How do you know if a memory is real or a delusion?
Question
A few years ago, I struggled with methamphetamine abuse for about eight months. Even before that, as a young teen, I had experienced delusions and paranoia. During my addiction, I became convinced that something terrible had happened to a loved one, something I could have prevented or was responsible for. This haunting thought consumed me, especially because I was not sure if it was a delusion or a real memory.
The memory came to me in fragments and shifted the more I tried to recall it. Eventually, I completely lost touch with reality, becoming withdrawn, paranoid, and deeply depressed. I was unable to function and was ultimately hospitalized in a psychiatric facility.
That experience still haunts me and keeps me awake at night. There is no one I can ask who would know whether this event actually happened or if it was just a false creation of my mind. It happened years ago, and since then I have not used any illegal drugs. I try to move past it, but I keep having flashbacks to that memory.
I also still experience occasional paranoia, false memories, and delusions. Sometimes I forget important things people have told me and am absolutely certain they never said them. Other times, I remember conversations or events that never actually happened, and it feels like I am lying, even though to me, these are real memories. So far, no one has been able to explain what is happening to me. Is it possible to believe a delusion so strongly that you actually create a false memory?
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Answer
It is impossible to make an accurate psychiatric diagnosis over the Internet but I can share several possibilities that occurred to me as I read your very interesting email.
- One of the possibilities is that you suffer from a severe anxiety disorder that, when it intensifies, explodes into a severe Obsessive Compulsive Disorder. The symptoms you describe as delusions have the quality of obsessive thoughts that take over your mind, paralyze you and cause you to feel paranoid.
- Another possibility and it can go hand in hand with what I described above, is that you experience a type of Bipolar Disorder. BD is a mood disorder and can result in delusional thoughts and all of the other symptoms you experience. OCD can also be part of this BD picture. People with BD also tend to self medicate with dangerous drugs, just like meth.
Yes, a delusion can be so very fixed that it seems to create or lead to a form of memory, even though the memory is false.
In my opinion and this is one man’s opinion, your memory of something terrible that happened is not a memory at all but truly is a delusion or false belief. In all likelihood, if such an event happened in your life you would remember it.
I do not know what treatment you received when you were hospitalized but you really need to consult a good psychiatrist for the correct diagnosis and medication. After that, you need a psychotherapist to talk with, whether its cognitive behavioral therapy or psychodynamic. This combination of diagnosis, medicine and psychotherapy can help you learn to understand and manage your symptoms.
Best of luck.