Religious Delusions in Schizophrenia: What Loved Ones Should Know

If your family member or friend believes they’re appointed by God to save the world, or they’re convinced they’re being persecuted for a sin or wrongdoing, they may be experiencing a religious delusion.

The key to identifying a religious delusion starts with adequately interpreting what’s normal for the person’s culture and religion. Labeling an authentic religious experience delusional can be harmful and may impede treatment, but not identifying the delusions can be as well.

That’s why it’s so important to know what to look for in religious delusions in schizophrenia. Here’s how to recognize them and get your loved one help.

What Are Religious Delusions in Schizophrenia?

Religious delusions are fixed false beliefs that can cause a person to have religious or grandiose ideas about who they are or how God interacts with them. Some people may believe they’re a religious figure like the Messiah or a prophet. Others may believe they’re godlike or that they have supernatural powers like the ability to heal people.

Religious delusions are common in schizophrenia. One study estimates that the prevalence of these types of delusions can vary from 6 percent to 63.3 percent.

Researchers estimate that those who are very active in their religion are three times more likely to experience religious delusions than those who don’t practice a religion. But it can be challenging to distinguish between authentic religious experiences and religious delusions.

In fact, there aren’t any guidelines to determine what’s a normal religious belief and what’s a religious delusion. Even the Diagnostic and Statistical Manual of Mental Disorders indicates that authentic religious beliefs aren’t considered delusional, even if they’re strange or extreme.

To qualify as a religious delusion, the beliefs must fall outside of the person’s religious background and cause distress, impairment, or safety risks.

How Religious Delusions Can Affect Daily Life and Treatment

Experiencing religious delusions can negatively impact a person’s life and the management of their schizophrenia. In fact, one study found that people who experience religious delusions have worse symptoms, don’t function as well, and are prescribed more medication than those with schizophrenia who have other types of delusions.

Other studies have found that those with religious delusions may not receive treatment in a timely manner and are less likely to follow their treatment plan. They also tend to become dissatisfied with psychiatric treatment and often don’t have good outcomes. They may also become violent or engage in self-harm.

That said, being religious can also have a positive impact on those with schizophrenia. In fact, some people who are religious have more social connections and a lower risk of substance use. Some even experience a reduced relapse rate and a better prognosis.

How Loved Ones Can Recognize Religious Delusions

Having a healthy religious faith typically provides a person comfort and connection. But if their religious dialogue focuses on fixed beliefs that don’t align with their religion’s teachings, it’s likely a religious delusion.

Here are some examples of religious delusions in schizophrenia:

• Believing they’re a god, a prophet, or some other religious figure
• Maintaining that they’re chosen by God to do something significant in the world
• Feeling they’re being persecuted by God for a sin or wrongdoing
• Believing they’re being controlled by spiritual beings at war with one another
• Fearing being attacked or possessed by spirits, witches, or demons
• Claiming symptoms or illnesses are caused by a spiritual force or a curse

Typically, people with religious delusions have more conviction about what they believe is true than other delusions. They may also experience more auditory hallucinations (hear voices).

And their delusions can also be grandiose. For instance, one study found that a person with religious delusions is six times more likely to have grandiose delusions and three times more likely to have delusions of being controlled.

The Role of Religion and Spirituality in Schizophrenia

Religion of some form can be common in people with schizophrenia. One study found that as many as 91 percent of people with schizophrenia participate in private religious activities, and 68 percent attend public religious services or activities.

This religiousness can have both a negative influence and a positive one. In one respect, religion can provide people with schizophrenia a way to cope with their condition. It can also help people with schizophrenia become more resilient and have more social support.

But practicing a religion while having schizophrenia can also present some challenges. If the person has religious delusions, this can sometimes make it more difficult to recognize their delusions.

A religious person may also distrust mental health professionals and refuse to take their medication. For instance, someone with religious delusions might assume their antipsychotic medications will be ineffective, especially if they feel their condition is caused by something supernatural.

They may also avoid psychotherapy and other treatment options in favor of spiritual interventions, which can be risky. Not only can they experience prolonged periods of psychosis, but they’re also at an increased risk of relapse.

How To Respond to Religious Delusions

Often, people with schizophrenia have authentic religious beliefs. But at the same time, their faith can get confused with their mental health condition. This can make communicating with and supporting them challenging.

One way to address this issue is to draw attention to parts of their faith that are based in truth. You can also validate their feelings, emotions, or concerns, but let them know that you have a different viewpoint. The key is to be respectful in doing so.

You could also try the LEAP (Listen-Empathize-Agree-Partner) approach. This is a common family communication framework for people with mental illness, especially for those who lack insight into their illness.

Here are some other ways to support your friend or family member:

• Refrain from dismissing the delusions, but avoid agreeing with them.
• Attempt to soothe and calm the person’s distress.
• Remind them that help is available, and offer to go with them to see a mental health professional.
• Take threats of suicide or harm seriously and get help immediately.
• Take care of yourself and consider talking to someone.

Note: If you or someone you know needs help, you can contact the 988 Suicide & Crisis Lifeline by calling or texting 988 or chatting online.

If you’re unsure where to find help for your loved one, consider calling the National Alliance on Mental Illness (NAMI) HelpLine. This free service provides mental health information and resources to help you address the challenges you and your loved one are dealing with.

You can call 800-950-6264 or text NAMI to 62640 for help. Or, you can also email the organization at helpline@nami.org. If it’s an emergency or your loved one is at risk, call 911 or text 988.

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On MySchizophreniaTeam, people share their experiences with schizophrenia, get advice, and find support from others who understand.

If you have a loved one with schizophrenia who has religious delusions, how has this impacted their life and yours? Let others know in the comments below.