Delusional Disorder - Cognitive Decline?

I don’t have Schizophrenia according to my Therapist.

But when My Delusions take over me during the Delusional Disorder, My functionality and cognitive ability shows a sharp decline almost to the levels of Mental Retardation.

Can Delusional Disorder cause Cognitive Decline during Psychotic episodes or is this a Diagnose of Schizophrenia?.

I do not have any Emotional Blunting (Verified with my therapist and my Psychiatrist) whatsoever and negative affect.

I also do not have Hallucinations.

I find the same, schizophrenic with hallucinations [not delusions] - Amongst my hallucinating, the visual and tactile aspects limit my functionality greatly. I can’t move in some instances, can’t think in others.

I am able to Move, Function etc there is no problem with that.

I can also function in a relatively low end job quite easily.

I am talking about High Technology and Dynamic industry where a High IQ is the immediate requirement (> 120).

More like Problem Solving Skills.

It is in this enviornment that I am unable to function during the Delusion episode.

Technically none of the shrinks I went to suspected that I was sz either but there was definitely something wrong with me.

What I hadn’t realized is that I fell into the Twilight Zone like many people before me but I was aware of the situation enough so that it (logically) alarmed me.

However sticking with rational logic I still had x number of years of my life to go and I couldn’t do them hiding under my bed so I had to accept the paradigm shift (so to speak) and see that new strange world as something to explore although I am still quite pissy a lot of times feeling like a ‘rat in a cage.’

I’m not sure if this is your same issue but ultimately the flood of conspiracy notions and loss of reality template isn’t ‘crazy.’ Crazy is defined by our reaction to our suspicions. Or, as example, suspecting everyone in the neighborhood to be aliens isn’t too crazy but proceeding to attack them because of that suspicion would be.

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You didn’t mention work at all in your original post?

I work full time at a solicitors, dealing with property law - We handle millions of pounds worth of property sales, purchases and repossessions daily. The job requires high intelligence and focus.

If that was your original subject or point of interest, then obviously the attacks can leave someone unable to carry out their normal lives as the same level of functionality [let alone a working capacity] - Over here [UK] diversity laws state that equal opportunities must be given to mental health sufferers as long as declared fit to work - So if a company employ you knowing of your condition they cannot then dismiss you fairly for struggling with it’s symptoms, so we’re you to obtain a job requiring intelligence and a high level of functionality, the onus would be on you to seek help where needed and the employer to provide adequate assistance where needed.

Not sure if the same applies in the US, but given only an estimated 7% of the worlds schizophrenic patients are in employment, it would suggest either: Not all countries adopt the same perspective on mental health, or, not all have the fight to function at the best of their remaining ability.

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It is Software Technology Industry.

Just read the Diagnosis of Paranoid SZ

Common symptoms for paranoid schizophrenia include auditory hallucinations (hearing voices) and paranoid delusions (believing everyone is out to cause you harm).[4] However, two of the symptoms separate this form of schizophrenia from other forms.

  • Auditory hallucinations - NONE
    Paranoid Delusions - YES (But not everyone only my parents).

And yes Cognitive Decline.

I have delusional disorder but I haven’t experienced cognitive decline during an episode. With that said however, keep in mind that if the delusion is troubling it can ‘mute out’ frontal lobe functioning. That, as you likely know, is the center of rational calculative thought. An emotional disturbance (e.g., anger, fear, etc.) causes the amygdala to take over instead. When that happens, we become highly reactive instead of cognitively rational.


If you find the delusions stressful (are they negative delusions?) then the problem could simply be the stress response on your memory and cognitive abilities. You can learn more about this here:

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Any decline in Speed of Execution and Problem solving during an episode?.

Yes they are Paranoid or Persecutory delusions.

My diagnosis is exactly like yours. I also get obsessed like your injection obsession.

What medicine do you take? And do you do any therapy? Do you feel you have memory cognitive problems during the obsessions/delusions periods?

Yes I have done Intensive Therapy for the past 2 months. (everyday).

I was hospitalized for 4 days where I was given Antipsychotics 24*7.

Apart from that I am not on Meds.

However my delusion is precisely focused on that - That I was injected an Antipsychotic so most of the times I do not know if it is a delusion or that I am actually on Meds.

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Why don’t you talk to the doctor about adding a low dose of medication for a while and try it out. That way you could compare how you feel now and how you feel with the medication - and see the difference and see if you do better.

The issue, I think, is that when a person is delusional (and the delusions are negative) they cause a person a lot of stress. That stress (specifically - the stress hormones), if it goes on for a long time (days or longer) can cause damage to the brain. This is one of the theories on why there is cognitive decline in schizophrenia and psychosis.

The medications help reduce your stress and reduce the delusions - which can help your brain.

See this news:

Gray Matter Loss in Brain Due to Psychotic Episodes / Schizophrenia, Not From Medications

And check out this poll on whether people here in our forums have found medication helpful:

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Could you confirm if my diagnosis is DD or SZ?.

No - you’d have to talk to another doctor about that. Ultimately I wouldn’t worry about the diagnosis. Just focus on getting your symptoms (delusions) undercontrol and working towards enjoying your life. That is the most important thing you can do. Work to keep your stress levels low. Try to identify what is triggering your delusions - are there certain stressful environments or people around you just before they start? That type of thing. I’m sure your therapist is helping you with this.

If I take Anti-Anxiety Medications, My delusion episodes are less frequent. Right now(without Anti-Anxiety med) it is on an average rate of 3-4 delusion episodes per week.

With Anti-Anxiety Medication - the delusions episodes go away all together or take a max rate of 1 delusion episode in 15 days. (That too the recovery from that episode is within 4-5 hours).

I think my delusions are highly connected to my Anxiety.

Yes - it sounds like. Stress / Anxiety are the common triggers for psychosis / delusions.

I recommend you learn all about CBT (Cognitive Behavioral Therapy) to help in this and reduce your anxiety and stress:


to start with…