Columns

ON MENTAL ILLNESS: The Difficulty of Resolving Delusions

Jack Bragen
Friday September 12, 2014 - 02:20:00 PM

If you have chronic mental illness, as I do, and if it includes low-level psychosis that persists despite taking plenty of medication, it helps to periodically do cognitive exercises in which you recognize, identify, and dismiss delusions. 

Clinical depression, some of which I have also had, can include illusions that things are far worse than they actually are. Thus, depression is more similar to psychosis than you might think. 

Giving air to your thoughts is one way of clearing up the cobwebs. Delusional thoughts can be partly resolved by talking about them. It is important to use as a sounding board someone who is not subject to having their own delusions, since you could create shared delusions that actually get worse. 

It is not always easy to relinquish a delusion. Some delusions are pleasurable while others bring forth fear or pain. When a delusion has any type of emotional charge connected to it, it is harder to release. 

If you can learn to accept the disappointment that goes along with acknowledging that something you hoped for was a delusion, you are in a better stance to resolve that delusion. If you can learn to ignore fear or apprehension connected to a frightening delusion, it will be easier to get free of that aberrant thought. 

Low-level delusions that are relegated to peripheral consciousness or to the subconscious can create ongoing anxiety, angst, anger, or bad moods. When a delusion is in the background or when it is subtle, it is a lot harder to detect. When a delusion, just by chance, coincides with a truth (the same belief but generated differently), it could reinforce the rest of a person's delusional system. 

A delusion isn't merely an incorrect belief. Plenty of people believe things that aren't true and they are not considered mentally ill. The belief must accompany some difficulty in functioning in society, and it must be considered bizarre, paranoid, or grandiose by most people. 

To qualify as a psychotic delusion, an incorrect belief must be generated by a different type of brain activity compared to a "normal" but mistaken belief. However, since we can't know exactly what transpires inside someone's cranium, psychiatrists are forced to do guesswork, surmising what is happening for a patient by analyzing their speech and behavior. 

Most psychiatrists are smart people, although they do not know everything. If you are having a symptom, or perhaps a disturbance, the psychiatrist will have no way of knowing that unless they are told about it. It is important not to lie or hide things from a psychiatrist, since they can't help you if you do that. 

If a psychiatrist seems to be treating you badly, ask to be referred to another one. Some psychiatrists either have a bad or abrasive manner to them, or assume that you are intellectually inferior. Some psychiatrists don't believe in the potential and prospects of the patients they are treating. Others are more empowering and have a better "bedside manner." 

A psychiatrist or psychologist, if you open up to him or her, can help in identifying delusional thoughts. Once they have told you that by their perspective a particular belief is a delusion, it is largely up to you to "hear that" and to consider that they are likely to be right. 

On the other hand, at some point, it is time to begin trusting your own opinion. Mental health practitioners are not accurate in their assessments one hundred percent of the time. If you accept someone's assessment that you don't have potential and will never be able to work (or do something) then you will probably not even bother trying, and you may be depriving yourself out of a better outcome.