Monday, July 30, 2012

A Bit About Paranoia

It's been a while since I did a purely informational post, so I figured it was about time. Today, I chose a light, fun topic: paranoia!

Paranoia involves a heavy dose of fear, but with an added twist that sets it apart from anxiety. See, a person can be anxious about crowds or birds or heights or ... parallel parking (*raises hand*). But with paranoia, there's nearly always an element of they're-out-to-get-me (AKA persecutory beliefs).

My quick and dirty guide to personality disorders is here. The diagnostic criteria for paranoid personality disorder, as laid out in the DSM-IV-TR, describe a pattern of distrust and suspiciousness defined by symptoms like suspecting others are deceiving or harming him/her, doubting the trustworthiness of friends and family, reading hidden negative meaning into casual remarks or events, and bearing grudges in a persistent and unforgiving way (full diagnostic criteria are here). The critical feature that separates these symptoms and makes them impairing is that the suspicion is intense, but also unwarranted and unjustified. Symptoms can't be part of another disorder, such as paranoid schizophrenia (which would require the presence of delusions or auditory hallucinations) or other personality disorders.

There's not a ton of research on what treatments are effective for this disorder because, as you can imagine, folks with PPD don't often show up and ask for help. That would be pretty hard for them. In general, it's rough to deal with a person in the grip of paranoia. Making jokes, arguing with or challenging him/her, asking too many questions ... all likely to go down badly. Prognosis is ... not awesome, let's put it that way.

I was recently talking with a clinician who had worked with a paranoid individual, a person who believed that anyone he came into contact with was part of a big conspiracy to keep him from getting something he needed. The person quickly decided the clinician was part of it, colluding with the others to prevent him from reaching his goal. I started thinking how absolutely frightening it must be ... think about it--if you really believed all these people were trying to hurt you, how terrifying would that be? Where would you turn, if everyone you met was part of it? How lonely and isolating and awful.

I recently observed an incident online where an individual was exhibiting some features of paranoia, though that clearly wasn't the only thing going on. One thing was clear, though: arguing was completely useless, and in fact only convinced the individual that more people were out to get him/her.

Sounds like the stuff of a psychological horror novel, no? So ... have you ever known anyone who was paranoid?

15 comments:

  1. Anyway, for a more serious response to your post - I've been in contact with severely paranoid people once or twice, and the only thing I can think of that would be more terrifying than being around them, would be to be them.

    It makes me shiver just thinking about it.

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  2. Light and fun? You're funny. No, I don't know anyone who's paranoid, but they were hyper vigilant with good cause. Their life was threatened numerous times.

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  4. One thing about having a strong imagination is it's really easy to read those hidden negative meanings into casual remarks.

    Thankfully I read a bit about cognitive therapy, where you can challenge those thoughts instead of adding to them, so you don't end up your own worst enemy.

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  5. Wow. Um, there have been moments where I have to ask myself if I'm being paranoid or if my gut feeling on not trusting a person or situation is legit.

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  6. Oooh just read your news on stina's blog! Huge Congrats!!

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  7. Paranoia really has its brand of flavor, when you see it in a person or a patient. Wonderful post, as usual Sarah!

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  8. yup. i've known someone who was paranoid, but they seem to be doing much better now.

    my brother's favorite saying about paranoia:
    "just because you're paranoid, doesn't mean they aren't really trying to get you."

    because, as you do say it needs to be unjustified, but if it is the way you see and treat the world, others may eventually turn on you... you might create rationale for your paranoid behaviour... so then are you still paranoid or are you justified??? :P (sorry, a bit silly today... )

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  9. I like what Vic said. :D

    I've never met anyone with a real paranoid disorder. I think people like to believe others are paranoid because the label explains a LOT of things without us having to think too much about the causes. A truly paranoid person must be a scary encounter.

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  10. If I was sitting next to you when you were raising your hand about the parallel parking, I would have been pointing to you with a big, fat grin on my face.

    Since I deal with paranoia on a regular basis lately, I find changing the subject is an excellent way to go. And keeping conversations short. And talking about food or baseball.

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  11. Also, I saw your announcement on PW this morning! Sooo Cool!

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  12. It must be a very frightening condition and very difficult to treat, but then I suppose many of the most serious mental disorders are. It's terrible enough to have your body working against you in a physical ailment. To have your mind work against you ... even worse.

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  13. wonderful, informative post, as always, sarah!:)

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  14. Scary. Really scary. I actually do know a few people that I think suffer from geniune paranoia and I find it . . . fascinating. Isn't that horrible of me to say? Great post!

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