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1. “I am so ugly that strangers walk on the other side of the street when they see me coming. People whisper about how ugly I am when I ride the bus.” Depending on the severity, and how much this affects the sufferer, this can be considered a delusion, yes. The reason it's a delusion is because there is no evidence of people saying these things. If this person is actually believing wholeheartedly that people are talking about him, then yes he would be delusional. Delusional people don't realize they are sick. “I feel really ugly.” Is common. But then your pal says, “you’re just a normal looking guy” or you really take a look at the other people in line at the DMV, and you think, “oh, I guess I’m just another person.” Again, that's low self esteem. You can objectively say whether or not someone said something about you. You can't read peoples minds. That arises from faulty beliefs around how other people view them, not how they view the world. Also, beauty is in the eye of the beholder. Just read the comment section here, people are telling this guy over and over that there is someone out there for him, and different strokes for different folks. You can't objectively measure something as subjective as beauty, you can only base beauty standard off of a subgroup of people, the majority of people within x group agrees that these features are attractive. One person However, can objectively determine whether or not someone is speaking about them when their senses are functioning correctly. If no one else on the bus heard it, then that would imply that they are sick. Low self esteem arises from our beliefs about how other people view us, delusions arise from our senses and memories tricking us. You can treat delusions with an antipsychotic, which alters dopaminergic signaling ( which plays a major role in motivation, learning, and perception). It would imply that that there is a biological process responsible for the formation of delusions. You can't treat low self esteem with an antipsychotic, because the brain is functioning abnormally in these instances. When you say someone is delusional, you are implying that they need medical treatment. Just like me, and everyone else, you're not a doctor. You're not qualified to diagnose someone as delusional.

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2. If you're not exclusive, condoms are necessary for safe sex. Even if you were exclusively it's perfectly fine and recommended to use some kind of contraception other the pulling out.

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