“Are you paranoid?” is a question people oft times ask of someone, sometimes in jest, sometimes with a note of concern. Like most mental health frames of mind, paranoia can be understood across a spectrum of severity and type. This article will give you a glimpse of what paranoia is and some of its expressions.

A working definition from Mosby’s Medical Dictionary follows:

“A condition characterized by an elaborate, overly suspicious system of thinking. It often includes delusions of persecution and grandeur usually centered on one major theme such as a financial matter, a job situation, an unfaithful spouse, etc…”

People with paranoid disorder tend to have excessive trust in their own knowledge and abilities and usually avoid close relationships with others. They tend to be defensive and antagonistic. When they are at fault they cannot accept blame, not even mild criticism. They are convinced they are right. They do not trust others.

Paranoid individuals are usually delusional, holding firm beliefs that are untrue, not shared by others in the culture and not easily modifiable. People with grandiose delusions feel they have been endowed with special powers that could cure diseases, banish poverty or perform other extraordinary feats. They tend to be very obsessed with their beliefs.

The exact cause of paranoia is unknown. Potential causal factors may be genetics, neurological abnormalities, changes in brain chemistry and stress. Paranoia is also a possible side effect of drug use and alcohol abuse.

Some types of paranoia are:

Persecutory: person believes that those around him are his enemies bent on harming him.

Delusion of Grandeur: person believes himself to be a great individual with unique insights and gifts. This condition usually includes a persecutory dimension.

Religious: a delusion focusing in the religious realm. Example: person believes s/he is a messenger from God.

Reformatory: the person considers him/herself a reformer or curator.

Hypochondriac: person believes s/he is suffering from all kinds of ridiculous diseases.

There are other idiosyncratic types but these are the most common.

The paranoid person is difficult to treat. A chief reason is that the paranoid person rarely admits to this disorder and submits to treatment. Cognitive behavioral therapy is usually the psychotherapy of choice. Because the paranoid person finds it difficult to be wrong or change s/he presents a real challenge to the therapist. Occasionally a variety of medications may be tried depending on the symptoms presented as well as the acceptance by the person, who tends to be distrustful of any intervention or medicine.

Again, I would like to stress that paranoia, like any other abnormal mental condition, must be seen across a spectrum of severity, ranging from mild to serious. Such a diagnosis must be made only by a competent professional.

 

Dr. Stathas can be reached at 706-473-1780; e-mail: Stathas@plantationcable.net; web site: DrStathas.googlepages.com; blog: drstathas.com.