Persecutory Delusion

What is persecutory delusion?

Persecutory delusions are when a person has the absolute belief that they are being treated with malicious intent. A person believes that the “persecutor” intends to harm them or ruin their life.

These delusions are no laughing matter. They can become so real that the person believes their life is in danger. They may hear voices, experience hallucinations and in the worst cases act to defend themselves against the “person” attempting to harm them. Some may suffer from these delusions but not know anything about what’s going on.

It’s real to them so the fact that it’s all in their head never even occurs to them. The best way to defend against delusional episodes is to learn as much as possible about them and prepare for the worst.

Symptoms and types of persecutory delusions

Symptoms of persecutory delusions are the delusions themselves. What makes it a delusion is the fact that nothing going on in the real world supports the person’s fear. It’s literally all in their head. People will have an exaggerated belief that someone is out to get them. If they catch a cashier giving them a look, they take it beyond personal.

Picture a person who believes that aliens walk among us. They may think that everyone around them is an alien trying to read their mind or steal their thoughts and that they are the only normal one. Different types of persecutory delusions include, but are not limited to:

A fear of being fooled

Nobody wants to be played for a fool or be tricked. One that suffers from this type of delusion truly believes that someone is trying to trick them and they may be afraid to do certain things or indulge in certain activities. A person might think the bank teller is cheating them out of their money. They may constantly count their change or only carry cash because of paranoia of someone stealing their bank information to get all their riches.

Even if they only have twenty dollars in the bank, this scenario seems very real to them. They don’t want to be tricked into a faulty relationship – not like anyone does, but the difference is they believe every person that attempts a relationship is trying to trick them even if there is no evidence that they are. They can be with the most faithful person ever, but to them, it’s all a trick so they don’t want to take the chance with anybody. It’s total obsessive behavior at its worst.

A fear of being spied on

Big brother watching is a good way to describe this specific delusion. The person believes that they are being watched by the government, aliens, or big brother. They may go as far as to live off the grid, go without technology, and swear their phone is bugged and they’re being followed.

This person may block all their windows for fear of being seen, or soundproof their home for fear of being heard. Extreme cases may turn into hermits or complete recluses to avoid being “made.” What makes it even more unlikely is the person may just be a regular person with no reason whatsoever to think they are being watched.

A fear of being ridiculed

Fear of being ridiculed is common among a lot of people. But if you suffer from persecutory delusions you believe you’re being ridiculed to the point of ruin. You believe the persecutor is out to destroy your life. This is one of those people who believes everybody is after their job.

They think that every time they walk into the break room the conversation is about them. The way they look, the way they act, their performance at work etc. So they tend to withdraw in the workplace so that no one says anything to them. They will also tend to have either low self-esteem or the total opposite of self-esteem so high it borderline delusions of grandeur as well.

A fear of being killed

In extreme cases, a person may believe that someone is trying to kill them. They may be afraid to go out, or afraid to talk to people because they fear everybody is in on it. They think it could be a conspiracy or that they have some top secret information, you just never really know the full story behind the delusion. What you will notice about every scenario is that the person fully believes there’s a conspiracy, they won’t understand why you don’t know and don’t believe them, and the delusion has an effect on their quality of daily life.

The worst result of a fear of being killed is that the person goes on the defense and kills somebody they think is out to get them. This person thinks somebody tampers with their car, poisons their food, tried to push them down stairs, tried to drown them, or they think somebody might shoot them for example. The harm comes in when they don’t eat for fear of poison, they financially set themselves back constantly getting the car checked, won’t go in the water, and won’t take the stairs. The fear puts limits on the way they live their life and that is one of the worst things that can happen.

Persecutory delusion causes

The cause for persecutory delusions is different on a case to case basis. Most cases are caused by defects in the brain.


Head trauma from car accidents or from playing sports is an example of brain injuries that have the potential to cause persecutory delusions. Any injury to the temporal lobe of the brain causing lesions may cause an episode. A combination of frontal and temporal lobe damage is a double whammy for a person. The damage can be life changing and irreversible.

Receptor densities

The right balance of dopamine is what keeps you balanced. When there’s too much or an over release it can cause persecutory delusions. But when there is a low concentration of dopamine receptors, that means the receptor densities that process the dopamine aren’t properly functioning.


Like with any part of a working machine, when the parts aren’t in the right places or are improperly connected, the car won’t run right. The body is the same way with all its organs. When certain regions of the brain are different from normal brain anatomy it can cause dysfunction of the frontal lobe, parietal cortices, and striatal circuitry.

If the “wiring” is off, it’s just like electrical wiring – there’s a possibility of a “short”. People who suffer from these “shorts” can’t fathom that some things happen by chance, they feel everything is on purpose and against them. That part of their brain doesn’t work so they just don’t have the ability.

Neurotransmitter concentrations

Too much attention to detail can drive anybody crazy. But when the brain is constantly attempting to “connect” everything around you, it creates paranoia. This is caused by too much dopamine.

Hemispheric activation

Neurodegenerative diseases cause the left hemisphere of the brain to overwork and go into high gear and become hyperactive.

Other causes include:


Illicit street drugs are definitely not recommended. But any drug that increases dopamine to an extremely abnormally high level has the possibility to cause a drug-induced psychosis. The person will be in a euphoric state in the beginning but once overly stimulated the stimulation turns to fear followed by suspicion and paranoia.


The genes responsible for dopamine may be altered or wired incorrectly causing the neurotransmissions to lead to paranoia. In other words, if a parent or sibling suffers from some sort of psychosis, there’s a chance you may suffer from some type of psychosis.

Other illnesses

Other illnesses like bipolar disorder, depression, drug abuse, schizophrenia, paranoid personality disorder, encephalitis and any other neuro generative disease can cause delusions.

Persecutory delusion treatment

Persecutory delusions are in fact a psychotic break. Anti psychotic medication may be prescribed in some cases on a daily basis. Cognitive behavioral therapy is another outlet for treatment that people who don’t like a lot of meds may prefer. Therapists can then break down the delusion, everything that is unrealistic about it, and open the mind to the suggestion of what’s going on in real life. In extreme cases, hospitalization may be the best option to get a handle on the delusions and bring the person back to the real world.

People tend to live in these ideas and it may take more than a session or a pill to help them. If you are exhibiting violent tendencies, the hospital is the best option for your safety and the safety of the so-called persecutor. If you choose to treat it with medication, take the medicine as prescribed. Don’t under dose and don’t overdose. If you choose cognitive behavioral therapy, go to every session.

Be honest with the doctor about feelings and experiences and continue any therapeutic exercises the therapy gives you to do at home. When those feelings get extreme and a person feels as if they need to go to the hospital, don’t hesitate to go in if the usual method of treatment isn’t working. Thoughts of suicide or harming others or vivid hallucinations are all valid reasons to check yourself in. Every person should do the treatment that works for them and don’t try things based on other people’s experiences.

Persecutory delusion prevention

The most effective action a person can take to prevent persecutory delusions is to treat any existing underlying conditions. Bipolar disorder, depression, drug abuse, schizophrenia, paranoid personality disorder, encephalitis, and any neuro genetic diseases can all be treated to avoid the onslaught of delusions.

Mental health issues affect millions of people around the world of every race, ethnic background, age, and economic status. It has no prejudice. Society today does not shun those that suffer from depression, bipolar disorder or anything else that may trigger your delusions. Every person that has tendencies to have episodes should identify their triggers, and work every day to control their environment as much as possible.

The right balance of medication, diet, exercise, and therapy can allow anybody to lead a pretty normal life. The key is to maintain a regular, consistent schedule and follow the doctor’s orders. Do not attempt to self-medicate with drugs and alcohol because that will only enhance the delusions. Keep a journal or diary and record daily actions that do and do not send you into an episode.

The worst thing that can happen is that if there’s a psychotic break someone doesn’t come back from, they hurt somebody or they hurt themselves. Nobody has to be that person. If you feel you are slipping into a delusional state, call your doctor or family member for support. Making lifestyle changes as simple as a morning meditation, yoga, a good night’s sleep and a quick 10-minute walk might be the difference between a good day and a bad day.

Last Reviewed:
September 16, 2017
Last Updated:
September 16, 2017
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