Mental-Cognitive Symptoms
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Anxiety is Often the Cause of Delusions

Denise Griswold, MSc, LCAS
Anxiety is Often the Cause of Delusions

Delusions are beliefs that are not true. Often these are beliefs that you hold despite considerable evidence to the contrary. When experiencing a delusion you are likely to “know” a fact to be true even if others have more proof that the fact is actually false.

Delusions are linked directly to psychosis, but not all delusions are that extreme. In fact, anxiety commonly causes delusional thinking, simply because of what it's like to deal with anxiety.

Different Anxiety = Different Delusions

Each person with anxiety experiences it in a unique way with a different makeup of symptoms and worries. People with anxiety who experience delusions also have a large variety of delusions. Delusions are most common in severe forms of anxiety but can be present in milder cases as well. 

When discussion delusions most people think of a paranoid delusion such as believing that the CIA is monitoring your home or that aliens have abducted your parents. Those are paranoid delusions that often occur in mental health disorders that cause psychosis, and in these cases, the person will have lost touch with reality.

Delusions related to anxiety are usually less intense and overall more benign. A few examples of common delusions in people diagnosed with anxiety disorders are:

"There is Something Wrong With My Health"

This is a very common delusion that occurs in people with anxiety. It seems to have the highest prevalence in people who have panic attacks but is found across all forms of anxiety disorders. 

A person with anxiety is likely to be hyper-aware of every sensation in their body—ones that most people would usually dismiss if they even noticed them. The person with anxiety, however, notices these symptoms and immediately think of the worst case scenario often jumping to serious medical conditions such as heart disease or lyme disease. It is thought that the physical symptoms that cause the anxiety are actually the cause of this additional health anxiety and delusion. 

The physical symptoms of anxiety and panic attacks are nearly identical to many of the symptoms of serious health disorders which leads the person to believe their health is declining and in danger. 

For people who truly experience this delusion, seeing a doctor is unlikely to ”fix” the problem. While the doctor may inform you that you have no signs of disease and state you are in perfectly good health, you are unlikely to believe it. Remember, a delusion is a false belief maintained despite evidence against it. For many with this delusion their physical symptoms of anxiety feel too real, cause too much fear, and cause too many symptoms to be something that isn't actually health related.

"X is Dangerous/Scary"

The next common delusion is most often experienced by people with specific phobias but can be present in all forms of anxiety. The idea behind this delusion is that something specific in life needs to be avoided and/or feared. 

For example someone with a specific phobia of birds may convince themselves that something about birds is dangerous - whether the birds will attack, or the birds carry disease, or some other fear, they convince themselves despite all available evidence that birds are to be feared and thus avoided at all costs.

It's the same with other phobias, like a fear of spiders or a fear of dogs. It's also common with those that have obsessive compulsive disorder, where there may be obsessive concerns about germs, disorder/disorganization, or even their own thoughts. Those with OCD may fear that they left the oven on even though they know they turned it off until they're compelled to check it. For people with Post-Traumatic Stress Disorder the fear of the trauma happening again may cause this type of delusion. For example someone who is robbed at gunpoint walking down a poorly lit ally at night may become convinced that night is dangerous and do everything they can to avoid being outside during the dark. 

Every anxiety disorder has its own fears, and often these fears can become delusions when they start to control your thoughts.

"I Can't Be Helped"

The final delusion to be discussed often is directly related to symptoms of anxiety. It occurs when a person believes that their anxiety has no hopes of being effectively treated. Even when effective treatment is offered they do not fully engage because they believe so strongly that there is nothing that can be done about it. The source of this delusion may be caused by the difficulty in treating anxiety in terms of recurrences and setbacks. Even the most effective treatment will occasionally have some setbacks and problems working. In addition, many people do not choose effective, evidence-based treatments  that are unlikely to help. When they do not obtain the results they were expecting they become more certain that they are a hopeless case. 

This delusion causes people to give up and ignore potential options, and in some cases it causes people to drop out of effective treatments early when they experience a setback.

While there is no one size fits all treatment for anxiety, numerous studies have shown that anxiety is one of the most treatable mental health disorders. Thus when a person is insistent that their anxiety will never improve even when presented with evidence about treatability, they are having a delusional belief. 

Avoiding Anxiety Delusions

Recognizing that your beliefs may be faulty and opening yourself up to trying suggestions from others, especially from medical doctors and mental health professionals, can be one of the most effective ways to begin reducing your anxiety delusions. Delusions are unlikely to disappear overnight but by challenging your delusions they will begin to loosen their grip on you.

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