Identifying Signs of Clinical Paranoia

Paranoia is a mental disorder described by the Diagnostic and Statistical Manual of Mental Disorders, or DSM IV, to be characterized by delusions, anxiety, irrational feelings of persecution, irrational thought process, and the generalized suspicion and mistrust of others. A patient suffering from paranoia can become aggressive and violent if convinced that a perceived threat is real, and a serious danger to their person. Many times paranoia manifests as an extreme irrational distrust in the motives of others, delusions of grandeur, anxiety, and a fear of a conspiracy directed at the client.

There are different types of paranoia. Conjugal paranoia is a type of morbid jealousy, in which the client has recurring, unfounded suspicions about a spouse or partner. Erotomania is the paranoid delusion that someone, usually of higher status, is infatuated or in love with the client. Hypocondriacal paranoia is the believe that the patient suffers from a plethora of imagined illnesses. This type of paranoid client may be so convinced of his illness that he may exhibit physical symptoms of the perceived disease. A paranoid personality disorder is marked by a generalized mistrust of others, and Paranoid Schizophrenia involves impaired perception, bizarre delusions, and auditory and visual hallucinations.

The exact cause of paranoia is unknown. Biochemical factors, such as medications, or drug and alcohol abuse have been suggested, childhood trauma, such as molestation or the death of a parent have been implied as the cause, and genetic causes have been studied in relation to paranoia, all to no avail. Studies continually come up short when trying to find an explanation for the occurrence of paranoia. It is known, however, that acute stress can cause episodes of paranoia, but once the stresses is removed, the symptoms dissipate.

According to hamiltoncenter.org, persons suffering from paranoia may appear to others as tense, obstinate, difficult, abrupt, argumentative, self-righteous, and/or perfectionists. An overall suspicion may indicate that an individual is paranoid. Other symptoms can include being easily offended, difficulty forgiving, a defensive attitude, nervous behavior, agoraphobia, preoccupation with hidden motives and a fear of deception.

It can be extremely difficult to diagnose paranoia because of irrational general mistrust. The patient believes that this behavior is justified and normal. The behavior exhibited by paranoid persons usually interferes with treatment and diagnosis. For this reason, it is important to have a compiled list of symptoms and observations from the friends and family members of the client.

The DSM_IV mandates that for an individual to be diagnosed with paranoia, he or she must exhibit four or more of the following traits:
1. Does the patient in question suspect that others are deceiving or harming them?
2. Is the patient mistrustful of family and associates?
3. Is the patient reluctant to confide in others out of the fear that the information will be used against them?
4. Does he/she read hidden threatening meanings behind innocent remarks?
5. Does the patient hold grudges.
6. Does the client react angrily to imagined or perceived attacks?
7. Does the patient have recurrent unjustified suspicions?

During the diagnostic process, other disorders have to be considered. Antisocial, avoidant, histrionic, narcissistic, schizoid, and schizotypal personality disorders have to be ruled out in order to confirm the paranoia diagnosis.

Treatment of paranoia is difficult because the patient has unfounded suspicions and mistrust directed at medication protocol, doctors, and psychotherapy. Many paranoid clients will resist, sabotage, or end treatment, before progress can be made.

Anti psychotic medications such as Clozapine, Haldal, Thorazine and Seroquel may be used first in the treatment of the paranoid client. If it is possible to gain the patients compliance with a medication regime, the paranoid symptoms may be lessened, thereby opening the door to other treatments proven useful in managing paranoia.

While group therapy is discouraged for obvious reasons, Psychotherapy may help to improve the quality of life for the client and those close to him/her. Long-term psychotherapy and life-long drug therapy are required to manage the paranoia.