How Bipolar Disorder Often Leads to Harmful Delusions Among the Religious

Mania and hypomania in bipolar disorder can be characterized by an increased focus on religion or religious activities. The heightened focus doesn’t necessarily distinguish bipolar disorder from other mental health disorders, such as schizophrenia, schizoaffective disorder, and schizophreniform disorder.

Psychoses are not indicative of all forms of increased religiosity-some may be subtler than others.

As Duke University psychiatrist Harold G. Koenig discussed in his 2007 literature review that around a third of all psychoses have religious delusions, but not all religious experiences are psychotic.

According to Koenig, some spiritual approaches may benefit patients. When religious delusions aren’t immediately apparent, the treating clinician needs to examine the patient’s religious beliefs and behaviors carefully, Koenig concluded.


What Are Religious Delusions?

False beliefs are defined as delusions, and among the most common types are paranoid or persecution delusions, delusions of reference, delusions of grandeur, and delusions of jealousy. Particularly two of them may be religious in nature. Here are a few examples:

Religious paranoid delusions

“Demons are watching me, following me and looking for ways to punish me,” or “God will set my shoes on fire to punish me, so I have to go barefoot all the time.” Auditory hallucinations, such as, “I hear voices telling me there are devils in my room,” often accompany religious paranoia.

Religious delusions of grandeur

“Suppose I am exalted above you, and God claims that I do not need help,” “I do not need medicine.” “I’ll go to heaven and you’ll all go to hell.” I am Christ reborn.”


Cultural impact on religious delusions

Researchers reviewed 55 studies from around the world in 2015 to analyze the relationship between religious delusions (RD) and religious hallucinations (RH).

In the US, a 2001 study found that the degree of involvement in religion could actually predict the severity of religious delusions and that Protestants were more likely than Roman Catholics to experience RD. In 2002, an English study reported a higher incidence of religious belief and religious delusion in schizophrenia patients.

Additionally, in 2010 researchers in Pakistan concluded that Muslim patients with schizophrenia are more likely to hear voices of ‘paranormal agents’ and to experience RD.

A 2008 study in Lithuania that followed schizophrenic patients concluded that religiosity did not directly influence religious delusions and that further research was needed to validate these findings.

Approximately 25% to 39% of patients with schizophrenia and 15% to 22% of those with mania/bipolar have religious delusions, according to Koenig.


Religion and religious delusions in psychotic disorders

Many psychotic patients see spiritual faith as a way to cope. For those who are not delusional, religious beliefs and activities as coping mechanisms have been found in some studies to be associated with better outcomes for the illness as a whole.

In contrast, having religious delusions has been found to be associated with a more serious illness and poorer outcomes. Religious delusions have been linked to more severe psychotic symptoms, a longer history of illness, and worse functioning before a psychotic episode.

Therefore, clinicians must be aware of these differences in order to be effective.

Patients’ beliefs should be taken into account when evaluating a patient as a whole, and doctors should be careful to distinguish between strong religious beliefs and delusions.


Religion, Delusion, and Psychosis

The issue of whether culture plays a role in delusions, despite the conflicting findings of the research, is undoubtedly one worthy of further study.

Researchers agree that those who treat people with psychoses need to take into account a the religious beliefs of that patient, both in distinguishing them from delusional beliefs and in evaluating their usefulness for the patient.