Paranoia
WHAT IS PARANOIA?
Mental health professionals consider behavior to be paranoid when it is based on suspiciousness or an irrational belief that one is being persecuted. There are four varieties of paranoid behavior: paranoid ideation, paranoid personality disorder, delusional disorder, and paranoid schizophrenia.
Symptoms of these disorders range from mild tendencies to those of serious mental illnesses.
Paranoid Ideation
People with this disorder have suspicious thoughts or ideas based on the view that others are "out to get them." Symptoms include thinking that one is being watched, followed, or talked about. Such thoughts are irrational and unfounded. A person with paranoid ideation tends to hold these views very intensely, often becoming preoccupied with them.
Paranoid Personality Disorder
The behavior of a person with paranoid personality disorder (PPD) is more extreme, at times even becoming delusional (i.e., having false beliefs). A person with PPD engages in most of the following behaviors:
- Sees everyday events as presenting a threat or a put-down
- Sees the actions of others as threats and reacts defensively
- Avoids confiding in others for fear of reprisals
- Is suspicious of others
- Thinks that one’s spouse or partner is unfaithful
- Bears grudges against others
- Doubts the loyalty of others
- Sees others as either allies or enemies
As a result of these behavior patterns, people with PPD have difficulty getting along with others and maintaining relationships. They tend to be loners and even develop odd ways of thinking and speaking. They seem self-centered, guarded, and rigid and may be devious and malicious toward others. People with PPD are frequently litigious; they may be involved in frivolous lawsuits. This disorder is more common in men than in women.
Delusional Disorder (Persecutory Type)
People with this disorder have delusions that they (or someone else) are being treated maliciously. They may think that they are being poisoned, followed, or deceived by someone. The behavior of a person with this disorder is not as odd or bizarre as that of a person with paranoid schizophrenia.
Paranoid Schizophrenia
This is a severe mental illness. People with paranoid schizophrenia have delusions that they are being persecuted and plotted against. These delusions, often bizarre and grandiose, may involve auditory hallucinations (i.e., hearing voices).
WHAT CAUSES PARANOID IDEATION?
The causes of paranoia are uncertain and varied, as is true for many mental disorders. Growing up in a home where one was the object of rage, humiliation, or threats may cause a person to feel helpless and develop a sense of paranoia as a result. Other possible causes are brain abnormalities, (e.g., altered brain chemistry), drug abuse, and extreme stress.
WHAT IS THE TREATMENT FOR PARANOID BEHAVIOR?
Treatment for paranoia varies depending on the severity of the paranoid behavior. Many paranoid people do not view themselves as having a problem and do not seek treatment. They are very resistant to treatment if they are ordered into it by the legal system. They often find it difficult or impossible to trust the therapist and are usually resistant to medication and self-help groups. For these reasons, they usually stop treatment early.
A person diagnosed with PPD or delusional disorder should be treated by a psychologist or psychiatrist. A person diagnosed with paranoid schizophrenia should be treated with antipsychotic medication under a psychiatrist’s care.
WHERE CAN I GO FOR MORE INFORMATION?
Diagnostic and Statistical Manual of Mental Disorders (4th ed.). Washington, DC: American Psychiatric Association, 1994.
Hampton, William, Smith, James, and Burnham, Virginia. The Two-Edged Sword: A Study of the Paranoid Personality in Action. Santa Fe, NM: Sunstone Press, 1990.