Delusional disorder, (previously called paranoid disorder,) is a type of serious mental illness called a “psychosis“ in which a person cannot tell what is real from what is imagined. The main feature of this disorder is the presence of delusions, which are unshakable beliefs in something untrue.
People with delusional disorderexperience non-bizarre delusions, which involve situations that could occur in real life, such as being followed, poisoned, deceived, conspired against, or loved from a distance. These delusions usually involve the misinterpretation of perceptions or experiences.
In reality, however, the situations are either not true at all or highly exaggerated.
People with delusional disorder often can continue to socialize and function normally, apart from the subject of their delusion, and generally do not behave in an obviously odd or in a bizarre manner. This is unlike people with other psychotic disorders, who also might have delusions as a symptom of their disorder. In some cases, however, people with delusional disorder might become so preoccupied with their delusions that their lives are disrupted.
Types of delusional disorder
There are different types of delusional disorder based on the main theme of the delusions experienced. The types of delusional disorder include:
Erotomanic — Someone with this type of delusional disorder believes that another person, often someone important or famous, is in love with him or her. The person might attempt to contact the object of the delusion, and stalking behavior is not uncommon.
Grandiose — A person with this type of delusional disorder has an over-inflated sense of worth, power, knowledge, or identity. The person might believe he or she has a great talent or has made an important discovery.
Jealous — A person with this type of delusional disorder believes that his or her spouse or sexual partner is unfaithful.
Persecutory — People with this type of delusional disorder believe that they (or someone close to them) are being mistreated, or that someone is spying on them or planning to harm them. It is not uncommon for people with this type of delusional disorder to make repeated complaints to legal authorities.
Somatic — A person with this type of delusional disorder believes that he or she has a physical defect or medical problem.
Mixed — People with this type of delusional disorder have two or more of the types of delusions listed above.
Basic Principles
There are no systematic studies on treatment approaches and results in Delusional Disorder. The patient’s distrust and suspiciousness usually prevents any contact with a therapist.
Hospitalization
Hospitalization is indicated if a potential for danger is present; otherwise outpatient management is advisable. Unfortunately, involuntary hospitalization may increase distrust and resentment and increase the patient’s persecutory delusions.
Antipsychotic Drugs
Antipsychotic medication may be useful, particularly for accompanying anxiety, agitation, and psychosis. Because patients may be suspicious of medication, depot forms may be helpful. Although antipsychotics may have a good response, they are often only marginally effective for specific forms of Delusional Disorder.Other Therapies
Other treatments have been tried (electroconvulsive therapy, insulin shock therapy, and psychosurgery), but these approaches are not recommended.
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“Brothers and sisters, do not be children in your thinking; yet in evil be infants, but in your thinking be mature.”
1 Corinthians 14:20
Those of us who are broken have to think through lots of stuff. But Jesus is our Teacher, and He fully intends to educate His disciples. Following Him is to be vibrantly alive, and yet I still must deal with the issues of living, and of having a growing faith that is becoming real at long last.
I’ve found that this really isn’t a “one and you’re done” experience.
The Bible describes a slow growth into the image of Jesus– -painstakingly learning about our frosty hearts, and how God keeps pouring His “super-heated” grace on the broken. We’re finally becoming ‘poor in Spirit’ and we’re learning to ‘mourn’ over our sins, perhaps we realize that we’ve fallen quite short of His will for us. (Matt. 5:3-4).
This list isn’t orderly or exhaustive, and it’s written primarily for the mentally ill Christian believer:
Stigma-This is one of the basic hazards that come with being a believer with a mental illness. People will whisper and treat you like you’re a moron, even in God’s church. You’ll try to become thick-skinned and ask Jesus for His help. He understands you completely. Even the Lord’s own family considered Him mentally disturbed. You’re in good company.
“And when those who belonged to Him (His kinsmen) heard it, they went out to take Him by force, for they kept saying, He is out of His mind (beside Himself, deranged)!” Mark 3:21, Amplified.
Medications– This will be a stretching time as you must determine what’s best for you, your family, and basic functionality. There will be many opinions and definite issues that ‘disciples.’ must navigate. Some say that therapy and ‘meds’ are wrong. Perhaps for some. No matter what though, your patience will be required and you’ll need to seek His wisdom. He will tell you what to do.
“Not neglecting to meet together, as is the habit of some”must anchor us. We were built for real fellowship. It’s quite easy to attempt to go it alone, but that isn’t what God wants, it’s wrong. Not being with others is a disease of the spiritual heart. I’ve chafed at this from time to time.
Therapy— To go or not to go? I happen to believe a good counselor is worth their weight in gold, but a bad therapist can be a real challenge to your faith. Figure out your tolerance level on this. Quite often I simply need a good listener, and listening is a skill that is developed over time. Find a listener.
Marriage— A good spouse is your key to managing your mental illness. God has gifted them to deal with your disability; they’re your partner in this. Bring them into some of your appointments. Talk, and listen. Learn to pray and worship together. Read the Word out loud. Remember they are learning too. Your disability is also shaping their own discipleship to Jesus.
Family— They’ll often feel the brunt of your issues. It is good to be aware of this and adjust to their needs. Above all, don’t flog yourself for your failings. Allow God to redeem your situation. Trust in the Lord, and try not get in His way. He wants to renew things. Always look for creative ways to love your family. (Surprise ice cream does wonders!)
Work— Not surprisingly, some employers have very little tolerance for your issues, but the law says is that they can’t discriminate against a mental illness. I hope it won’t come down to that.
Fellow strugglers-– Finding other mentally ill believers is priceless. When I meet someone who also struggles with severe depression I want to give them a big bear hug. We instantly have a rapport that isn’t easily defined. Finally, there is someone who understands my battle!
Prayer and worship—Desperate prayers have a tendency to get answered. Start praying for five minutes a day. Pray, do not complain. Be real, not religious. Talk with Jesus like he was your best friend. Prayer is the key to making the above work. Prayer is the “heartbeat” of heaven. And of course–worship! (The real stuff, not religious.)
The Word of God–the scriptures (especially the Psalms) are pretty real stuff. Check out Psalm 88, it’s especially written for the one who struggles.
We have the joy of combining our discipleship with our illness.
This is a formidable task. But the Helper, the Holy Spirit stands ready to give us His wisdom. He graces us with intense spiritual power. The battle rages and times get tough. Perhaps “grittiness” should we should add to the fruits of the Holy Spirit? I’ve now walked with Him for over 40 years now, and I know Jesus has never left me alone. He never lets me ‘twist in the wind.’ He promised, I’m never alone. No matter what.
The Lord truly will accommodate your illness with His power and grace. He promised.
He always does this for His children. No believer is ever overlooked or forgotten. He is constantly aware of you. What comfort and peace that brings.
“There is no circumstance, no trouble, no testing, that can ever touch me until, first of all, it has gone past God and past Christ, right through to me. If it has come that far, it has come with a great purpose.”
— Alan Redpath
These are some of the areas that are affected by your mental illness. A wise spouse, pastor, elder, friend, or therapist can do wonders when things get difficult. Sometimes we need a new perspective as we sort things out. God will often use others to bandage and heal us. That’s the way He works.
“There has never been the slightest doubt in my mind that the God who started this great work in you would keep at it and bring it to a flourishing finish on the very day Christ Jesus appears.”
“Whoever isolates himself seeks his own desire; he breaks out against all sound judgment.”
Proverbs 18:1
Research reveals the reality of social isolation. It seems more and more people are veering away from social contact. A Duke University study found that Americans are choosing to become more solitary than ever. Many are eschewing all relations all together. This is a problem, socially and spiritually.
I’ve seen some of the statistics– fully 25% of people have no relationships at all, and something like 50% have no relationships outside of their spouse and children. This disturbing trend is building momentum. In 1985 the figure was just 15%.
I think that a lot of pressure may be coming from the internet, although Facebook and Twitter have reconfigured social connections. Longer work hours, the phone and streaming video, all contribute to the move away from human contact.
The commute time is also a factor. For every 10 minutes stuck in traffic there is roughly a 10% drop in social relationships. So if you have a bad commute on I-80 you are more likely not to want to have a friend over.
Hundred years ago our society was far more geared for personal contact. People would regularly visit each other. Neighbors knew each other. There were parlor games and dinners. Music recitations and skits. Card parties. Television and radio had not yet grabbed the countries psyche. Sociologists and anthropologists confirm that our history was deep in contact with each other. We were not built for solitary living.
With community life disappearing people are turning to online relationships. Our churches are trying to adapt, as even Christians are not connecting like they should. I have been out in the Alaskan bush villages, and the older generation is frustrated because the younger generation seems to be in trouble. “They don’t pick berries, or hunt; all they do is sit in front of the TV playing Nintendo, or their laptops.”
We need fellowship with others, and God as well. There are very few solitary believers.
I guess the biggest issue of all is mental illness. Social isolation is a direct part of depression and other disorders. In order to get better, people must reach out and connect. There is no substitute, no other option.
I see the shift in my own life. I am seeking to back off from being online 6-8 hours a day. I am trying to be around flesh & blood as often as possible. I am personally trying to consciously maximize that time.
It keeps me healthier.
To be healthier, we think its physical. We have our gym memberships and we run on the treadmill. That is good. But I’m thinking we are losing out if we don’t workout socially (and spiritually) as well. Christians are a special species; we need fellowship with others, and God as well. There are no solitary believers.
“A man who isolates himself seeks his own desire: To cut one’s self off from family, friends, and community is often to express a selfish desire. It shows an unwillingness to make the small (and sometimes large) sacrifices to get along with others.”
David Guzik, enduringword.com
“This is the message you have heard from the beginning: We should love one another.”
This should give direction and dialogue on the issues faced by every church member. It is a great opportunity we have been given— to minister to every person in the Body of Christ. —Bryan
by Ken Camp, Associated Baptist Press —
Living with depression — or any other form of mental illness — is like viewing life “through a glass darkly,” according to Jessy Grondin, a student in Vanderbilt University’s Divinity School. “It distorts how you see things.”
Like one in four Americans, (25%), wrestles significantly with a mental illness.
Depression is one of the most common types of mental illness, along with bipolar disorder, another mood-altering malady. Other forms of mental illness include schizophrenia and disorders related to anxiety, eating, substance abuse and attention deficit/hyperactivity.
Like many Americans with mental illness, Grondin and her family looked to the church for help. And she found the response generally less-than-helpful. “When I was in the ninth grade and hospitalized for depression, only a couple of people even visited me, and that was kind of awkward. I guess they didn’t know what to say,” said Grondin, who grew up in a Southern Baptist church in Alabama.
Generally, most Christians she knew dealt with her mood disorder by ignoring it, she said. “It was just nonexistent, like it never happened,” she said. “They never acknowledged it.” When she was an adolescent, many church members just thought of her as a troublemaker, not a person dealing with an illness, she recalled.
Mental Illness that affects believers must be accepted by the Church.
A few who acknowledged her diagnosed mood disorder responded with comments Grondin still finds hurtful. “When dealing with people in the church … some see mental illness as a weakness — a sign you don’t have enough faith,” she said. “They said: ‘It’s a problem of the heart. You need to straighten things out with God.’ They make depression out to be a sin, because you don’t have the joy in your life a Christian is supposed to have.”
A Baylor University study revealed that among Christians who approached their local church for help in response to a personal or family member’s diagnosed mental illness, more than 30 percent were told by a minister that they or their loved one did not really have a mental illness. And 57 percent of the Christians who were told by a minister that they were not mentally ill quit taking their medication.
It’s not a sin to be sick.
That troubles neuroscientist Matthew Stanford. “It’s not a sin to be sick,” he insists. Stanford, professor of psychology and neuroscience and director of the doctoral program in psychology at Baylor, acknowledges religion’s longstanding tense relationship with behavioral science. And he believes that conflict destroys lives. “Men and women with diagnosed mental illness are told they need to pray more and turn from their sin. Mental illness is equated with demon possession, weak faith and generational sin,”
Stanford writes in his recently released book, Grace for the Afflicted. “The underlying cause of this stain on the church is a lack of knowledge, both of basic brain function and of scriptural truth.” As an evangelical Christian who attends Antioch Community Church in Waco, Texas, Stanford understands underlying reasons why many Christians view psychology and psychiatry with suspicion. “When it comes to the behavioral sciences, many of the early fathers were no friends of religion. That’s certainly true of Freud and Jung,” he noted in an interview.
Often sin is not the main issue.
Many conservative Christians also believe the behavioral sciences tend to justify sin, he added, pointing particularly to homosexual behavior. In 1973, the American Psychiatric Association famously removed homosexuality from its revised edition of its Diagnostic and Statistical Manual of Mental Disorders. As a theologically conservative Christian, Stanford stressed that scripture, not the Diagnostic and Statistical Manual, constitutes the highest authority.
But that doesn’t mean the Bible is an encyclopedia of knowledge in all areas, and all people benefit from scientific insights into brain chemistry and the interplay of biological and environmental factors that shape personality. Furthermore, while he does not presume to diagnose with certainty cases of mental illness millennia after the fact, Stanford believes biblical figures — Job, King Saul of Israel and King Nebuchadnezzar of Babylon, among others — demonstrated symptoms of some types of mental illness. “Mental disorders do not discriminate according to faith,” he said.
Regardless of their feelings about some psychological or psychiatric approaches, Christians need to recognize mental illnesses are genuine disorders that originate in faulty biological processes, Stanford insisted. “It’s appropriate for Christians to be careful about approaches to treatment, but they need to understand these are real people dealing with real suffering,” he said. Richard Brake, director of counseling and psychological services for Texas Baptist Child & Family Services, agrees. “The personal connection is important. Church leaders need to be open to the idea that there are some real mental-health issues in their congregation,” Brake said.
Pastors much carefully reach out to the mentally ill.
Ministers often have training in pastoral counseling to help people successfully work through normal grief after a loss, but may lack the expertise to recognize persistent mental-health problems stemming from deeper life issues or biochemical imbalances, he noted. Internet resources are available through national mental-health organizations and associations of Christian mental-health providers. But the best way to learn about available mental health treatment — and to determine whether ministers would be comfortable referring people to them — is through personal contact, Brake and Stanford agreed. “Get to know counselors in the community,” Brake suggested. “Find out how they work, what their belief systems are and how they integrate them into their practices.”
Mental-health providers include school counselors and case managers with state agencies, as well as psychiatrists and psychologists in private practice or associated with secular or faith-related treatment facilities, he noted. Stanford and Brake emphasized the vital importance of making referrals to qualified mental-health professionals, but they also stressed the role of churches in creating a supportive and spiritually nurturing environment for people with mental-health disorders. Mental illness does not illustrate lack of faith, but it does have spiritual effects, they agreed. “Research indicates people with an active faith life who are involved in congregational life get through these problems more smoothly,” Brake said.
You can’t fix the issues, but you can love them.
Churches cannot “fix” people with mental illness, but they can offer support to help them cope. “The church has a tremendous role to play. Research shows the benefits of a religious social support system,” Stanford said. They stressed the importance of creating a climate of unconditional love and acceptance for mentally ill people in church — a need Grondin echoed. “There needs to be an unconditional sense of community and relationships,” she said. She emphasized the importance of establishing relationships that may not be reciprocally satisfying all the time.
People with mental-health issues may not be as responsive or appreciative as some Christians would like them to be, she noted. “Others need to take the initiative and keep the relationship established. People don’t realize how hard it can be (for a person with a mood disorder) to summon the courage just to get out of bed,” Grondin said. Christians who seek to reach out to people with mental illness need to recognize “they are not able to see things clearly, and it’s not their fault,” Grondin added.
Mostly, Christians need to offer acceptance to people with mental illness — even if they don’t fully understand, she insisted. “Just be present. Offer support and love,” Grondin concluded. “You won’t always know what to say. Just speak words of support into a life of serious struggles. That means more than anything.”
(EDITOR’S NOTE — Camp is managing editor of the Texas Baptist Standard.)
A great book:
“Grace for the Afflicted: A Clinical and Biblical Perspective on Mental Illness” [Paperback] can be found at www.Amazon.com, by Matthew S. Stanford Ph.D
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For more information: National Alliance on Mental Illness (800) 950-6264 Anxiety Disorders Association of America (240) 485-1001 Depression & Bipolar Support Alliance (800) 826-3632 American Association of Christian Counselors (800) 526-8673 Stephen Ministries (314) 428-2600
Broken Believers 