Many mental illnesses are accompanied by impaired thinking. One of the main symptoms of obsessive-compulsive disorder, schizophrenia and other painful conditions of the psyche is the appearance of delusional and overvalued ideas. What is the difference between these violations and what is common between them? You will learn about this by reading this article.
Study History and Brief Definition
The term “overvalued ideas” was coined by the psychiatrist Wernicke in 1892.
Such ideas are judgments that arise in a patient under the influence of events in the outside world. Moreover, the judgment has a strong emotional connotation, it prevails in thinking and subjugates human behavior.
Wernicke divided overvalued ideas into two categories:
- normal, in which the experiences experienced by the patient are commensurate with the event that caused them;
- painful, the main sign of which is excessive exaggeration of the causes that caused them.
It is important to note that, focusing on the overvalued idea, the patient finds it difficult to perform other tasks, experiences difficulty concentrating.
The main symptoms
What are overvalued ideas? Psychiatry identifies several of their main characteristics:
- Ideas arise on the basis of real events.
- The subjective significance of ideas and the events that caused them is too great for the patient.
- Always have a pronounced emotional coloring.
- The patient can explain the idea to others.
- The idea has a close relationship with beliefs and the patient's value system.
- The patient seeks to prove the correctness of his idea to others, while he can behave quite aggressively.
- The idea has a direct impact on the patient's actions and his daily activities. We can say that everything that a person does is somehow connected with his idea, the carrier of which he is.
- Having shown some efforts, it is possible to dissuade the patient in the correctness of the idea.
- The patient retains the ability to objectively evaluate his own personality.
Can such ideas arise in healthy people?
Overvalued and obsessive ideas can occur in healthy people who do not suffer from mental disorders. As an example, we can cite scientists who are passionately committed to their work and devoted to some scientific idea for the sake of which they are ready to neglect their own interests and even the interests of loved ones.
Overvalued ideas are characterized by constancy, they are not alien to consciousness and do not make their carrier an inharmonious personality. Some psychiatrists, for example, D. A. Amenitsky, call such ideas “dominant”. If a person has a dominant idea, he becomes extremely purposeful and ready to do anything in order to prove to others that he is right.
It is worth noting that D.O. Gurevich believed that dominant ideas cannot be called overvalued in the full sense of the word: they can only indicate a tendency toward their appearance. The researcher believed that overvalued ideas always have the nature of pathology and make a person disharmonious, affecting the adaptive capabilities and making thinking inconsistent and devoid of logic. However, over time, the dominant idea can acquire the character of overvaluation, and this is due to the development of some kind of mental illness. Under certain circumstances, this can turn into delirium: a judgment begins to dominate the psyche, subjugating the patient’s personality, and becomes a symptom of a serious mental disorder.
Overvalued and crazy ideas: is there a clear boundary?
There is no consensus on the issue of the relationship between crazy and overvalued ideas. Two main positions on this issue can be distinguished:
- delirium, overvalued ideas and dominant ideas are independent symptoms;
- There are no differences between crazy and overvalued ideas.
Why did such uncertainty arise, and what does modern psychiatry think about this? Overvalued ideas and nonsense are not uniquely defined, and it is practically impossible to draw a clear border between them. For this reason, in the scientific literature and research, these concepts are often mixed together and are considered synonymous. For example, the main signs of overvalued ideas are considered to be a dominant place in the psyche, a bright emotional color, the ability to dissuade the patient in the correctness of the idea, as well as its comprehensibility to others. However, the first two signs are also characteristic of crazy ideas. Some patients' delusions can also seem intelligible and even rational. Therefore, we can confidently speak of only one differential feature: the ability to convince the patient that his idea is erroneous. Syndrome of overvalued ideas is characterized by all of the above, except for the patient's unwavering conviction of his own rightness. In case of delirium, it is impossible to convince a person. If the patient is confident in his irrational beliefs, then we can conclude that he has delusions.
Reasons for the appearance
Studies show that two factors are enough for a symptom to appear:
- Personal characteristics of a person, that is, a tendency to overvalued ideas. As a rule, patients who have overvalued crazy ideas have accentuations of character and overvalued values. That is, a person is characterized by a certain enthusiasm throughout his life.
- A certain situation, which serves as a "trigger" to start the formation of super-valuable ideas. Often these are traumatic situations: for example, if a relative of a person is seriously ill, an overvalued idea may arise regarding caring for one’s own health. At the same time, in a premorbid (a benign state) personality should have disturbing and hypochondriacal features.
Thus, the syndrome of overvalued ideas develops according to the same laws as any disorder of the neurotic level. A person with a certain premorbid, getting into a traumatic situation, develops a certain idea, which at the same time does not contradict the previously existing values and beliefs.
Content
Overvalued ideas, the classification of which is given below, are very diverse. The most common varieties are:
- Ideas of invention. The patient believes that he can invent some device that will change the life of mankind. The person is ready to devote all his time to activities to create his invention. Interestingly, often such a passion brings good results.
- The ideas of reformism. Such ideas are characterized by the fact that the patient is confident that he knows how to change the world for the better.
- The idea of adultery. The person is sure that the partner is wrong with him. At the same time, a lot of effort is being made to prove this idea. As evidence of infidelity, too well-groomed appearance, a five-minute delay at work, or even watching a movie in which a handsome actor plays, can be regarded.
- Hypochondriacal overvalued and obsessive ideas. A person believes that he is sick with a dangerous disease. If doctors are unable to find evidence of this idea, then the patient will contact new medical institutions and undergo expensive diagnostic procedures to prove their case.
Delusions: Key Features
In some circumstances, an overvalued idea, examples of which are given above, can become delirious. Delirium is a collection of judgments that have nothing to do with reality. Delusions completely capture the mind of the patient, while it is impossible to convince him.
The content of delusions is always associated with the events that surround the patient. Moreover, the content of ideas varies from era to era. So, in past centuries, mystical ideas related to witchcraft, obsession, corruption, evil eye or love spells were very common. These days, such ideas are regarded as archaic forms of delirium. In the 19th century, patients developed delusions, the main content of which was self-accusation and thoughts about their own sinfulness. At the beginning of the twentieth century, hypochondriacal ideas dominated, as well as impoverishment. Nowadays, patients often have ideas of harassment by the special services, delusional fear of psychotropic weapons, and even ideas that the world will be destroyed due to the work of the andron collider. The delirium of obsession was replaced by the delirium of influence from aliens from other planets.
It is worth noting that if the emergence of overvalued ideas is closely connected with events from the patient’s life, then in the presence of delirium it is not always possible to determine why ideas have a certain content.
The main forms of delirium
Based on the development mechanisms of crazy ideas, three main forms of delirium are distinguished:
- Delusional perception. In this case, patients peculiarly assess the perceived. It takes on a new meaning and inspires fear, anxiety and even horror.
- A delusional idea, expressed in the sudden appearance of unusual thoughts or ideas. Such ideas may have nothing to do with reality: for example, the patient decides that he is the messiah and must save the world from imminent death. At the same time, under the influence of such ideas, a reappraisal of the patient’s past life often takes place.
- Delusional insight. A person is sure that he has comprehended the meaning of everything. At the same time, his explanations of reality seem strange to the surrounding, pretentious and not justified by any facts.
Delirium can be accompanied by hallucinations: in these cases it is called "hallucinatory delirium." Overvalued ideas are never accompanied by hallucinations. Typically, this symptom occurs in patients with schizophrenia.
The content of crazy ideas
Most often in psychiatric practice there are the following types of crazy ideas:
- Querulant delirium. The patient is prone to bribery, appeals to the courts to prove his case, writes numerous complaints to various authorities. At the same time, he can complain, for example, about neighbors who irradiate him from their apartment or even want to kill him.
- Delirium of reformism. Based on very peculiar and unusual ideas, the patient seeks to change the political structure in the country (or even in the world) or the social structure of society.
- Bullshit inventions. Patients devote their lives to creating some kind of mechanism, for example, a teleport, a time machine, or a perpetual motion machine. Moreover, the fundamental impossibility of inventing such devices of a person cannot be stopped. A significant part of the family budget can be spent on the purchase of necessary parts: a person can easily leave his children without the most necessary, if only to "realize" his creation.
- Religious nonsense. Patients have a very peculiar understanding of religion. For example, a person with religious delusions considers himself to be the son of God or the new reincarnation of Buddha. With schizophrenia, a person even feels that God regularly comes into contact with him, gives advice and leads him.
- Megalomania, or crazy ideas of greatness. A person overestimates the significance of his personality and believes that he has a direct impact on events taking place in the world. Such patients may believe that it was they who caused the earthquake on another continent or triggered a plane crash.
- Erotic delirium. At the same time, the delirium of jealousy is inherent in men, and love delirium, or erotomania, is more often observed in women. The delirium of jealousy is expressed in a firm belief in the infidelity of a partner. In the presence of an overvalued idea with a similar content, one can be convinced that he is mistaken, it is impossible to do this with delirium. Patients can be convinced that the partner managed to change them by going out for a few minutes for bread. With erotomania, the patient is confident that the other person has romantic feelings for him. As a rule, this person is not even familiar with the patient: it can be a show business star, politician, actor, etc. With love delirium, there is an unshakable belief that the delirious object sends him secret signs during his speeches or informs encrypted information in their publications or interviews.
Pathological pursuers occupy a special place: patients have a tendency to harm their imaginary opponents.
Thus, it can be noted that it is not always possible to distinguish in content which patient has delirium and which one has an overvalued idea. Psychiatry suggests focusing on what role the idea takes in the patient’s mind and whether it is possible to make him doubt his own beliefs.
Chronic and acute delirium
There are two main forms of delirium - acute and chronic. Naturally, in chronic delirium, symptoms accompany the patient for a long time, disappearing under the influence of drug treatment. In acute delirium, symptoms develop suddenly and quickly enough.
Chronic delirium has a number of rather unpleasant consequences, which include:
- Fraud. Delusions can cause the patient to deceive others in order to prove their own right. Often, patients who believe in their own messianism organize entire sects, collecting rather impressive “contributions” from the flock.
- False testimony in court: the patient is convinced that he is telling the truth, while he can easily confirm his innocence on a lie detector.
- Vagrancy: under the influence of delusions, the patient can begin to lead a marginal lifestyle.
- Development of induced (induced) delirium in family members of the patient. Close people can join the patient’s delusions, especially if they are quite impressionable, inspired by people.
In addition, under the influence of delusions, the patient can commit a serious crime, for example, kill a person by deciding that he attempted to encroach on his life or the lives of his loved ones. Often murders are committed by patients suffering from delusions of jealousy, firmly believing in the infidelity of a partner. Moreover, aggression can be directed both at the “betrayed” partner, and at the one with whom the betrayal allegedly occurred. In addition, under the influence of delirium, a person can commit suicide: often this occurs when delusions of self-incrimination. Therefore, if a patient has a delusional overvalued idea, treatment should be immediate: otherwise, a person can harm himself and others. As a rule, therapy is carried out in specialized medical institutions, where the patient remains around the clock under the supervision of specialists.
Overvalued and crazy ideas have much in common. They occupy a dominant place in the patient’s mind, make him act in a certain way, affect adaptation in society. However, delirium is considered a more serious disorder: if, in the presence of an overvalued idea, a person can be convinced that he is mistaken, then delusional beliefs disappear only after drug therapy. At the same time, delirium always arises as one of the symptoms of a serious mental disorder, while overvalued ideas can also appear in healthy people. And dei, having the character of super-value, can develop and acquire the features of delirium over time, so their appearance requires immediate appeal to specialists in the field of psychiatry and psychotherapy.