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Is paranoia a symptom of anxiety


Paranoia: Symptoms, Causes, and Treatments

Written by Paul Frysh

Medically Reviewed by Jennifer Casarella, MD on September 09, 2021

In this Article

  • What Is Paranoia?
  • Anxiety vs. Paranoid Thoughts
  • Symptoms of Paranoia
  • Causes of Paranoia
  • Paranoia Treatments

What Is Paranoia?

Paranoia is the feeling that you’re being threatened in some way, such as people watching you or acting against you, even though there’s no proof that it’s true. It happens to a lot of people at some point. Even when you know that your concerns aren’t based in reality, they can be troubling if they happen too often.

Clinical paranoia is more severe. It’s a rare mental health condition in which you believe that others are unfair, lying, or actively trying to harm you when there’s no proof. You don’t think you’re paranoid at all because you feel sure it’s true. As the old saying goes, “It isn’t paranoia if they’re really out to get you. ”

Anxiety vs. Paranoid Thoughts

A paranoid thought is a type of anxious thought. Anxiety can cause paranoia, affecting what you’re paranoid about and how long the feeling lasts. But paranoid thoughts can also make you anxious.

It’s normal to be anxious sometimes, especially if you’re going through something hard like losing a job or the end of a relationship. When in large groups of people, you may worry that others will judge the things you say or the way you dress or behave. You might walk into a party by yourself and think, “Everyone is wondering why I’m alone.”

Some call this paranoid, but we all have thoughts like this from time to time. Just because you’re worried that people might be talking about you doesn’t mean you have a mental illness. Clinical paranoia happens when you’re 100% convinced of it, even when facts prove that it isn’t true.

If you worry that your thoughts are paranoid, you probably have some anxiety rather than paranoia. If your anxiety isn’t linked to anything obvious and it never seems to get better or go away, you may need to talk to a doctor about it. Feelings of anxiety and panic that last a long time or get in the way of your daily life might be signs of an anxiety disorder. Symptoms of paranoia may be more severe. 

Symptoms of Paranoia

The symptoms of paranoia can include:

  • Being defensive, hostile, and aggressive
  • Being easily offended
  • Believing you are always right and having trouble relaxing or letting your guard down
  • Not being able to compromise, forgive, or accept criticism
  • Not being able to trust or confide in other people
  • Reading hidden meanings into people’s normal behaviors

Causes of Paranoia

Too Little Sleep

A single restless night probably won’t cause paranoid thoughts. But if you often go without sleep, it can start to take a toll. You might not think as clearly, and you’re more likely to clash with others or have misunderstandings with them. It may start to look like people are working against you when they’re just acting like they always do. If you go without sleep for long enough, you could even start to see and hear things that aren’t there (your doctor will call them hallucinations).

Adults should shoot for 7 to 9 hours of sleep a night to stay alert and mentally healthy.

Stress

When the tension ratchets up in your life, you could start to feel more suspicious of other people. And the stress doesn’t have to be something negative like illness or job loss. Even a happy occasion, like a wedding, can create a kind of stress that brings out paranoid thoughts along with the joy.

To help ease the tension, you can:

  • Take time to relax and try to forget about what’s stressing you out
  • Spend time with friends
  • Find something to smile and laugh about
  • Get plenty of exercise
  • Meditate to clear your mind

Psychiatric Disorders

One condition, paranoid personality disorder, can make it hard to trust others. It can cause negative thoughts about people that just aren’t true, like “They don’t like me,” “They’re making fun of me,” or even “They’re plotting against me. ” In some cases, no amount of evidence will convince you otherwise. This can lead to true clinical paranoia. Though you might not believe every unrealistic thought that enters your head, you believe some of them.

Schizophrenia, another serious disorder, can make it hard to tell what’s real and what’s imagined. Most of the time, you simply don’t know when your thoughts have become paranoid. Friends, loved ones, or medical professionals often have to point it out and try to help you get treatment.

Borderline personality disorder, in which you have fast emotional swings where you can worship someone one moment and hate them the next, can also cause paranoid thoughts and even clinical paranoia in some people.

Just because you feel paranoid or worry about what others think about you from time to time doesn’t mean you have a psychiatric disorder. The fact that you know your thoughts don’t make sense could be a sign of good mental health. But if these paranoid feelings happen all the time or start to get in the way of your home or work life, you might want to talk to your doctor or a mental health care provider.

Drug Use

Drugs like marijuana, hallucinogens (LSD, psychotropic mushrooms), and stimulants (cocaine, methamphetamine) have chemicals that make some people paranoid for short periods. Once the chemicals leave your system, the paranoia goes away, too. Days or weeks of intense alcohol abuse also can cause short-term paranoia, and over the long term, it can lead to ongoing paranoia and even hallucinations.

If paranoid thoughts are making you anxious or if you have minor symptoms of depression, drugs can make them much worse. In some people, they can trigger a psychiatric disorder with true clinical paranoia as a symptom.

Alcohol can also worsen paranoia. Plus, it makes us less inhibited, which makes it harder to control these feelings.

Memory Loss

Alzheimer’s disease and other forms of dementia, which are more likely as you age, can change your brain in ways that make you more suspicious of others. You might notice that a loved one with dementia starts to hide things like jewelry or money, or becomes convinced that people have bad intentions toward them. This is part of the disease. Their doctor might be able to help you manage these symptoms.

Paranoia Treatments

If you feel that you’re losing touch with reality, a doctor or mental health professional is the best place to start. Because you can still tell that your thoughts aren’t reasonable, there are things you can do to help.

To start with, it’s important to eat a healthy balanced diet, exercise, and get plenty of sleep. All these things are part of a mental balance that can help keep paranoid thoughts at bay.

After that, it can actually help to talk to yourself about paranoid thoughts. This works only while you can still tell that your thoughts are not reasonable. Keep it realistic. Instead of thinking to yourself “I’m crazy” or “I’m paranoid,” try something like: “I’m worried about something that’s highly unlikely to be true.”

Even if you don’t have a mental illness, if your paranoid or irrational thoughts get in the way of doing things you want to do, talk to a social worker, psychologist, or psychiatrist. Talk therapy or some kind of medication could help you feel better.

Often, people who feel paranoid don’t get treatment because they don’t realize their thoughts are unrealistic. If you’re worried about a friend or family member, talk to a health professional or use a resource such as the National Alliance on Mental Illness (www.nami.org, 800-950-NAMI) or the Substance Abuse and Mental Health Services Administration (www.samhsa.gov/find-treatment, 800-662-HELP).

Paranoia vs. Anxiety: Understanding the Differences

While paranoia and anxiety may share some overlapping symptoms and can even co-occur at times, they are not the same. There are important clinical differences between the two disorders.

Knowing the differences and getting an appropriate diagnosis will help you find effective treatment options.

Read on to find out more about paranoia and anxiety.

Paranoia is a thought process that causes an irrational mistrust of other people due to beliefs of persecution. This can sometimes occur in dementia, as well as in people who misuse certain drugs. Symptoms of paranoia can include:

  • mistrust of others
  • feeling disbelieved or misunderstood
  • feeling persecuted or victimized when no threat is present
  • isolation
  • constant stress related to beliefs about others

Anxiety is a natural response to stress. It’s typically a feeling of nervousness.

If feelings of anxiety are extreme, disproportionate, or long lasting, it might be an anxiety disorder instead of typical anxiety. Regular anxiety does not interfere with your daily life, but anxiety disorders do.

Over 40 million adults in the United States live with an anxiety disorder. Anxiety disorders include:

  • generalized anxiety disorder (GAD)
  • panic disorder
  • social anxiety disorder
  • specific phobias
  • obsessive-compulsive disorder (OCD)
  • post-traumatic stress disorder (PTSD)

Symptoms can include:

  • increased heart rate
  • fast breathing
  • trouble concentrating
  • restlessness
  • insomnia

A main difference between paranoia and anxiety is that with paranoia, there are delusional beliefs about persecution, threat, or conspiracy.

In anxiety, these thought processes are not generally present. Paranoia is characterized by distrust in others and their motives. This is generally not found in anxiety.

Paranoia and anxiety can arise from each other. Paranoia can cause significant fear and anxiety based on a person’s belief in the delusions, and anxiety may lead to paranoia. However, this is not always the case.

Both can cause similar bodily feelings like racing heart or feeling nervous, but the thought processes for each condition are different.

Each condition may have similar treatment options, like therapy, medication, or both. However, the focus of this treatment is different for each condition, and the medications are not necessarily the same.

Accurate diagnosis is important for any mental health condition, especially when it comes to conditions that share some similarities, like paranoia and anxiety.

Diagnosis is a layered process in order to rule out any other conditions.

Paranoia

Before making any kind of diagnosis, your doctor will do a complete physical exam to rule out any underlying medical conditions that could be causing paranoia, like dementia.

They will also document your personal history to collect information about your health, behaviors, and lifestyle. This information may be an important factor in paranoia. For example, drug use may cause paranoia.

Your doctor may also order blood tests to check for any medical conditions that could be causing your symptoms.

They may also do some interviews or assessments in order to understand your thought processes and use the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) criteria to make a diagnosis of a paranoid-type disorder.

Anxiety

A physical exam is typically done in order to rule out illnesses that may be causing your anxiety. The doctor will also take a personal history to get more information about your:

  • symptoms
  • functioning
  • health behaviors
  • lifestyle

They may order a variety of tests to also rule out other medical conditions with symptoms that mimic anxiety symptoms.

The DSM-5 has certain criteria for anxiety disorders, and you may be given some questionnaires or tests that will then be reviewed. These can include:

  • the Generalized Anxiety Disorder-7 (GAD-7) screening tool
  • the Beck Anxiety Inventory (BAI)
  • Hamilton Anxiety Scale (HAM-A)
  • Yale-Brown Obsessive Compulsive Scale (YBOCS)

Your healthcare professional will also use the DSM-5 to evaluate your symptoms to make an informed diagnosis.

Finding care for paranoia or anxiety

Paranoia and anxiety can both be treated and managed. Appropriate treatment can help you manage symptoms and minimize their impact on your life and functioning.

If someone is in acute danger of hurting themselves or someone else, call 911 or your local emergency services. Here are some resources for finding help and care:

  • Substance Abuse and Mental Health Services Administration’s (SAMHSA’s) National Helpline
  • How to Find Mental Health Services Near You
  • Anxiety & Depression Association of America

There are various treatments available for both paranoia and anxiety. Treatment often depends on the cause of the disorder and the severity of it. Treatment plans can vary among people.

Paranoia

Psychotherapy (talk therapy) and medication are two common treatments for paranoia. Psychotherapy helps people with paranoia:

  • develop coping skills
  • build trust in others
  • gain the tools they need to manage their emotions

Atypical antipsychotic medications or anti-anxiety medication may help relieve symptoms. This is especially true for those with paranoid schizophrenia.

If the paranoia is related to drug use, supportive treatment is given until the effects of the drug wear off. Then, a drug treatment program is typically recommended.

Anxiety

While normal anxiety passes on its own, anxiety disorders do not. Treatment can help manage anxiety disorders.

Anxiety disorders are typically treated with psychotherapy, medication, or both. Psychotherapy is tailored to the person’s specific needs and triggers, so a variety of types of psychotherapy can be used. Cognitive behavioral therapy (CBT) is often used because it helps a person identify and challenge the distorted thoughts that cause anxiety.

Medication is not a cure for anxiety disorders, but it can help manage symptoms. Some common medications prescribed to treat anxiety are:

  • anti-anxiety drugs
  • antidepressants
  • beta-blockers

The good news is that, like many mental health conditions, paranoia and anxiety can be treated and managed, helping you lead a full life. While they cannot be cured, they can be managed.

Paranoia and anxiety can both be found in anxiety disorders, and although they share some similarities, they are very different conditions. Getting an accurate diagnosis and appropriate treatment is important in order to address the unique thought processes and symptoms in each.

What is paranoia?

Paranoia is a severe psychiatric illness characterized by the development of logically constructed delusional ideas. This is one of the first diseases that began to be dealt with in modern psychiatry, along with the treatment of schizophrenia and neuroses. With paranoia, the patient does not progress negative symptoms, to some extent the integrity of the personality is preserved and there is no disturbance in perception - hallucinations.

The term "paranoia" was coined by the German psychiatrist Carl Ludwig Kahlbaum in 1863. Later, another psychiatrist, Emil Kraepelin, described paranoia as an independent disease. For a long time, paranoia was considered in classical psychiatry as an independent mental disorder, and in Soviet and Russian psychiatry it was customary to distinguish paranoid syndrome from paranoid delusions.


Symptoms of paranoia

The main signs of paranoia are delusional ideas and, as a result, negative emotions in relation to others (touchiness, hostility, pathological jealousy), as well as megalomania and the inability to perceive criticism and adequately evaluate oneself. The delusion of persecution, which all patients with paranoia suffer from, is an inadequate perception of reality, some fixed idea that constantly accompanies a person in his daily life and is not questioned. With paranoia, a person is convinced that someone is following him and wants to harm him. This disease differs from other diseases, such as paranoid schizophrenia, in that the person suffering from this disorder does not withdraw into himself and does not lose himself as a person. People suffering from paranoia are characterized by unhealthy suspicion, a tendency to see the intrigues of enemies in random events, to build complex conspiracy theories against themselves. However, in another they retain the logical thinking.

Paranoia can coexist with other illnesses such as anxiety and depression.

If such a person is sufficiently socialized, that is, other people continue to communicate with him, he can work at the same job for many years, he can have acquaintances and friends. As a rule, those who suffer from paranoia do not have close friends. However, a paranoid patient may well have a family that will stay with him until the moment when the paranoid delusions intensify and the patient becomes a danger to himself or others.


Causes of paranoia

As in the case of other mental illnesses, the causes of paranoia are a genetic predisposition and some external trigger that launched the development of the disease. At the moment, science does not know exactly which genes are responsible for the development of paranoia and what specific triggers turn on this disorder. Paranoia can coexist with other illnesses such as generalized anxiety disorder and depression. Sometimes depression is a consequence of paranoia, as it becomes difficult for a person to live with the current picture of the world, according to which he is constantly being persecuted and they want to harm him.

The paranoid patient accepts for himself a certain axiom that is not subject to proof.

In many cases, individual signs of paranoia can develop in old age with degenerative processes in the brain, for example, with atherosclerotic lesions of the cerebral vessels, Alzheimer's disease, Parkinson's disease, Huntington's disease and others. Also, the development of paranoia can cause the use of psychoactive substances - hallucinogens, amphetamines, alcohol and certain drugs.

Delusions of persecution


See also

Psychiatric notes on the margins of the film "The Apprentice" by Kirill Serebrennikov

As a rule, a crazy idea is well formed in the mind of a person. The paranoid patient accepts for himself a certain axiom that is not subject to proof. He convinces himself that someone from his environment, for example, a neighbor or brother, is opposed to him and everything that this person does is aimed at harming the patient with paranoia. Any action that will be performed by this person will be interpreted as an action against the patient. The object of delusional thoughts can be not only people from the inner circle of communication, but also those who are not connected with the family, for example, the police, the KGB, the CIA and others.

Paranoia is very well organized, like a pseudo-logical system. A person suffering from this disease is clearly focused on only one crazy idea, which is why such people often manage to maintain themselves as whole individuals for many years. For example, if a person believes that a neighbor is opposed to him, he will not communicate with this neighbor, but will continue to communicate with everyone else. At the same time, he will try to convince them that the neighbor is harming him.

Paranoid people usually do not make the decision to start treatment themselves.

When a person believes that he is constantly persecuted, he either runs away from this persecution, or defends himself by attacking the one he considers the offender. If a patient with paranoia is ready to live with a sense of persecution, and not to attack the one who, in his opinion, is persecuting him, then he is considered socialized in society, and his illness proceeds passively. At the moment when he begins to actively run away from society or attack those who are the object of his delirium, such a person must be hospitalized.


Paranoia diagnostics

For the diagnosis of this disease, the patient must undergo a clinical interview with a psychiatrist. During the appointment, the specialist reveals how long ago the symptoms of the disease began, what triggered the onset of the development of the disorder, and, most importantly, with what or with whom the delusion of persecution is specifically associated. After that, it is important to find out whether the person who is chosen as the object of delirium is not in danger, those around him or the patient himself. At the end of the clinical interview, the specialist needs to decide whether the patient needs hospitalization or in this situation he can be prescribed outpatient treatment.

See also

Why do we need a psychotherapist?

Paranoid people usually do not make the decision to start treatment themselves. They are sincere and deeply convinced that their perception corresponds to reality and their thoughts are not painful. Such a person, as a rule, will appear at a specialist’s appointment only under external pressure: family, superiors, or by a court decision. In the event that the patient is not dangerous and does not require inpatient treatment, the task of the specialists who carry out the diagnosis is to try to convince the patient to start drug treatment and psychotherapy.


Treatment of paranoia

The treatment of paranoia takes a long time - sometimes more than 10 years. The main task of psychotherapy is to convince the patient that some of his thoughts and certain beliefs are painful. The psychotherapist teaches a person to notice paranoid thoughts in time and not to get involved in them so that they do not lead to actions. This is a very long and hard job. Patients who do not require hospitalization and continue to function in society usually do not stay for long-term treatment, and attend psychotherapy for only a month or two. Paranoia is a chronic disease that lasts for many years, and, unfortunately, there is no cure for it. It takes root, its symptoms begin to appear more acutely, and eventually, when the patient enters the hospital or for psychotherapy, the disease is already in a neglected state.

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What is paranoia: symptoms and signs

Paranoia - what kind of disease it is, how it affects the life of a person and the people around him. What is the relevance of the problem? What are the main causes and signs of paranoia, what is its differential diagnosis based on? Whether its effective treatment of this disease is possible or probable? The answers to these questions are offered by the Chief Physician of the Health Harmony Medical Center, a practicing psychiatrist, psychiatrist-narcologist and psychotherapist Vladislav Sipovich.

What is paranoia and how relevant is its problem?

Paranoia in Greek literally means "next to the mind", which can be regarded as a deviation from normal thinking in the direction of exaggeration of one's own personality and the ideas produced by it, while maintaining the logic of judgments. A person actually retains the ability to reason, but all his thoughts are aimed solely at proving his significance and the recognition by society of his overvalued ideas. At the same time, self-criticism is practically absent, but a critical attitude towards people who do not share ideas about the exclusivity of the patient himself literally rolls over.

Paranoia is a rare type of chronic mental disorder that develops mainly in people who have reached adulthood. According to statistics, among patients undergoing treatment in psychiatric hospitals, the proportion of patients with paranoia is only 0.5-1%, and among all mental disorders 2-4%. Perhaps such low statistics is due to low detection, which in turn is associated both with the difficulty of differential diagnosis and with the patient's non-recognition of his disease state and the ability to integrate and function in society.

A paranoid person is a person who is convinced of the value of his ideas and the prejudice of others. Attempts to prove the irrationality and unreality of the thoughts put forward by the paranoid cause only anger, distrust, hostility and even aggressiveness not only towards outsiders, but also to close people themselves, as well as to specialists trying to help. Establishing contact with such a patient is extremely difficult and requires, at the initial stage, a partial recognition of the supervalue and uniqueness of even the most delusional ideas. Paranoia is a disease that has such features as:
• Gradual development without aggravation of the pathological dynamics of symptoms and without an increase in personality changes. In practice, this means the absence of apathy, a decrease in vitality, abulia (loss of will and motivation). The nervous and energy potential of the patient remains consistently high, aimed at achieving the goal, and internal dissatisfaction finds a way out in conflict with the outside world and the fight against imaginary injustice.
• Logical validity and consistency of false ideas, which is almost impossible to refute. All objections have seemingly logical antitheses.
• The topic of ideas is usually monodirectional, i.e. concerns a certain sphere of knowledge and activity of society. A classic example is graphomania, when a person, having once achieved the publication of his poems or story, begins to consider himself an outstanding and unsurpassed poet or writer. The constant refusals of publishers to publish his "masterpieces" are perceived as the intrigues of envious people, unprofessionalism and bias of editors, publishers, and so on. It is almost impossible to prove the inconsistency of the claims of the paranoid, tk. he takes criticism as a personal insult and reacts with extreme hostility. Switching to another topic is uncharacteristic, the patient stubbornly achieves his goal and attacks various publishing houses ad infinitum. All these torments last for years and decades, causing extreme anger and hostility to the whole world.
• Absence of hallucinations, i.e. distortions in the perception of reality. By the way, experts do not have a unanimous opinion on this matter, many sources recognize the existence of various types of illusions in paranoid people, but usually these symptoms are observed in combined mental disorders, for example, delusions similar to paranoia in schizophrenics. These phenomena have nothing to do with classical "pure" paranoia.
• Consistent and generally predictable behavior based on the formal connection of many real elements with the paranoid's false ideas.

A person with paranoia is characterized by extreme suspicion, blaming imaginary enemies for his failures, and a tendency to construct conspiracy theories against him in his imagination.
The urgency of the problem is that one paranoid person can complicate the lives of many people, including not only those closest to him, but also those to whom he addresses with his "projections". The circle of interests of the paranoid includes officials, specialized specialists, writers, directors, producers, public figures, judicial authorities, etc. The received refusals to satisfy requests and logical explanations do not stop the paranoid, but only increase his perseverance. Sometimes he turns into a manic persecutor and can even stoop to physical violence against those who refused him protection.

What is the differential diagnosis of paranoia based on?

If earlier in classical psychiatry paranoia was considered as an independent disease for a long time, then according to the modern international classification of diseases of the 10th revision (ICD-10), it is not distinguished into a separate heading, but is referred to as a subheading of delusional disorder.
Paranoia should be differentiated from similar paranoid (paranoid) personality changes. The latter often accompanies many mental disorders, in particular, schizophrenia, paraphrenia, social phobias, anxiety disorders, post-traumatic stress and borderline conditions, and alcoholic psychoses.

The difference between paranoia and paranoid personality disorders (hereinafter BPD):
• Paranoia is characterized by following one idea, for example, if a paranoid person is convinced that a neighbor is harming him, then he will not communicate with him, maintaining communication with another environment. A hostile and aggressive attitude towards certain people develops when they do not recognize the overvalued ideas of the patient and when they make critical statements about him. With paranoid disorder, distrust of everyone and everything comes to the fore, colleagues, the CIA, the FSB and the whole world can be objects of distorted ideas. At the same time, the presence of an initial overvalued idea is absolutely not necessary.
• Paranoia is always distinguished by a consistently built and logically connected system of ideas, which is based on the acceptance of some idea as an axiom that does not require proof. Otherwise, thinking retains its rationality and allows paranoids to exist and function normally in society. They usually do not make friends, but they may have family relationships. In BPD, delusions are unsystematized and inconsistent.
• In paranoia, there are no hallucinations or illusions. Paranoid disorder is characterized by a distorted perception of reality.
• Paranoid disorders are much more common than paranoia. For example, in the United States, about 2-4% of the population suffer from more or less pronounced mental disorders of the paranoid type. This is due to the fact that the very concept of BPD is broader and includes paranoia itself, endogenous (paranoid schizophrenia) and exogenous (provoked by stress, an unusual situation, etc.) paranoid psychoses.
• In BPD, there is a progressive change in personality, which can lead to a complete disorganization of thinking, which is not typical for classical paranoia with the preservation of structured, consistent and logical thought processes.
• Cause of paranoia unknown. There are only hypotheses about a genetic predisposition, but the gene responsible for its development has not been found. An external trigger that starts the psychopathological process can be any event that is extremely difficult to identify. A number of factors predispose to the development of a paranoid disorder. These include schizophrenia and delusional disorders in close relatives, problems of upbringing in a family with violence, totalitarianism and increased parental care, as well as restriction of communication due to physical defects or illness. In fact, paranoid disorder is formed as a hypertrophied self-preservation instinct, which leads to isolation, pathological suspicion and distrust of close and distant environment, constant readiness to defend oneself from hostile, harmful persons and events. In addition, hallucinogens, amphetamines, alcohol, and other chemicals can cause a temporary paranoia-like disorder.

Only an experienced specialist can differentiate paranoia from paranoid disorder. Moreover, there is no complete clarity on this issue in psychiatry. The importance of the problem is that the choice of an effective method of its treatment depends on the nature of a mental disorder.

What are the types of paranoia?

The classification of certain types of paranoia is based mainly on the prevailing fixed idea. Depending on this, the most common forms of paranoia are distinguished:
• Involutional paranoia that develops at a mature age of 45-60 years, in women often coinciding with menopause. It is characterized by systematized delusions of persecution, jealousy, less often grandeur. The onset is usually acute, the course is long, the treatment is stationary.
• Paranoia of greatness, or megalomaniac with ideas of reforming society, science and art, as well as inventions and "great" discoveries.
• The paranoia of jealousy is based on the dogma of adultery or adultery. Moreover, treason does not need fixation and proof, but is accepted as an axiom. No arguments of the second half are able to shake the confidence of the pathological jealous that he is right. Initially, the patient accuses the partner of coquetry, the desire to attract the attention of the opposite sex, cheeky behavior, shameless snuggling during the dance, and even a bashful reaction to compliments. This goes on for several years, after which suspicions develop into a firm belief in treason.
• A religious form that develops against a background of religious beliefs.
• Erotic paranoia, in which the main content of delusional ideas is erotic fantasies. It develops mainly in women between 40 and 50 years of age.
• Persecutory form - paranoia with systematized delusions of persecution.
• Senile paranoia of old age, often coinciding with senile dementia, Alzheimer's, Parkinson's and other degenerative diseases of the brain.
• Alcoholic paranoia, which is a chronic psychosis caused by alcoholic encephalopathy. Most often occurs in men and is manifested by delusions of jealousy and / or persecution.
There are other types of paranoia, such as those with complainer delusions or hypnotic charms, but these are much less common.

What are the main signs of paranoia and its clinical picture?

The main symptoms of paranoia include such mental manifestations as:
• The presence of overvalued ideas that become fixed ideas and haunt the patient throughout his life. At the same time, paranoids are as persistent as possible, they spend all their strength and finances on proving the importance of their invention, discovery or method of reforming society. The literature describes a case when a man from Vladivostok "discovered" a new way of fishing, taking into account the location of the stars. He arrived in Moscow, knocked on the thresholds of various authorities, which gradually began to ignore him, went down and even spent the night at railway stations. At the same time, the fate of the family abandoned in Vladivostok - parents, wife and children, did not bother him at all.
• Overestimation of the role of one's own personality, leading to delusions of grandeur or persecution. In the first case, the patient considers himself capable of doing good to all mankind, and in the second, that all the forces of the world are directed against him. For example, the neighbor's dog barks because the neighbors tease her to spite him, the March cats yell specifically to prevent him from sleeping, the children in the yard make noise in order to annoy him, etc.
• Pathological suspicion, in which a person sees in everything the machinations of enemies and ill-wishers. He connects even the most insignificant events into a conspiracy theory built by him against himself. All this is accompanied by suspiciousness, vindictiveness, vindictiveness, inadequate assessment of criticism and a complete lack of a critical attitude towards one's own actions. The patient does not perceive someone else's opinion, it is useless to prove the fallacy and inconsistency of his ideas. The paranoid is convinced that everyone around wants to harm him, take away his property, downplay his merits, exploit him and try to manipulate him in their own interests. As a result, a hostile attitude towards everyone around is formed, which, with an attack of acute paranoia, can turn into aggressive actions and make the patient dangerous even for the closest people.
• Extreme susceptibility to stressful situations. The state of affect lasts for a long time and at any memory of it “comes to life with renewed vigor. Even if the paranoid does not show his emotions, then only with an eye on future revenge, because. he does not forgive insults.
One's own failures, mistakes made are experienced very sharply because of wounded pride. Paranoids are extremely ambitious, distinguished by arrogance and a tendency to overestimate their abilities and achievements.

What are the main ways to treat paranoia and how should others behave during an attack of paranoia?

Paranoia is a psychiatric illness that is very difficult to treat. This is explained by the fact that because of his supernatural suspicion, the patient does not trust anyone or anything, extending his suspicions to the doctor and the drugs prescribed by him. He perceives psychotherapy as another attempt to manipulate his mind. In addition, the paranoid categorically denies the morbidity of his condition, and relatives who prove the need for treatment are transferred by the paranoid into the category of "enemies".

The need for treatment becomes especially acute if a person ceases to be socialized, which is manifested by a willingness to isolate himself from the “persecuting” society or even attack an object that is harmful, in his opinion. Such a transition from the passive course of the disease to the active phase is an indication for inpatient treatment.

In the event of an attack of paranoia, it is necessary to call an ambulance, and unnoticed by the patient. Before the arrival of a specialized team, in no case argue with the patient, accept his position and even play along a little. Do not try to prove something or appeal to common sense. This is useless and even dangerous, since the delusions of the paranoid cannot be corrected. If the arrived specialists cannot stop the attack and relieve the psycho-emotional stress on the spot, the patient is hospitalized.
In the chronic course of paranoia, outpatient complex treatment is indicated, the main element of which is drug therapy with the use of anti-delusional antipsychotics. Their action is aimed at normalizing the exchange of neurotransmitters and blocking the excitation of the nerve centers responsible for the symptoms of paranoia. The appointment of other pharmacological drugs is symptomatic and is aimed at eliminating the symptoms of paranoia that prevail in a particular patient. For example, antidepressants are used to relieve depressive moods, tranquilizers - to eliminate fear and anxiety, sleeping pills - to normalize sleep.

An additional and important direction in the complex treatment of paranoia is psychotherapy. It is aimed primarily at restoring socialization and eliminating elements of irrational behavior in patients with paranoia.

At the first stage of treatment, the main thing is to establish contact and trusting relationships with the patient. This is extremely difficult to achieve, but possible. If the patient himself decided to be treated and correctly assesses his condition, this is already half the success in getting rid of paranoia. Unfortunately, this development is rare. Most of these patients remain outside the attention of psychiatrists and psychotherapists (what is the difference between a psychiatrist and a psychotherapist) for a long time, sometimes for decades. If, during an exacerbation, situations occur that are dangerous to the life of the patient himself (auto-aggression) and / or his environment, then only then treatment begins, usually in stationary conditions.

The choice of drugs, as well as psychotherapeutic methods of correction, depends on many factors - on the general physical condition of the body, mental characteristics, gender, age and the main symptoms.

In drug treatment, it should be borne in mind that abrupt discontinuation of drugs can lead to the so-called withdrawal syndrome, when, after stopping treatment, the symptoms of the disease return again and sometimes with more force than before treatment.

Only drug therapy, not supported by psychotherapy, is not able to fully return the patient to a normal life in society. It is possible to achieve stable and long-term remission only with the use of both methods of therapy - medication and psychotherapy. The most effective in the treatment of paranoia are Gestalt therapy, cognitive behavioral therapy (CBT) and psychodynamic psychotherapy. Unfortunately, paranoia is a disease that is treated for a long and difficult time, sometimes for 10 years. If the treatment is carried out on an outpatient basis, then it is important to take drugs according to the scheme developed by the doctor, the regularity of psychotherapy sessions, following the recommendations of the psychotherapist, using the acquired communication skills, and after achieving remission, periodic consultations with the specialist observing the patient.

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