What are delusions?

Delusions are false fixed beliefs that feel very real to the person experiencing them but are out of touch with reality. They do not change even when new facts or ideas are presented to them. Delusions are a possible symptom of psychosis and schizophrenia but can also occur in other mental illnesses such as bipolar disorder or major depressive disorder with psychotic features. These experiences can be confusing or upsetting for both the individuals and their families.   

Understanding what’s happening – and responding with compassion – can make a real difference.  

Understanding delusions

Delusions are considered one of the positive psychotic symptoms of psychosis. In this context, “positive” doesn’t mean good; it refers to experiences or behaviors that are added to a person’s usual way of thinking or perceiving.  

The person experiencing delusions may: 

• Express grandiose beliefs, such as feeling unusually powerful or important 
• Have problems concentrating, communicating, or thinking clearly 
• Feel like their thoughts are blocked  
• Believe that their body is diseased, distorted, or missing 
• Experience persecutory (paranoid) thinking, such as thinking others are trying to harm them or that messages are being sent through the TV or phone 

Delusions can last for short or long periods of time and may vary in intensity. Stress and anxiety often make symptoms worse. Remember, these are symptoms of the illness, not a choice or a reflection of someone’s character. Approaching the person with calmness, empathy, and consistency helps create safety and trust, which are essential for recovery.  

What causes delusions?

The exact cause isn’t fully understood, but research suggests a complex combination of biological, genetic, psychological, and environmental factors may increase risk. Recent research has also linked cannabis use to a higher likelihood of psychotic symptoms.  

Treatment options

Delusions are treatable, and recovery is possible. Treating delusions usually involves a combination of strategies with the goal of reducing delusional beliefs and improving their quality of life and coping skills. 

Treatments often include: 

• Medications (such as antipsychotics) 
• Therapies such as Cognitive Behavioral Therapy for Psychosis) and counselling support for both the person and their family 
• Education 
• Stress management  
• Hospitalization or short-term inpatient care (if necessary) 

Treatment works best when paired with understanding, care, education, support and connection; people can manage symptoms and build a meaningful life. 

How to offer support

Supporting a loved one who is experiencing delusions can be challenging, but your kindness and encouragement can make a big difference. Focus on connection, understanding, and safety rather than challenging what they believe.  

Here are some things to remember as you help them.