Schizophrenia vs. Delusional Disorder

   
As with all psychotic disorders, an extensive medical evaluation to rule out other causes of the delusions should be undertaken.  Delusional disorder tends to occur later in life and can be insidious, developing slowly over several years.  A lot of patients are very reluctant to receive treatment, as they seriously believe their own delusions.  One thing that many friends and family members have a hard time understanding is that the delusions cannot be rationally explained away.  You can offer all the evidence in the world that the fumes coming from the upstairs apartment are not toxic, but if this is the person’s delusion, they will not be convinced.  Instead of addressing the delusion directly, it’s sometimes helpful to talk to the person about the depressed mood and anxiety that they may be feeling as a way of explaining to them that they need to seek help.  People usually see a psychiatrist when they or their loved ones are suffering, and if someone doesn’t think they have a problem, it makes therapy very difficult.  A future blog can explore some of the challenges faced by family members of people with serious mental illness.