September 17, 2013

Paranoia-Greatly Misunderstood and Surprisingly Common

“Oh, he’s so paranoid” is an expression we hear tossed about casually.  It is mistakenly used to describe fearfulness as in, “she’s paranoid about driving by herself”. Paranoia is also incorrectly used to describe worry that is excessive such as “he’s paranoid he’ll lose his job.” What paranoia truly represents is a negative distortion in how the world is perceived, most commonly the intentions and behaviors of others.

The Navy Shipyard shooter demonstrated classic paranoid psychotic behavior, documented by the police when the shooter, Aaron Alexis, called the Newport, Rhode Island police on August 7th, just a little over a month before this very disturbed person shot and killed at least 12 people. The following is quoted in the police report from that date, He said the person he had argued with “had sent three people to follow him and to keep him awake by talking to him and sending vibrations to his body” via a microwave machine”. He also reported ” voices speaking to him through the wall, flooring and ceiling,” Inpatient psychiatric  workers are very familiar with this type of paranoid delusion. People suffering from severe mental illness such as schizophrenia or severe forms of Bipolar Disorder often have this type of thinking. Some imagine transmitters implanted in their body which broadcast their thoughts to imagined others who wish to do them harm.  Some forms of severe depression can also lead to paranoid delusions.

Not  all people who suffer from severe paranoia commit violent acts against others. Suicide is much more common than violence but paranoid thinking at some level has frequently been documented in those who do commit mass murder. It answers the “why” of these horrible tragedies. People suffering from extreme paranoia feel enormously threatened and fearful.  When these thoughts lead to violence, the paranoid person  believes they are making themselves or their loved ones safer.  Minds do run off the rails. They do not always function rationally and extreme and bizarre thinking has been a reported type of mental illness throughout history.

The Paranoid People We Love

Paranoia is not always so extreme or dramatic. A little paranoia can go a long way and there are many people living productive and successful lives who suffer from mild paranoia. You may know one well. These are the people who suspect the worst of others. They are quick to make a negative interpretation of the motives of other people. “She is only your friend because you’re so attractive. She thinks men will pay attention to her if she hangs out with you, she’s just using you.” “She’s only being friendly to you because she thinks you can help her get that assignment you want at work.”  The person with mild paranoia is always suspicious of the motives of others. They find it hard to believe that other people can be genuinely helpful or kind; they believe others only do things because they expect something in return.  Mild paranoia can also be expressed as bigotry against other groups. People who are quick to make negative generalizations about large classes of people due to their religion or ethnicity or race may be prone to mild paranoia. They will dispute counter-examples and remain rigid in their thinking even when exposed to information that would make most of us reconsider our preconceptions.

Another type of mild paranoid thinking can be seen in those spouses, parents and partners who are overly protective and have a very exaggerated sense of the possibility of harm in common situations. These types of people will strive to restrict their loved ones freedom unnecessarily. Their anxiety is so high about the risk of harm it becomes impossible to reason with them and relationships are filled with conflict over everyday desires and activities. The behavior is described as protective can be the work of paranoid thinking.


How To Help

Paranoia is one of the most frustrating of mental health problems because it can be very easy to treat. Medications have been around for decades that are highly effective and can be successful in eliminating or greatly diminishing even the most bizarre paranoid thinking. The great problem is that because paranoia causes someone to mistrust doctors, family members and medicine, people with this condition are among the most reluctant to seek help. In the case of Navy Shipyard shooter, his paranoia was extreme and obvious on August 7th when he was interviewed by police. Yet he must not have made any overt threats and  because he did not present an immediate danger to himself or others, there were no grounds to require him to seek involuntary psychiatric treatment.

For someone with mild symptoms, where anxiety disorders or depression or often part of the problem, the best approach is to focus on the person’s own unhappiness and complaints and urge them to seek help for those. When anxiety and depression come under control the paranoid thinking often dissipates with it. Instead of arguing about their unreasonable suspicion or distrust of others, express concern about their level of distress, worry or unhappiness. Directly confronting even mildly paranoid thinking is usually futile-it will usually be perceived as threatening by someone who perceives  much of human behavior as threatening.

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