When someone believes others are out to get them, despite evidence to the contrary, they may be having persecutory delusions.
Persecutory delusions are a false belief that a person or group of people are trying to harm you.
People with persecutory delusions often base this fear on irrational thoughts, and not on evidence. This isn’t a personal choice, but rather a symptom of a mental health condition.
In most cases, this type of delusion can be managed and with professional support, the underlying condition can also be treated.
A delusion is a firm belief in something despite evidence or logic that contradicts that belief.
“Persecutory” refers to the feeling of being persecuted or attacked.
When someone experiences persecutory delusions, they’re convinced that people are trying to harm them despite a lack of proof. In other words, they irrationally believe they’re being persecuted, sabotaged, or attacked.
Persecutory delusions aren’t considered a mental illness on their own. Rather, they’re a symptom of other mental health conditions, including:
- schizoaffective disorder
- delusional disorder
- schizophreniform disorder
- psychotic disorders
Persecutory delusions can also occur in some people with dementia or brain injuries.
Only a mental health professional can determine if someone’s having persecutory delusions and which conditions may be underlying this symptom.
Difference between paranoia and persecutory delusions
Persecutory delusions are a type of paranoia.
Paranoia refers to constantly doubting and mistrusting other people without reason.
Persecutory delusions are when those feelings of paranoia become a more fixed belief.
While paranoia might be temporary and soothed by opposing evidence, persecutory delusions are strong, irrational beliefs that don’t change if you see proof that contradicts them.
Difference between conspiracy theories and persecutory delusions
Persecutory delusions are a mental health symptom. Conspiracy theories may be the result of a mental health symptom but not always.
Persecutory delusions tend to take over someone’s entire life, making them fear and avoid ordinary situations. They also impact daily functioning.
Conspiracy theories aren’t necessarily delusions. They can be personal opinions or products of personal analysis.
Also, conspiracy theories are often about a group of people trying to harm a group or society as a whole. Persecutory delusions are about the believer themself. The believer thinks that they, specifically, are being targeted, harmed, or sabotaged by an outside entity.
If someone has delusions that can’t be explained by a mental condition, physical injury or illness, or substance use, they could be diagnosed with delusional disorder.
Delusional disorder can include persecutory delusions.
Delusional disorder is diagnosed when a person persistently experiences delusions for at least 1 month but doesn’t present symptoms of other conditions. They might also experience hallucinations as well as a low mood and irritability.
Persecutory delusions differ from one person to the next. It may depend on the environment, concerns, past experiences, or other factors.
Examples of persecutory delusions include believing:
- the government is trying to frame you
- someone who is parked outside your house is trying to kidnap you
- you’re being followed in the grocery store
- co-workers are trying to sabotage your work
- your neighbors are spying on you
- someone is stealing your belongings
These delusions are different from regular suspicions or doubt because they don’t change in the face of evidence. The delusions will not be deterred by rational arguments or facts that contradict these beliefs.
Persecutory delusions can be a symptom of a number of mental health conditions.
Schizophrenia often involves delusions. Persecutory delusions are the most common delusions in schizophrenia.
Other signs and symptoms of schizophrenia include:
- disorganized thinking and speech
- social withdrawal
- lack of emotional expression
- unusual motor behavior
- difficulty processing information
Schizophrenia can be treated and symptoms managed.
Schizoaffective disorder includes symptoms of schizophrenia and a mood disorder (either depression or bipolar disorder). These symptoms can include persecutory delusions.
Other signs and symptoms can include:
- disorganized thinking
- social withdrawal
- avoiding typical daily activity
- unusual motor behavior
- changes in mood
Some people with bipolar disorder might experience symptoms of psychosis, including delusions.
Bipolar disorder involves changes in mood, including periods of mania or hypomania and episodes of depression. Persecutory delusions can manifest during episodes of mania.
Major depressive disorder with psychotic features
Major depressive disorder (MDD) with psychotic features, previously called psychotic depression, can include persecutory delusions as part of the episodes of psychosis.
In major depressive disorder with psychotic features, someone might have persecutory delusions when experiencing feelings of guilt, numbness, and worthlessness.
Post-traumatic stress disorder (PTSD)
Persecutory delusions can also occur in people with PTSD. These delusions might be about the traumatic event itself.
For example, if someone has PTSD because of trauma during military combat, they may have delusions about enemy soldiers trying to harm them.
There are various treatments for PTSD.
Physical illnesses and conditions
Delusions, including those with a persecutory theme, can be caused by physical conditions and illnesses, particularly those that affect the brain.
- dementia, including Alzheimer’s disease
- a brain tumor or cyst
- neurological conditions like Parkinson’s disease or Huntington’s disease
- multiple sclerosis (MS)
Substance use can sometimes lead to an episode of psychosis, which in turn could result in persecutory delusions.
Using hallucinogenic drugs can also lead someone to have hallucinations about being in danger or under attack.
The conditions associated with persecutory delusions can be treated and managed.
Depending on the cause of the delusion, a combination of talk therapy, medication, and hospitalization could be necessary.
You might benefit from certain medications. Your doctor might prescribe drugs such as:
- antipsychotics, used to manage hallucinations and delusions
- antidepressants, used for mood disorders and PTSD
- mood stabilizers, used to treat changes in mood, mostly in bipolar disorder
If the delusions are caused by a physical illness, physical treatments may be necessary.
Also known as psychotherapy, talk therapy can be useful for anyone experiencing delusions.
When it comes to persecutory delusions, therapy — together with medication — can help you manage your symptoms.
Not everybody with persecutory delusions will need to be hospitalized, but some people benefit from it, especially if their symptoms are severe.
If you’re unable to take care of yourself, or if you put your safety or other people’s in jeopardy, hospitalization can be helpful.
In the hospital, a team of professionals will establish a treatment plan for your underlying condition, and keep you monitored until you experience improvement.
Persecutory delusions are irrational beliefs that one is being targeted or sabotaged by a person or group of people.
These delusions are often a symptom of a mental health or physical condition. In most cases, these can be treated.