Delusions of Love: Signs of Living with Erotomania

Erotomania is a type of delusion. These are defined in psychology as firm beliefs that don’t change even when you’re presented with evidence that contradicts them.

Even though it isn’t a condition on its own, the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) has erotomania as a symptom under delusional disorder.

Delusions in delusional disorder may have many themes. In the case of erotomania, the delusion typically presents as a fixation on someone along with a belief that they’re in love with you.

This someone may be anyone, but most often it’s a public figure, famous person, or someone considered to be of a higher social status.

This person may be someone you know, but it can also be a stranger or someone you’ve had limited contact with or who has communicated that they don’t reciprocate your romantic feelings.

Other mental health conditions that may have erotomanic delusions as a symptom include:

• bipolar disorder
• borderline personality disorder (BPD)
• brain diseases (cognitive impairment)
• schizophrenia and schizoaffective disorder
• major depressive disorder (MDD)

Some people who participate in stalking behaviors are diagnosed with erotomania. However, not everyone who does this lives with erotomania, and not everyone with erotomania engages in stalking.

Clinical experts typically categorize erotomania in two groups.

Primary erotomania

Also known as “de Clérambault’s Syndrome,” primary erotomania is a subtype of delusional disorder.

In sum, this involves:

• no other mental health diagnoses
• quick onset of symptoms
• symptoms that last for a long time
• difficulty responding to treatment

Secondary erotomania

Secondary erotomania is considered a symptom of mental health conditions other than delusional disorder.

In sum, it involves:

• comorbidities (other conditions) present
• slow and gradual onset of symptoms
• symptoms that present in episodes
• effective management with talk therapy and medications

Not everyone experiences erotomania in the same way or with the same intensity. Its signs may be emotional or behavioral or both.

Emotional signs

• longing for the other person
• feelings of loneliness and emptiness
• low self-esteem
• feelings of guilt and shame
• denial of someone’s expressions of rejection or disinterest
• feeling like you can’t take “no” for an answer

“You may also experience jealousy and suspicion that the other person is being unfaithful to you,” says Brian Wind, PhD, a clinical psychologist in Brentwood, Tennessee. “Also, a loss of interest in most activities, other than that person.”

Behaviorial signs

• getting angry at people who don’t believe you
• spending time on the delusion even when it’s negatively impacting work, home, or school life
• trying to decode secret messages directed at you through the media, captions, wardrobe choices, postures, lyrics, or telepathically (delusions of reference)
• repeatedly calling, writing, or messaging someone
• furtively approaching someone online or in-person
• harming others who get in your way of reaching the person
• aggressive behaviors towards the person (more commonly in males)

Researchers haven’t pinned down one cause of erotomania in their case studies. Like other conditions, it’s likely a combination of factors, which may include:

• a coping mechanism for stress or trauma
• emotional abandonment, neglect, or feeling unfulfilled
• genetics
• family history of mental health conditions
• sexual inexperience
• social isolation

Recent research suggests that social media is known to heighten erotomania, with the plethora of information available about other people online.

Erotomania may occur by itself (primary) or as a symptom of other mental disorders (secondary), says Makin.

Sometimes, that includes schizophrenia, but not in every case.

“Erotomania is not always a symptom of schizophrenia because those with this diagnosis may experience different types of delusions, or no delusions at all,” she says.

Psychosis, or a break with reality, is usually a symptom of a mental health condition that can last anywhere from a few hours to a few weeks.

It can include false beliefs or delusions, including those about someone being in love with you.

“Erotomania that occurs only in short episodes can be similar to a psychotic episode […] but it’s not always the same,” says Wind.

If you live with primary erotomania that features a chronic pattern of thought and behavior, that’s different from a temporary state of psychosis.

If you’re open to it, erotomania can be managed with professional support, which usually includes a combination of different approaches.

Psychotherapy

Talk therapy may be an integral part of your treatment plan to manage erotomania. Older research suggests that cognitive behavioral therapy (CBT), specifically, can be effective.

This method may help you develop deeper insight into your patterns, strengthen your coping skills, and identify the cues that drive your behavior.

Medications

Research shows that medication may be helpful in reducing symptoms of delusions for some people. Only a mental health professional can determine whether this is the best type of treatment for you.

If they do, some options they’d consider include antipsychotics, antidepressants, and anti-anxiety medications.

Hospitalization programs

In some cases, people with erotomania feel like they want to harm themselves or others. In this case, a hospitalization program may be a good fit.

“Those who live with delusions may not recognize it and become a danger to themselves or others,” says Makin. “This is when it is necessary to hospitalize someone so they can get the required care.”

Erotomania is a type of delusion where you’re convinced someone else is in love with you, even if you don’t know them yet or they tell you this isn’t so.

Living with erotomania can direct how you spend your spare time to how you show up in your interpersonal relationships. You may find that it impacts your life at home, work, or school.

But erotomania can be managed, and you can experience improvement.

“Treatment for erotomania often has successful outcomes, as long as any co-occurring mental health conditions are also treated,” says Wind.

With a desire for change and a well-rounded treatment approach, you can do this. You’re already on the way.