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5 Types of Delusions in Schizophrenia and 3 Ways To Navigate Them

Medically reviewed by Paul Ballas, D.O.
Written by Emily Wagner, M.S.
Updated on April 10, 2024

Have you ever thought that a coworker was out to get you fired from your job, even with no evidence? Or maybe you believed that a song on the radio was sending a special message from a higher power to you? These beliefs are known as delusions, and they affect 80 percent to 90 percent of people with schizophrenia.

Delusions can be distressing and can interfere with your day-to-day life, work, and relationships. In this article, we’ll discuss what they are and describe the five types seen in schizophrenia. We’ll also cover three ways you can manage them, together with the help of your doctor and mental health professionals.

What Are Delusions in Schizophrenia?

Schizophrenia is a serious and chronic mental health condition that affects how you think, feel, and perceive the world around you. It’s commonly associated with two main symptoms — hallucinations and delusions.

Hallucinations involve hearing or seeing things that aren’t actually there, like hearing voices. Delusions are sets of false beliefs with no real or clear evidence to back them up. People with schizophrenia will believe their delusions to be true, even when someone tries to tell or show them otherwise. Delusions can be part of psychosis — being unable to tell the difference between what is and isn’t real — and are often among the first symptoms of schizophrenia.

It’s important to note that delusions in schizophrenia are different from delusional disorders. Schizophrenia involves other symptoms outside of delusions — like disorganized behavior or speech and decreased emotion. Delusional disorder is characterized by the presence of one or several delusions.

Here are five different types of delusions associated with schizophrenia and signs and symptoms to look out for.

1. Paranoid Delusions

The most common type of delusions seen in people with schizophrenia are paranoid delusions. Also known as persecutory delusions, they cause a person to think that someone is trying to harm or harass them.

Someone with paranoid delusions may think someone is “out to get them,” or that they’re being watched or followed. They may also struggle with anxiety and depression or have trouble sleeping.

Someone with paranoid delusions may think someone is “out to get them” or that they’re being watched or followed.

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Paranoid delusions may be about a person, a group, or even a government entity. Some types of delusions a person may have include:

  • The FBI is listening to all of their calls and following them.
  • Their doctor is trying to give them medicine that they “know” is poison.
  • Their boss is hacking into their email to watch them and get them fired.

One MyDepressionTeam member asked others about their experiences with delusions: “Can you tell if you’re in a delusion? I truly believe that my family and friends are working with the shadows that are trying to hurt me, but I also get the feeling that maybe it’s not completely true and I don’t know what to think.”

2. Delusions of Grandeur

Delusions of grandeur — or grandiose delusions — are false beliefs that a person holds lots of power or is extremely important. People believe in these delusions because they make them feel strong or give them a sense of identity or purpose. Studies estimate that around half of people with schizophrenia experience delusions of grandeur.

Studies estimate that around half of people with schizophrenia experience delusions of grandeur.

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Grandiose delusions come in many forms and may seem similar to narcissism, which is a feeling of superiority. Someone with schizophrenia who has these delusions may believe:

  • They’re a celebrity or famous person and the real celebrity is an imposter.
  • They’re God or a messiah.
  • They hold an important position, like working undercover for the Secret Service.
  • They have special powers like telepathy (the ability to communicate with thoughts).

3. Delusions of Control

When a person has delusions of control, they believe that someone or something is trying to get inside their mind and control their thoughts and feelings. They may also believe that someone is successfully controlling them from outside their body.

The following are examples of delusions of control that a person with schizophrenia may experience:

  • They believe someone implanted a computer in their brain and now their movements are being controlled remotely.
  • They think their doctor or a news broadcast is trying to plant thoughts or ideas in their mind.
  • Aliens are trying to steal their thoughts.

4. Delusions of Reference

A person with delusions of reference believes unrelated events are actually referring to them. Everyday events like listening to music, watching television, or seeing a billboard on a drive home can have special meaning behind them to someone with schizophrenia.

Some people may look for or think that they’re receiving messages from someone through these events. For example, they may believe that a song on the radio was played to communicate with them or that the president on a news broadcast is speaking directly to them.

Delusions of reference can also revolve around objects. An example would be a person thinking there was a message or a special meaning behind the numbers and letters on a license plate they see while driving.

5. Delusions of Erotomania

Lastly, delusions of erotomania refer to someone believing that another person — or several people — are in love with them, without any evidence. In most cases, a person with schizophrenia or another mental illness believes a celebrity or someone of importance is in love with them.

In some cases, erotomanic delusions can eventually lead a person to stalk their “crush” on social media or in person. They may send repeated messages or love letters or even follow their crush around. A person caught stalking or harassing another individual can be arrested or face other legal action.

Managing Delusions in Schizophrenia

Like other symptoms of schizophrenia, delusions can be managed with a combination of medication and therapy. Your doctor and a mental health professional will work together to create the best treatment plan for your specific case if you’re trying to discover how to stop delusions. They’ll also give you tools to help you recognize and manage delusions while they’re happening.

Here are three ways to manage delusions.

1. Talk to Your Doctor About Your Treatment Plan

If you’re currently experiencing delusions with your schizophrenia, make an appointment with your health care provider as soon as possible. If you aren’t taking any medications, your doctor will likely prescribe you some to help control your symptoms. If you’re already taking medications for your schizophrenia, your doctor may need to change the dosing or the drug entirely.

Antipsychotic medications help manage delusions, hallucinations, and other symptoms of schizophrenia. Examples of medications you may be prescribed include:

2. Try Talk Therapy

Psychotherapy — also called talk therapy — is a type of mental health treatment that helps people identify, understand, and change their thoughts, emotions, and behaviors. There are several types of talk therapy, including cognitive behavioral therapy (CBT).

In CBT, you’ll work with a mental health professional who can help you unlearn how you think and behave during delusions. Your specialist will then teach you new skills and behaviors to replace the old ones. Group therapy with family members or others with schizophrenia can help you build a supportive community.

Cognitive behavioral therapy can help you unlearn how you think and behave during delusions.

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3. Learn Strategies To Manage Delusions in the Moment

By working together with your doctor and therapist, you can build a skill set to use when you’re having delusions. You may learn to recognize the warning signs of a delusion and how to approach it logically.

One strategy is to write your schizophrenia symptoms or delusions on a chart. When you begin believing in a delusion, you can look at the chart for the facts. Be sure to ask others in your support group for new ideas and strategies.

Talk With Others Who Understand

MyDepressionTeam is the social network for people with depression and related mental health conditions and their loved ones. On MyDepressionTeam, more than 146,000 members come together to ask questions, give advice, and share their stories with others who understand life with different mental health conditions.

What types of delusions have you or a loved one experienced while living with schizophrenia? Share your experience in the comments below, or start a conversation by posting on your Activities page.

Updated on April 10, 2024
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Paul Ballas, D.O. is an attending psychiatrist at Friends Hospital in Philadelphia, Pennsylvania. Review provided by VeriMed Healthcare Network. Learn more about him here.
Emily Wagner, M.S. holds a Master of Science in biomedical sciences with a focus in pharmacology. She is passionate about immunology, cancer biology, and molecular biology. Learn more about her here.

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