What Does It Really Mean to Be Delusional?

From calling yourself “delulu” to saying you’re in a “delusionship,” the word delusional has become a prominent part of cultural slang. But I’m not sure it should be. With these terms being so casually thrown around on social media, it feels like the real meaning behind delusional has been lost.

Delusions, or fixed beliefs in something that is untrue, can be a symptom of several mental health conditions. And using the phrase offhandedly can inadvertently perpetuate negative stereotypes about mental health. So how did the word delusional enter the mainstream lexicon in the first place and what should you be saying instead?

Experts Featured in This Article:

Leon Garber, LMHC, is a NY-based psychotherapist.

Emily Green, PsyD, is a psychologist based in Washington DC.

Stephanie Freitag, PhD, is a licensed clinical psychologist in NY, NJ, CT, GA, and FL, and an adjunct professor at the Emory School of Medicine.

What Is a Delusion?

The DSM-V defines a delusion as a firmly-held, fixed, false belief that’s not amenable to change in light of conflicting evidence. “Clinically, someone who is delusional carries [at least] one of these false, immutable beliefs,” says Emily Green, PsyD, a psychologist based in Washington DC. Beyond this, delusionality is usually associated with psychotic disorders such as schizophrenia or severe bipolar disorder.

“Delusions are beliefs about oneself, others, and the world, which are normally extreme and held mainly to cope with difficult realities and resulting feelings,” explains psychotherapist Leon Garber. They can provide hope, meaning, comfort, clarity, and self-esteem when an individual can’t find another way to access those states, and people experiencing delusions can be highly resistant to change, he adds. “Delusions significantly influence an individual’s life in extremely negative ways, impacting relationships and reputation,” he says. “No amount of factual evidence seems to alter them, and the individual, through an intense fear of losing them, seeks out more reasons to sustain them.”

“Delusions can also vary quite widely, from what we call ‘bizarre’ delusions (believing things that are impossible, such as the ability to control other people’s minds) to “non-bizarre” delusions, things that could actually occur in reality but aren’t true, such as believing that you’re the president,” says Dr. Green. Garber notes that there are also delusions of persecution — false beliefs that others are conspiring to harm you — as well as delusions of grandeur, when someone believes they are more important than they really are.

It’s important to note that a lack of insight is inherent when it comes to delusions. If the person can acknowledge the belief is silly or unlikely, it’s not a delusion.

Why Are Delusions Problematic?

Delusions can become problematic when they interfere with a person’s ability to empathize with others’ perspectives, turn skepticism into severe mistrust of the world, and/or isolate one from the broader community. Some delusions may be relatively harmless, but the true impact is reflected in how much it affects functionality (e.g. not getting a job because you believe you are the president) or unsafe behavior (trying to climb the White House fence).

“While some people may carry fixed, false beliefs that don’t impact their life in a significant way, when we think about the clinical presentation of delusionality we are likely talking about someone who’s inflexible attachment to this false belief is making it difficult for them to function and relate to others. It can trigger harmful behavior and may be coupled with other mood instability, confusion, and agitation, especially when their delusions are challenged,” Garber explains.

At the same time, clinical psychologist Stephanie Freitag, PhD says that paranoia is also typically synonymous with delusions. For example, when people display paranoid delusions they may think that others want to directly hurt them in some way even if there is no intent. An innocuous event like a stranger walking nearby could be interpreted as dangerous. “There’s also the very interesting concept of erotomanic delusion where a person becomes convinced that another individual is in love with them, frequently involving a famous person,” she says. This has even led to criminal behaviors, like stalking.

All this to say, there’s a wide array of how delusional thoughts and behaviors can manifest, and how problematic they can be. Regardless, treatment can be challenging. “Delusions can be hard for the therapist to treat when it leads to disengagement or mistrust of the therapeutic relationship,” says Dr. Freitag.

So Why Is ‘Delusional’ Slang Trending?

Being delusional has become a pejorative term, similar to the ways people say they’re “OCD” when being meticulous or “bipolar” when they feel moody — both of which are problematic uses of the term. “Psychological terms are often adopted into popular lexicon because we want to make sense of life experiences that feel uncomfortable and can’t always verbalize for ourselves,” Freitag says. “Slang allows us to feel less alone in a challenging experience.”

According to Dr. Green, the proliferation of “pop psychology” terms oversimplify and often inaccurately convey the meaning of the original term, and stem from a desire for people to describe behavior with language that doesn’t exist yet. As it pertains to “delulu” it appears to be capturing the behavior or beliefs of a person that chooses to see the world in a way that benefits them.

She’s also quick to note that the clinical standard of “delusional” is not met in pop psychology references; these beliefs are almost exclusively non-bizarre and more conducive to logic. “The person likely has the capacity to acknowledge that this belief may not be true but that it benefits them to believe it anyway,” she says. Also noteworthy: Actual delusional disorder only impacts 0.05% to 0.1% of adults, so, from a statistical standpoint, it’s highly improbable that everyone calling themself “delulu” on social media actually is delusional.

The Problem With Saying You’re Delusional — When You’re Not

“Delulu” behavior may have some superficially similar elements to the clinical definition of the condition, but ultimately the implications are entirely different and the two can’t be conflated. Dr. Green says the slang is problematic because it undermines the seriousness and complexity of the condition. “When it’s used clinically, it’s descriptive. Calling someone ‘delulu’ is often not a neutral descriptor of their behavior or presentation but rather a judgment or a negative one,” she points out.

By making light of certain experiences we might also try to reduce our own cognitive dissonance or discomfort, but usually this is just a Bandaid, notes Freitag. “In my opinion, it [the slang] generally reflects poor mental health literacy combined with discomfort related to sitting with a full range of emotions, particularly ones that aren’t so fun to feel.”

Still, it makes sense that the term is trending; we’re constantly bombarded and overwhelmed with information and stimuli in the modern world, making it hard to feel grounded. Perhaps the concept of delusionality encapsulates a collective feeling of being untethered to the world around us — our bodies, our communities, our futures — in a time when there’s so much uncertainty in daily life, Freitag says.

Ultimately, “being delulu” has nothing to do with being clinically delusional, which is far from funny. Of course, it’s normal for everyone to feel off sometimes and to attempt to make light of the situation. But it’s important to be wary of using terms that can perpetuate further stigma and cause more confusion about what these actual psychological conditions are — and what they’re not.

Sara Radin is a writer and publicist based in Philadelphia. Her writing on internet trends, style, youth culture, mental health, wellness culture, and identity has been published by The New York Times, Glamour, Self, Teen Vogue, Refinery29, Allure, PS, and many others.