description of this concept, the previous description would be one of the most approximate.

Despite its pathological features, delirium

is not considered a mental illness or disorder on its ownRather, it would be a symptom of a wide variety of psychological conditions such as bipolar disorder, schizophrenia, mania or psychotic depression.

During the course of the delirium the mental state of the person undergoes a great number of changes. These make the patient live feelings of confusion and behavioral disturbances.

Other manifestations or problems of delusional states are:

• Sudden changes between states of lucidity and unconsciousness.
• Loss of contact with reality.
• Alteration of attention and memory.
• Emotional ups and downs.
• Muscle control problems.
• Sleep disturbances.

Diagnostic criteria

Although, as specified in the previous point, delusions do not constitute a clinical disorder, but are part of a larger pathological picture. Of course, they must meet a series of special and specific requirements in order to be considered as such.

Some authors and researchers have developed a series of defining constructs of delirium. These dimensions or constructs are given in the form of continuums that start from what is considered a normal belief, even a pathological, and they are key to being able to differentiate delusion from other types of beliefs or erroneous ideas. These characteristics are what we will see below.

1. Fixed and unchangeable beliefs or ideas

Delirium must be maintained over time; being little or nothing possible that it can be modified or corrected regardless of the evidence against it.

2. Intense conviction

A delusion is a firmly held idea. Namely, the person blindly believes in an idea or concrete event.

3. Lack of cultural supports

It is necessary to specify that the idea that the patient maintains cannot be shared by other people or cultural group. This means that for the belief to be considered irrational it cannot be shared or accepted by the rest of the reference society.

4. Excess of concern

Unlike other false or irrational beliefs, in delusions the person presents a great concern or rumination of the delusional idea, which implies significant psychological wear since the patient thinks about it obsessively.

5. Degree of likelihood

This last criterion refers to the degree of probability that exists that the idea can be real. This degree of plausibility can vary from one delusion to another. This means that although in some cases it is easy to detect the impossibility of the delusional idea, in others they may be entirely plausible but false.

What causes do they have?

Delusions and delusions have as their origin a series of mental and psychological disorders that accompany it and give it shape. These psychological conditions are:

• Paranoid disorders.
• Paranoid, Schizoid, and Schizotypal Personality Disorders.
• Schizophrenias
• Affective disorders such as psychotic depression and mania.

However, also can be part of other disorders of organic origin derived from the consumption of drugs and alcohol in abuse, as well as detoxification processes and as a secondary reaction to certain drugs.

• Related article: "Delirium tremens: a severe alcohol withdrawal syndrome"

What types of delusions are there?

Despite the large number of existing delusions, these can be categorized and classified according to their content. Next we will see some of the most frequent and well-known.

1. Paranoid delusion

In the case of paranoid ideas, the person you are convinced that a person or group wants to cause you some kind of harm, be it physical, psychological or social. This delusion can take the form of the idea that others want to kill you or that someone is trying to drive you crazy.

2. Delusion of persecution

People with delusions of persecution firmly affirm that someone is persecuting them, or even that there is a conspiracy against them. This persecution can be either on the street, directly, or in a more veiled way: patients can think that they are entering your house, that they open their mail or that they register their mobile devices or computers.

3. Delusions of greatness

The content of this delusion is manifested by excessive self-worth of abilities and powers of the patient; which attributes special abilities as well as a high regard for his own identity.

• You may be interested: "Megalomania and delusions of grandeur: playing God"

4. Delusion of reference

As her own name indicates, in the delusion of reference the patient believes that certain events, phrases or statements of other people have to do with his person or have a special significance that has to do with he.

It is common for these patients to think that both the media and other people are sending them all kinds of messages.

5. Somatic delirium

In the latter case, the patient shows the conviction that he is sick or his body is getting sick. In the same way, you may perceive a series of false changes or abnormalities in it. These are just a small sample of what is actually a long list of delusions and delusions.

6. Others

Other well-known delusions are:

• Delusion of control.
• Metacognitive delusion.
• Delusion of guilt or sin.
• Celotypical delusion.
• Delusion of false identification.
• Erotomanic delusion.

What is the difference between a delusion and a hallucination?

The fact that on many occasions they occur together and share certain characteristics makes delusions and hallucinations frequently confused. However, once we know what delusions consist of, it is much easier to differentiate them.

Unlike delusions, hallucinations are an original product of the person's mind. That is to say, they do not really exist neither in reality nor in the external world of this. Furthermore, just as delusion consists of an idea, hallucinations can be auditory, visual, tactile, or even taste experiences. Therefore, the main difference between both concepts is that hallucination is a totally original product and invented by the person's mind, while the delusion would be a distortion of an external stimulus.

For example, in a delusion the person may perceive a real stimulus such as the radio; however the mind of this distorts the message or interprets it as a kind of communication for him. While in hallucination the auditory stimulus would be completely invented by the mind, not being able to be perceived by anyone else.

The delusion would consist of a belief or erroneous interpretation of reality based on a real fact, situation or stimulus. However, both concepts have a point in common. In this case, it is that the patients are fully convinced of the reality and veracity of their ideas or beliefs.