In milder forms, you may have some insight into what’s going on and realises your suspicions might be groundless. In extreme forms, you can’t distinguish reality from fantasy. It can be a very isolating condition, because you feel you can’t depend on anybody. You may feel angry, fearful, guilt-ridden, suspicious, vengeful and excluded and may become very distressed, as a result.
The feeling of being threatened or betrayed can take many forms.
- Paranoid schizophrenia: Extreme paranoia is one of the symptoms of paranoid schizophrenia. This may also involve you hearing voices, which may comment on your behaviour, echo your thoughts or issue orders.
- Paranoid personality disorder: This problem may have been around you for some time, perhaps since adolescence. Commonly you will have little or no insight into their condition and will never have asked for treatment.
- Delusional or paranoid disorder: Sometimes, you can function quite well in day-to-day life yet develop one particular dominating, paranoid idea, of great complexity, that puts you at odds with those around you. This is sometime called a delusional or paranoid disorder. It doesn’t involve hearing voices.
Other diagnoses that may include paranoid feelings are manic depression (bipolar disorder), schizoaffective disorder, severe anxiety or depression and postnatal psychosis.
Paranoia is a complex blend of thoughts and feelings so it’s unlikely to have one simple cause. Very often, you have little insight into your state of mind, and don’t accept that there is a anything wrong with you. Unless you suspect your beliefs may be wrong, at least in part, you will not accept that you need treatment. The first point of contact is usually a GP, who may refer you to a psychiatrist or clinical psychologist.
- Medication: The main drugs for treating paranoia have a tranquillising affect
- Talking therapies: Cognitive behaviour therapy (CBT) involves carefully examining your thinking patterns and the evidence you have for your beliefs. It goes on to help you find alternative interpretations to the ones that are distressing you.
- Community Services: You may benefit by getting away from your current situation, either temporarily or permanently. This could involve visiting day centres or moving into a bigger group home or some kind of sheltered housing.
- Hospital: It may be necessary to admit someone to hospital if he or she is very disturbed and a threat to themselves or others.
What can family and friends do?
Living with a paranoid person is exceedingly distressing, made worse by the person’s own lack of insight into their condition, and occasional aggressive outbreaks. Families, friends and carers should not suffer in silence. They should ask friends and relatives to help out, and try to get some time away, and certainly seek a medical opinion. If the delusions have a religious content, it may be worth contacting an appropriate person at the local place of worship.
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