What is erotomania? Symptoms and treatment

Erotomania is a delusional belief that a person is in love with the affected individual, despite contrary evidence.

A person with erotomania has a delusional belief that another person is in love with him or her despite clear evidence against it.

The object of the person's delusions is often a celebrity or a person of a higher social status. An individual may believe that this person is communicating with them and affirming their love, using secret messages.

In this article, learn about this rare disorder and its associated conditions.

What is erotomania?

Erotomania is an uncommon form of paranoid delusion. The affected person strongly believes that another individual is in love with him or her.

This delusion develops and persists despite clear evidence to the contrary. The condition is rare, and erotomania affects women more often than men.

Erotomania can start suddenly, and the symptoms are often long lasting. The object of the affection is typically an older, inaccessible person with a higher social status who may have had little or no previous contact with the deluded person.

Erotomania is sometimes called De Clerambault's syndrome, after the French psychiatrist who first described it as a distinct disorder in 1921. Erotomania is often related to other psychiatric disorders, but may also occur on its own.

Causes

Recent reports have suggested that social media may potentially cause or exacerbate erotomania.

Erotomania may be a symptom of a psychiatric illness, including schizophrenia, schizo-affective disorder, major depressive disorder with psychotic features, bipolar disorder, or Alzheimer's disease.

Erotomania is a type of delusional disorder. Other types include delusions of persecution, grandiosity, or jealousy.

Case reports have suggested that social media networks could exacerbate or even trigger delusional beliefs linked to erotomania.

Social media eliminates some of the barriers between unacquainted people and can easily be used to observe, contact, stalk, and otherwise harass people who would previously have been completely inaccessible. Social media platforms can reduce privacy, which can make stalking behavior much easier.

Some studies have suggested that delusions may develop as a way of managing extreme stress or trauma. Genetics may also contribute to the development of delusional disorders.

Symptoms

The key symptom of erotomania is a resolute and delusional belief by someone that another person is in love with them.

Behavior linked to erotomania includes persistent efforts to make contact through stalking, written communication, and other harassing behaviors.

This can be accompanied by a belief that the object of the affection is sending secret, personal, and affirming messages back. Paradoxically, this belief can be triggered by the targeted person making it known that the attention is unwelcome.

People with erotomania can pose a threat to their object of affection. This is often underestimated as a risk factor when assessing the condition.

Diagnosis

The diagnosis of erotomania can be challenging because it is such a rare condition. Some psychiatrists do not see cases of erotomania in clinical practice and may not even recognize the symptoms when they do encounter them.

The following conditions must be met before a stand-alone diagnosis of delusion can be made:

• Delusions must involve possible events, even if they are highly unlikely.
• The delusion must only apply to the relevant issue, with all other aspects of the affected person's life being functional and normal.
• If low moods or manic episodes are also present, then the duration of the delusional period must be longer than the mood or manic episode.
• Schizophrenia, mood disorders, and intoxication must all be excluded.

Treatment and management

Treatment for erotomania should be tailored personally for the individual to gain the best results. Medication and therapy are common treatments.

Treating delusional disorder can be hard because those affected are not likely, or even able, to see that their beliefs are unfounded.

Comparatively few affected people will seek treatment of their own accord, and they may find it difficult to engage successfully in therapy.

Treatment should be tailored to the needs of each affected person. Priorities should focus on maintaining social function, minimizing the risk of problematic behavior, and improving the affected person's quality of life.

It may also be helpful to provide social skills training and to provide practical help in dealing with any problems stemming from erotomania.

Successful symptom management will focus on treating the underlying disorder and may include medications, therapy, and hospitalization. Any or all of these approaches can be applied, depending on the person concerned and the underlying causes.

Therapy should help the affected person to comply with an agreed treatment plan and to educate them about their illness.

Hospitalization may be needed if the affected person becomes a danger to themselves, to the object of their affection, or to anyone else.

Antipsychotic medication may control symptoms effectively and can be prescribed for the underlying disorder. Medication and psychotherapy can be used together.

The role that social media plays in any problematic behavior should be considered when developing a treatment plan.

Outlook

Diagnosis and symptom control is essential for helping a person with erotomania overcome their condition.

It is rare for erotomania to reoccur and treatment is often successful, especially for people with bipolar disorder or without other underlying conditions.

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