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Persecutory delusions occur when someone believes others are out to harm them despite evidence to the contrary. It’s a type of paranoid thinking that can be part of several different mental illnesses.

Whether people with this condition think co-workers are sabotaging their work or they believe the government is trying to kill them, persecutory delusions vary in severity. Some people with persecutory delusions believe they have to go to great lengths to stay safe—and consequently, they may struggle to function in everyday life.

While everyone may experience some false beliefs about people being “out to get them” at times, for people with persecutory delusions, their beliefs take a serious toll on their lives. Their delusions are usually a symptom of a mental illness that requires professional help.

Types of Persecutory Delusions

People with mental illness may experience persecutory delusions. These delusions are most commonly associated with schizophrenia, but they also may appear during manic episodes of bipolar disorder or with severe depression with psychosis.

Conditions that can cause persecutory delusions include:

Schizophrenia

A condition that involves distortions in thinking and perception. People with this condition often experience hallucinations and delusions, including persecutory delusions.

Bipolar Disorder

A condition that causes extreme shifts in mood, activity levels, and behavior. A person may shift rapidly between periods of excess energy and grandiose mood (mania) to periods of very low mood (depression). Persecutory delusions most often occur during manic episodes.

Major Depression with Psychotic Features

Sometimes known as psychotic depression, this condition involves having both depressive symptoms and episodes of psychosis.

Schizoaffective Disorder

Schizoaffective disorder is a condition that involves symptoms of schizophrenia along with mood symptoms such as mania or depression.

Post-Traumatic Stress Disorder (PTSD)

A condition that can occur after a person has experienced a traumatic event, which can lead to symptoms including flashbacks, nightmares, hallucinations, and delusions.

Dementia

It’s also common for people with dementia to develop delusions. It’s estimated that 27% of people with dementia experience persecutory delusions at one time or another.

Delusional Disorder

They may also signal a delusional disorder, an illness that is characterized by at least one month of delusions but no other psychotic symptoms.

Delusional disorders are far less common than other mental illnesses that may involve psychosis. It’s estimated that only 0.2% of the population experiences delusional disorder.

Less common types of delusions include:

• Somatic delusions: The fixed false belief that one has a physical defect or medical problem
• Erotomanic delusions: The conviction that someone is in love with them

Signs of Persecutory Delusions

People with persecutory delusions believe that harm is going to occur and that other people intend for them to be harmed.

People experiencing persecutory delusions may say things such as:

• “My neighbors break into my house at night and steal my clothes out of my closet.”
• “The police are following me because they want to torture me.”
• “An evil spirit is trying to kill me.”
• “The government is poisoning me through the drinking water.”
• “The people up the street are spying on me and are going to steal my stuff.”

Sometimes, people with persecutory delusions report their concerns to the authorities. When nothing happens, they often grow suspicious that the authorities are somehow involved. They also grow frustrated when no one will help them. They may be confused about why friends and family members don’t seem to share their concerns, or they may become angry that no one will take action.

Causes of Persecutory Delusions

There are several causes linked to psychosis, including childhood trauma as well as societal, genetic, and biological factors.

• Biological factors: Brain abnormalities or an imbalance of chemicals in the brain as well as alcohol and drug use can contribute to persecutory delusions.
• Childhood trauma: Some studies have specifically linked childhood trauma to paranoia.
• Genetic factors: Delusional disorders are more common in people who have a family member with a delusion disorder or schizophrenia.
• Societal factors: Movies, books, pop culture, and other societal factors may increase or fuel persecutory delusions.

Factors Associated With Persecutory Delusions

People who experience persecutory delusions tend to have several factors in common in terms of the way they think, feel, and behave. However, it’s unclear whether these factors cause persecutory delusions or whether persecutory delusions cause these things to occur.

Here are six things most people with persecutory delusions have in common.

Worry and Rumination

People who experience persecutory delusions are likely to spend a lot of time worrying. Several studies have found that rates of worry in people experiencing persecutory delusions are similar to the rates of worry that people with anxiety disorders experience.

Time spent imagining implausible outcomes and catastrophic ideas may go hand-in-hand with persecutory delusions. A 2014 study found that a period of worry often precedes persecutory delusions.

Negative Thoughts

People who feel different, apart, inferior, and vulnerable are more likely to be paranoid. A 2012 study assessed 301 patients with psychosis three times over the course of a year. The researchers found that negative thoughts about one’s self predicted the persistence of persecutory delusions.

People with persecutory delusions also tend to be overly critical of themselves. Researchers suggest that cognitive biases, including negative thinking, play a role in the onset and maintenance of persecutory delusions.

Interpersonal Sensitivity

People with persecutory delusions tend to be high in interpersonal sensitivity, meaning that they feel vulnerable in the presence of others due to fear of criticism or rejection.

People with persecutory delusions also are more likely to interpret neutral events as containing hostility from others. Interpersonal sensitivity is also positively associated with higher levels of anxiety and depression.

Abnormal Internal Experiences

People with persecutory delusions sometimes misinterpret external events. However, some research has found that this is only true when the person is experiencing an unsettled internal state.

For example, a person who has experienced a negative life event or poor sleep may feel “off.” Consequently, they may place blame on the environment for why they feel bad. Someone might think, “I feel anxious because someone is spying on me.”

Insomnia

A 2012 study found that having insomnia increased the odds of developing paranoid ideation by threefold. Poor sleep also has been found to be a predictor of the persistence of existing paranoia.

Irrational Reasoning

One study found that people who experience persecutory delusions are more likely to jump to conclusions. People who jump to conclusions gather little information before making decisions and can be quite impulsive.

For example, people who jump to conclusions may assume a stranger who is holding up a phone is taking a picture of them. They also may believe that a group of people who are laughing must be laughing at them. 

The study also found that people who jumped to conclusions had a poorer working memory of performance, lower IQ, lower intolerance of uncertainty, and lower levels of worry.

Diagnosing Persecutory Delusions

Persecutory delusions are a symptom of some types of mental health conditions. To treat them effectively, it is important to first determine what might be causing them 

To make a diagnosis, a doctor will perform a physical exam, take a medical history, and perform a psychiatric assessment. They may also screen for substances or order brain imaging tests to better understand what might be causing these symptoms.

Once they understand a person’s current symptoms, history, and health status, they can use the diagnostic criteria in the “Diagnostic and Statistical Manual of Mental Disorders” (DSM-5-TR) to help diagnose their condition.

Treatment for Persecutory Delusions

Treatment varies greatly depending on the type of mental illness someone is experiencing. Sometimes underlying issues, like insomnia or past trauma, must be addressed. At other times, reducing anxiety can be a helpful intervention.

Therapy

A 2014 study found that cognitive behavioral therapy (CBT) can be an effective intervention. When therapists helped patients reduce worry and rumination, persecutory delusions decreased. CBT also led to significant reductions in other psychiatric symptoms and general levels of paranoia.

The results of one clinical trial found that a specific treatment called the Feeling Safe program was an effective intervention for people experiencing persecutory delusions. The program focuses on helping people develop new memories focused on safety. Results suggest that half of people participating in the program significantly improve their symptoms.

Medication

Depending on the illness, antipsychotics, antidepressants, or other mood-stabilizing medications may be used. The specific medications that may be effective depend on an individual’s specific diagnosis. For example, research suggests that antipsychotics can be effective for the treatment of delusional disorders.

Support Services

People who are experiencing delusions also may struggle with everyday tasks, like going to work, running errands, and paying bills. They may require professional in-home support services to assist them with daily tasks.

Inpatient Hospitalization

However, sometimes people with delusions distrust professionals, which can make treatment even more complicated. Inpatient hospitalizations may be required at times to help a person gain better control over the symptoms.

Coping With Persecutory Delusions

Supporting a person who is experiencing persecutory delusions can be hard. You might have to spend a lot of time listening to them explain how they’re being persecuted—even though there’s no evidence that it’s true. Or, there may be times when they insist that you’re out to get them too.

Have Empathy

While you might be tempted to tell the person that they’re delusional and their thoughts are irrational, your efforts may do more harm than good.

Seek Support for Yourself

A support group could help you learn about the struggles, strategies, and resources other people in similar situations have found helpful. Whether the person experiencing persecutory delusions is your partner, sibling, parent, or child, consider seeking therapy for yourself also. A mental health professional can help you gain a better understanding of your loved one’s illness and the strategies that can help you cope.

If appropriate, they may even be able to coach you on conducting some reality testing with your loved one. This practice involves gathering facts that support the delusion as well as facts that refute the delusion.

Consider Family Therapy

Family therapy also can help you determine how to best respond to a person who is experiencing delusions. Knowing what to say and how to support someone can be very beneficial to their treatment.

Keep in Mind

Watching someone you love experience persecutory delusions can be overwhelming at times. But with intervention and support, you can help your loved one find ways to cope.

Marriage isn’t always easy, and all relationships have ups and downs. According to relationship experts, there are certain signs to watch for that serve as important predictors of divorce.

John and Julie Gottman are psychologists, relationship experts, and the founders of the Gottman Institute. Based on their years of extensive research, they have identified four primary predictors of divorce. They have termed these four main predictors the “Four Horsemen of the Apocalypse,” and they are criticism, contempt, defensiveness, and stonewalling.

Criticism

Some criticism is unavoidable in a relationship, but it becomes unhealthy when you do it in a way that implies something is inherently wrong with your partner. You may also be attacking your partner’s personality or character.

The intent is to win the argument or prove your spouse wrong. For instance, saying, “you always…,” “you never…,” or “you’re the type of person who …” or “why are you so …” will make the spouse feel attacked and is likely to elicit a defensive response. 

These harmful patterns cause you both to not feel heard. You both may start to feel bad about yourselves when you are around each other.

Contempt

Contempt is perhaps the most serious of the four predictors of divorce. It concerns any statement or behavior, verbal or nonverbal, that asserts superiority to your partner. 

Examples of such behaviors include:

• Mocking your partner
• Name-calling
• Eye-rolling
• Showing hostility
• Insensitive joking
• Hurtful sarcasm
• Sneering in disgust

Contempt attacks your spouse’s sense of self. It is also intended to put down or emotionally abuse or manipulate them.

Contempt doesn’t just hurt your relationship; it also takes a toll on your health. Research has also found that experiencing feelings of contempt can lead to increased illness and worse well-being.

Defensiveness

Defensiveness arises from a perceived attack with your own counter-complaint. It is another way to act like a victim or not to take responsibility for your mistakes. Such behaviors include making excuses or saying things like, “It’s not my fault.”

It can also involve cross-complaining. This is when you match your partner’s complaint or criticism with one of your own. You then ignore what your partner said.

Other defensive behaviors are “yes-butting” or gaslighting, where you deny your partner’s reality. It can also involve simply repeating yourself without really paying attention to what your spouse is saying.

You do not have to be perfect. Consciously communicate by speaking honestly and listening well. Don’t forget to validate your partner by letting them know you get what they are feeling.

Stonewalling

Complete withdrawal from communication (and essentially the relationship) as a strategy to avoid conflict is called stonewalling. It may take the form of physically leaving or completely shutting down. Stonewalling might be giving the “silent treatment,” monosyllabic mutterings, changing the subject, or storming out.

The antidote to stonewalling is to learn to identify the signs that you or your partner is starting to feel emotionally overwhelmed. It’s a good idea to verbalize that you feel overwhelmed. You can both agree to take a break and that the conversation will resume when you are both calmer.

How to Deal With Predictors of Divorce

All of these behaviors tend to affect relationships at some point or another. On their own, one issue is unlikely to derail your marriage. When you have a combination of these predictors that continue to undermine your relationship, it may be time to talk to a couples therapist.

An unhealthy or toxic relationship can seriously harm your health and well-being, so it is important to take steps to address the problem. 

The Gottoman’s research suggests that each of the four predictors of divorce can be dealth with in the following ways.

• Criticism: The Gottman Institute suggests you can resolve arguments and conflicts by softening how you begin your discussions. Rather than launching into a complaint or criticism, start the debate gently. Research has found that observing the first three minutes of a conflict discussion accurately predicts whether a couple will eventually divorce.
• Contempt: The Gottmans suggest that cultivating an appreciation for your partner’s positive qualities can help reduce contemptuous feelings and behaviors. Rather than focusing on the things that irritate you, try reminding yourself about the characteristics that you are grateful for.
• Defensiveness: If you feel defensive, focus on taking responsibility instead of avoiding blame. 
• Stonewalling: Since this behavior is often rooted in trying to avoid anxiety or stress, finding ways to self-soothe can be beneficial. Grounding activities, visualization, deep breathing, and thinking kind thoughts are a few ways to soothe feelings of anxiety that might arise.

There are ways to better control these behaviors in your relationship. After an argument, claim responsibility for your piece in the escalation. What can you learn from it and what can you do about it?

De-Escalate

There are many things you can do to help reduce tension or de-escalate an argument. For instance, apologize, express your understanding, or demonstrate your concern. There is no good reason to push buttons or purposely escalate the argument.

Virtually all negative interactions with your partner are really a self-perpetuating cycle that, thankfully, you can exit from. When one of you gets triggered, the other reacts, there is a reaction to the reaction, and so on and so forth.

Reflect

Slow things down and self-reflect by figuring out what you might actually be feeling underneath. For instance, are you really hurt when you yell in anger? You need to get comfortable expressing that deeper part of yourself.

All of us have a lot to learn and to benefit from the Gottmans’ research. But, if you still find the “Four Horsemen” are ruining your relationship, it’s time to seek out a skilled marriage therapist.

Many of us go through periods where we’re stuck in a rut. You feel like you’re going through the motions at work, treading water in your relationships, or jogging in place in your social life. Things that used to excite you no longer do and, instead of moving toward your goals, you remain stagnant—stuck where you are.

Being stuck can lead to feeling both disinterested and dissatisfied. It may even cause you to want to give up on your goals altogether. Fortunately, there are a few things you can do to not only figure out why you’re stuck but also to get motivated and excited about life once again.

Signs You’re Stuck in a Rut

If you’re stuck in a rut, you may not even notice at first as these feelings often build slowly over time. You might follow your same routines day after day, only to one day realize that it feels less like you are working toward something and more like you’re just killing time.

Here are some signs that suggest you might be stuck in a rut:

• Every day seems the same. You might even have trouble remembering what day of the week it is. Is it Monday, or is it Friday? It doesn’t matter because your days feel indistinguishable from one another.
• You feel like you’re just trying to get through another day. Your goal is to keep putting one foot ahead of the other until the day is done. You don’t feel excited or inspired.
• You feel unmotivated. You might want to take on new projects or engage in creative tasks, but it feels like your motivation has run dry. You just can’t seem to get started.
• You feel unfulfilled. Life feels dull and boring. You want to try new things, but you don’t know where to begin.
• You want to change, but fear discomfort. You know that changing things up will make you happier in the long run but stick with the status quo because it means you don’t have to risk failure or pain.

Reasons You Might Feel Stuck in a Rut

Some ruts are caused by a human tendency to make the same decision over and over again when faced with similar scenarios. You choose to drive the same way to work every day, for example. You could take another route but don’t because you’re naturally biased to avoid the uncertainty of the different path.

Fear of stepping outside your comfort zone can also cause you to feel stuck in a rut. You want to do something different but a fear of the unknown or a fear of failure is stopping you from taking action. To ease your fears, you do nothing at all and, instead, remain where you are.

Figuring out what’s causing your discontentment is important to finding ways to get out of your rut. If you are struggling to understand the reasons behind your feelings, working with a licensed counselor or a therapist specializing in cognitive behavioral therapy (CBT) can help.

When working to discover the cause of your rut, one thing to keep in mind is that not all ruts are the same. Some people might feel like they are in a rut with a romantic partner while, for others, it is their job. Even your health, family situation, friendships, hobbies, or home can contribute to these feelings.

It’s important to not criticize or berate yourself once you understand the root cause. Also, don’t try to minimize the issue. You might think “I have a great life” or “I don’t have a right to feel this way,” but these thoughts are counterproductive and can keep you trapped in a rut. While things may be “just fine” as they are, if you’re not satisfied, it’s time to make changes and regain your spark.

How to Get Out of a Rut

Once you’ve acknowledged what you’re feeling, it’s time to start looking for ways to get unstuck. There are a number of things you can do to break the negative cycle and move forward. Here are a few ideas to consider.

Take Care of Yourself

When you feel stuck in a rut, combat it by taking care of yourself. Self-compassion is critical to mental wellness. Start with a quick assessment of how well you’ve been taking care of you. Have you been eating well? Are you sleeping enough? Have you been spending time with people who care about and support you?

If something is lacking in the self-care department, now is the time to address it. Healthy food, adequate sleep, daily exercise, and social support are all essential to your physical and emotional health and wellness.

Change Your Routine

It’s hard to move forward or branch out if you’re engaged in the same routines day after day. People are creatures of habit and sometimes being stuck stems from boredom or feeling like you’re on auto-pilot.

Look for ways to add different experiences to your day, such as:

• Strike up a conversation. Talking to new people is a great way to expand your social connections. Plus, you will learn interesting things about the people around you.
• Have some fun. Spending time engaged in an activity you love is good for your health. Whether it’s hanging out with friends or pursuing a hobby, set aside time each week and focus your energy on having a good time.
• Try something new. Take a new route to work, watch a new show, or sign up for a class. Exploring the world around you can add zest to your life.
• Be spontaneous. If you’re bored with your life, live in the moment. Do things that are not pre-planned, say yes to new experiences, and don’t be afraid to do the unexpected.

Head Outdoors

Researchers have discovered that being in nature has a positive impact on the brain. For example, one study found that taking a walk outside reduced self-referential rumination, a behavior that can increase depression risk. Another connected nature walks with decreased depression, lower stress, and improved mental well-being.

The next time you’re feeling bogged down, try going for a walk outdoors. Let go of the thoughts circling around in your brain and simply take in the world around you. Not only can being outside increase your mental wellness, but it can enhance your creativity as well.

While walking, allow yourself to relax, think of new things, and enjoy the beauty you see. This helps you return to your everyday life with a renewed sense of wonder.

Give Yourself Something to Look Forward To

Looking forward to an upcoming event or activity has a way of pulling you out of a rut and creating some excitement in your life. It puts a little pep in your step as you anticipate the fun that lies ahead.

You might look forward to the release of a movie or your favorite holiday, but you also can create these moments intentionally. Call or text friends and make plans for Friday night. Plan a vacation, even if it’s just taking a day trip to a local spot. Give yourself things to look forward to and get excited about.

Find Your Purpose

It’s easy to fall into a rut when it feels like you’re not working toward anything. Change this by setting goals related to your career or relationships. This helps you feel a sense of purpose, which is also good for boosting motivation.

Another way to develop a sense of purpose is by helping others. Look for ways to contribute to your community. Participate in your church, volunteer with a local organization. or engage in political activism. You could also help friends or loved ones with a project. Such activities give you a sense of greater purpose and meaning and are good for your mental well-being, too.

Boost Your Motivation

Sometimes getting out of a rut happens spontaneously. You might feel stuck in a rut one day, for example, then something suddenly clicks into place and the feelings vanish. In other cases, you might need to take a more active approach. One action you can take is to focus on your motivation.

Here are some ways to get motivated, even when you don’t feel particularly interested or excited about what you are doing:

• Take small steps. Pick an activity you would like to pursue, such as a new hobby or workout program. Start small with something you know you can accomplish. Don’t wait for motivation or inspiration to strike—just get going. Take the first step, then another, then another. Eventually, going through the motions will be a thing of the past and you will feel involved, excited, and interested in learning more.
• Reward yourself. Positive reinforcement is helpful when you’re struggling to get motivated. Promise yourself a reward for starting a task. Then, continue to reward yourself after completing each step. Eventually, pull back on the rewards but promise yourself a larger reward once you’ve reached your goals. Rewards can get you started and help generate greater interest in what you are working on.

Squash Perfectionism

If you struggle with perfectionism, this can keep you stuck in the same place. No matter how hard you try, it seems like whatever you’re working on is never good enough.

Squash your tendencies toward perfectionism right away and recognize that ‘done’ is better than perfect. In other words, rather than trying to make a project perfect, be satisfied with the fact that you completed it.

If left unchecked, perfectionism can keep you spinning your wheels for a very long time. Instead, focus on completing projects and moving forward rather than striving for perfection.

The human brain is an amazing organ. It’s capable of surprising feats of memory and learning. It’s susceptible to damage, and yet remarkably adaptable to change. Considering all of its many capabilities, you may begin to wonder, how big is the human brain?

While the human brain has a structure similar to that of other mammals, what makes it different is it’s size in relation to the rest of the human body.

Human Brain Size Stats

The average adult human brain weighs about 3 pounds (1300 to 1400 grams). A newborn baby’s brain weighs approximately three-quarters of a pound (350 to 400 grams). On average, the human brain measures about 5.5 x 6.5 x 3.6 inches (140 x 167 x 93 mm).

The brain is considered fully formed at age 25. It develops from back to front, ending at the prefrontal cortex; this is the part of the brain that’s responsible for decision-making and reasoning.

Men tend to have bigger brains than women. After taking overall body weight into account, men’s brains tend to be approximately 100 grams larger than women’s.

In women, parts of the frontal lobe and limbic cortex (areas associated with problem-solving and emotional regulation) tend to be bigger than those of men. In men, the parietal cortex (associated with the perception of space) and amygdala (involved in the processing of memory and emotional responses) tend to be larger than those in women.

Neurons are the building blocks of the brain and nervous system – they transmit and carry information, thus allowing different parts of the brain and body to communicate with one another. Researchers currently estimate that there are around 86 billion neurons in the human brain.

Does Brain Size Matter?

All humans do not have the same size brain. Does that mean that highly intelligent people have bigger brains? In some cases, there might be a link.

Autistic children tend to have bigger brains (and earlier disproportionate brain growth) than non-autistic children. The hippocampus (an area of the brain strongly associated with memory) tends to be smaller in older adults with Alzheimer’s disease.

What about intelligence? It depends on who you ask. According to an analysis done by Dr. Michael McDaniel, a professor at Virginia Commonwealth University, many studies have found a correlation between bigger brains and higher intelligence.

However, not all researchers agree with McDaniel’s conclusions. Such studies also raise important questions about how intelligence is defined and measured, whether relative body size is taken into account when making such correlations, and which parts of the brain should be looked at when evaluating intelligence.

It is also important to note that variations in brain size between humans are relatively small. Other influences that could play a pivotal role in determining intelligence include the density of neurons in the brain, social and cultural factors, and other structural differences inside the brain.

If you don’t have schizophrenia, it is probably difficult to understand the internal experience of schizophrenia. People with the condition often experience thoughts that do not align with reality or exhibit symptoms such as disorganized behavior and speech. Understanding what it is like to have schizophrenia can provide some insight into how these symptoms may feel and how they might affect a person’s daily life.

Schizophrenia is a condition that affects how the brain functions and results in problems with thoughts, feelings, and behaviors. The condition affects less than 1% of adults in the U.S. and tends to be misunderstood. While the condition is serious and can be very damaging if left untreated, there are effective medications and treatments that can help.

How People Experience Schizophrenia

Normally, when we describe our experiences to one another, we assume there’s a shared understanding of what it feels like to think and to perceive the world with our senses. We expect that we can talk about what we’re thinking—without having to describe the ways in which our brains connect different pieces of sensory information and memory to make a thought.

Every person with schizophrenia will have a unique experience of the world, but there are common themes. Some schizophrenia symptoms that a person might experience include illogical thoughts, hallucinations, delusions, and unusual movements.

Until the publication of the fifth edition of the “Diagnostic and Statistical Manual of Mental Disorders” (DSM-5) in 2013, schizophrenia was categorized into five different subtypes:

These subtypes were removed from the DSM-5 because symptoms were often inconsistent, which created complications when it came to diagnosing people with the condition.

Types of Symptoms

Symptoms of schizophrenia can include:

• Positive symptoms: These are symptoms that are not part of normal, everyday experience. The term “positive” means they are added or excessive. Such symptoms include things like hallucinations and delusions.
• Negative symptoms: These are normal behaviors that are absent in someone with schizophrenia. Examples include loss of emotion, pleasure, or the ability to initiate plans.
• Disorganized symptoms: These are problems with thinking and behavior, such as confused thinking, abnormal movements, and bizarre behavior.

What Symptoms of Schizophrenia Feel Like

One way to try to understand what it’s like to have schizophrenia is to understand the experience of each of the basic symptoms of schizophrenia. An individual’s personal and unique experience, of course, won’t be broken into these neat categories.

Symptoms of schizophrenia usually first appear sometime between the late teens and mid-30s. The symptoms typically appear gradually and increase in severity over a period of time.

Sadness and Loneliness

People who experience psychosis, which includes hallucinations and delusions, can also experience true sadness as well as isolation. Having schizophrenia can be a scary experience. Sadness is often a natural response to being trapped in a terrifying and isolating situation.

A stunning first-person account of schizophrenia, “Autobiography of a Schizophrenic Girl,” describes very clearly the sadness and loneliness the young author felt when gripped by psychosis.

Delusions

To have a delusion is to be obsessed with an idea, and to have absolute certainty that the idea is correct. The person’s thinking may be clear in other ways, with an otherwise logical ability to reason, starting with the absolute conviction of the incorrect premise.

Delusional ideas have a lot of power to preoccupy thoughts. Sometimes people with delusions can convince others that their delusions are true. This happens most often when the delusion is in the realm of common human experience, like an unfaithful spouse or a boss who’s “out to get them.”

Even after responding well to antipsychotic medications, a person with schizophrenia may continue to believe their delusions are true. It’s also possible that someone can develop an insight that other people think the ideas are probably delusions. Psychologists might call this a meta-awareness of the symptom or awareness that exists above the level of the symptom itself.

Hallucinations

Hallucinations are a symptom of psychosis that involves seeing or hearing things that are not there. Hallucinations and delusions can go hand-in-hand.

For example, hearing voices speaking to you from the radio is a hallucination. Being absolutely convinced that the voices are real and the things they tell you are true has a component of delusion.

Human beings usually rely on their perceptions to tell what’s real. We’re often unaware that different people experience the same situation differently because those small differences don’t usually come up in conversation. For example, people can go their entire lives without knowing they’re colorblind because they don’t know what they’ve never experienced.

Likewise, at a party, an outgoing person may perceive friendly, receptive faces, while a shy person may perceive the same faces as being indifferent or even critical. Both of these perceptions are within the realm of normal human experience, and neither are pathological.

Perception Distortion

People with schizophrenia may also experience perceptual distortions that make it difficult to distinguish between hallucinations and reality. For example, a person with schizophrenia may actually hear people saying things that are critical or insulting when those conversations aren’t really taking place. That would be a type of auditory hallucination.

Visual hallucinations can take many forms as well. A person with schizophrenia may find their attention drawn to one particular person’s face, notice that the teeth are very white, and then perceive the mouth and teeth growing to fill the room.

Some people have persistent visual hallucinations, such as small children or animals that frequently appear or follow them around. They may even hold open doors for these hallucinations to pass through when they leave a room.

Disorganized Speech

People with schizophrenia also experience thought disorder, which leads to problems with organizing speech. The process that disrupts the normal operations of the brain also disrupts the process by which the brain monitors its own operation.

They may earnestly try to communicate their thoughts in nonsensical, stream-of-consciousness language, and become frustrated when the other person doesn’t understand or the words aren’t coming out right. On the other hand, they may seem to be unaware that the listener doesn’t understand them.

Disorganized Behavior

There are many kinds of disorganized behavior, and people are usually unaware of these motions and believe the behavior is entirely reasonable. For example:

• Moving their empty hands as if they’re knitting
• Making an apparently meaningless hand gesture or body posture
• Remove clothing in an inappropriate place

Disorganized public behaviors often result in contact with the law. More and more legal jurisdictions are recognizing mental illness and referring people for psychiatric evaluation. However, there are still far too many mentally ill people in jails and even prisons for nothing more than disruptive, disorganized behavior.

People without schizophrenia also perform bizarre and socially unusual behaviors. Relatively healthy people engage in socially inappropriate or unusual behaviors. The difference is that these people are aware that the behavior is unusual and are looking for the attention it attracts.

Negative Symptoms

People with schizophrenia have a particularly difficult time recognizing negative symptoms as being symptoms of an illness or even abnormal. In this way, the experience can be like that of certain kinds of depression.

For example, the person doesn’t express emotions or expresses them only mildly, even when confronted angrily or in a dangerous situation. Or the person may also fail to find significant pleasure in things that were once delightful, called anhedonia.

If you’re experiencing negative symptoms, you often have little energy or motivation, and your mental energy and acuity may also be depressed. Because the mind feels fuzzy or dull, there’s a limited perception that it’s possible to feel differently and little memory of a time when you felt differently. Many people who have experienced depression will understand this feeling of being in a mental fog.

Real People, Real Emotions

Psychiatrist Samuel Keith, MD, a professor at the University of New Mexico School of Medicine and former head of the Schizophrenia Research Program at the National Institute of Mental Health (NIMH), expresses the plight of a person with schizophrenia very well.

People with this condition may experience feelings of fear about not having control over their own minds. Problems with thinking and sensory disruptions can also make it challenging at times for people to trust their own thoughts and sensory experiences. 

While it can be challenging, supportive care and an effective treatment plan can help people manage their symptoms and experiences. There is no cure for schizophrenia, but there are ways to cope and function effectively in daily life.

Treatment for Schizophrenia

Treatments that can help with schizophrenia symptoms include medication, psychotherapy, and skills training.

Medications

Diagnosis and treatment with antipsychotic medications early in the illness, optimally within the first six months of symptoms, have the greatest potential to reduce the severity of a person’s illness. As such, antipsychotic medications are the first-line treatment for schizophrenia.

They can help reduce the frequency and intensity of psychotic symptoms and are usually taken each day as either a pill or liquid. Some antipsychotic medications can be administered by injection once or twice each month.

Psychotherapy

Therapy can also be helpful for managing the symptoms of schizophrenia.

• Cognitive behavioral therapy (CBT) may be helpful for some of the negative symptoms or cognitive symptoms of the condition.
• Family therapy can also be beneficial for addressing issues with family dynamics and relationships.
• Some people may find that group therapy can be helpful for practicing skills and getting encouragement from other people who are facing the same problems.

Psychosocial Treatments and Skills Training

Supportive psychosocial treatments can help people learn coping skills that will help them live with some of the day-to-day challenges they may face while living with their condition.

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Ways to Cope With Schizophrenia

While having schizophrenia presents a number of obstacles, there are things that a person can do that can improve their ability to cope. Having an understanding of how their individual symptoms affect them and the areas where they seem to have the greatest difficulty provides a solid foundation. 

The next step is finding strategies that can help them function and live their best. If your loved one has schizophrenia, encourage them to:

• Seek out social support: Encourage them to talk to you or their close friends or family members about their condition. Sharing their challenges can help their loved ones learn to notice when their symptoms might be worse and when they could use additional support. 
• Join a support group: In addition to leaning on their loved ones, joining a support group can be a way to learn new skills and get encouragement from people who share their experiences.
• Practice self-care: Caring for yourself is important. Encourage them to take steps to make sure that they are treating themselves with kindness and caring for their physical and mental health. 
• Participate in skills training: Skills training can help them with both daily living skills as well and social skills. They can explore ways to manage some of the daily challenges they face and build coping skills that will help both now and in the future.

Keep in Mind

While it is not a treatment per se, family support is an important part of coping with schizophrenia. Supporting a loved one with schizophrenia means more than just learning about symptoms and treatment; it’s about understanding what it’s really like to live with these symptoms day in and day out. This way, you can give your loved one the empathy and support they need to better manage their condition.