Paranoia is a disturbed thought process characterized by excessive anxiety or fear, often to the point of irrationality and delusion. Paranoid thinking typically includes persecutory beliefs concerning a perceived threat. In the original Greek, pa?????a (paranoia) simply means madness (para = outside; nous = mind) and, historically, this characterization was used to describe any delusional state.
Paranoia is distinct from phobia, which is more descriptive of an irrational and persistent fear, usually unfounded, of certain situations, objects, animals, activities, or social settings. By contrast, a person suffering paranoia or paranoid delusions tends more to blame or fear others for supposedly intentional actions that somehow affect the afflicted individual.

CAUSES OF PARANOIA

Genetic Contribution

Little research has been done on the role of heredity in causing paranoia. Scientists have found that the families of paranoid patients do not have higher than normal rates of either schizophrenia or depression. However, there is some evidence that paranoid symptoms in schizophrenia may be genetically influenced. Some studies have shown that when one twin of a pair of identical twins with schizophrenia has paranoid symptoms, the other twin usually does also. And, recent research has suggested that paranoid disorders are significantly more common in relatives of persons with schizophrenia than in the general population. Whether paranoid disorder–or a predisposition to it–is inherited is not yet known.

Biochemistry

The discovery that psychosis (a state in which the individual is out of touch with reality) is treatable with antipsychotic drugs has led scientists to look for the origins of severe mental disorders in abnormal brain chemistry. The search has become very complex, as more and more of the chemical substances that carry messages from one nerve cell to another–the neurotransmitters–have been discovered. So far, no clear-cut answers have been found. As with the genetic studies, biochemical studies have not examined paranoia except as a subtype of schizophrenia. There is, however, limited evidence that paranoid schizophrenia is biochemically distinct from nonparanoid forms of the disorder.
Abuse of drugs such as amphetamines, cocaine, marijuana, PCP, LSD, or other stimulants or “psychedelic” compounds may lead to symptoms of paranoid thinking or behavior. Patients with major mental disorders like paranoid schizophrenia may have their symptoms become worse under the influence of these drugs. Scientists are studying the biochemical actions of such drugs to determine how they produce their behavioral effects. This may help us to learn more about the neurochemistry of paranoid disorders, which is poorly understood at this time.

Stress

Some scientists believe paranoia may be a reaction to high levels of life stress. Lending support to this opinion is the evidence that paranoia is more prevalent among immigrants, prisoners of war, and others undergoing severe stress. Sometimes, when thrust into a new and highly stressful situation, people suffer an acute form–called “acute paranoia”–in which delusions develop over a short period of time and last only a few months.
Some studies indicate that paranoia has become more prevalent in the twentieth century. The connection between stress and paranoia does not, of course, rule out other contributing factors. A genetic defect, a brain abnormality, an information-processing disability–or all three–could predispose a person to paranoia; stress may merely act as a trigger.

Who is most vulnerable to these causes?

This is difficult to say, because paranoia can be an element in over eighty different medical conditions. A third of old people in geriatric wards may be affected. People who are getting on in years, or feeling depressed, can easily start feeling they are a burden to friends and relatives. Being partially deaf can also make them think that others are whispering, and hiding something from them.
The problem is more common for elderly women than men, while among the young, men are slightly more often affected. Younger patients also tend to have more spectacular delusions (for example, that “MI5 is controlling my mind”). Some studies of patients diagnosed with mental health problems have found paranoid ideas in as many as ten per cent of people interviewed.
Clearly, like depression and drug use, this problem is very much a part of modern life, particularly in towns and cities.

What treatments are available?

Very often, people have little insight into their state of mind, and don’t accept that there is anything wrong with them. They may have built up an immensely complex delusional system on the basis of a single incident – perhaps a telephone call, a remark they heard in a shop or an act of coldness from an old friend. But, generally, unless they suspect these beliefs may be wrong, at least in part, they will not accept that they need treatment.
The first point of contact with helping agents is usually a GP, who may refer the person to a psychiatrist or clinical psychologist. It’s also possible to contact practising clinical psychologists directly, and lists are available in major libraries and on the internet. However, a psychologist is likely to want a GP’s opinion to rule out any physical cause for the condition.

Medication

The main drugs for treating paranoia are called “typical” and “atypical” neuroleptics, also known as antipsychotics. The typical forms are well-established drugs, such as chlorpromazine and haloperidol. Both have a tranquillizing effect and tend to make people less aggressive, particularly haloperidol. But they do have some unpleasant side effects.
The newer atypical neuroleptics include clozapine, risperidone and olanzapine. These medicines generally have fewer long-term side effects. Doctors should prescribe atypical drugs for new cases, unless there are good reasons not to, such as a known sensitivity to an ingredient. All antipsychotic medication needs to be prescribed at the lowest effective dose, to minimize side effects.
Fear and persecutory delusions may lead people to refuse or sabotage their drug treatment, for example, by holding the drug in their mouth until they are alone, and spitting it out.

Talking treatments

Cognitive behavior therapy (CBT) is a very effective psychological therapy. It involves carefully examining a person’s thinking patterns and the evidence they have for their beliefs. It goes on to help them find alternative interpretations to the ones that are distressing them. It teaches them to monitor and control their thoughts, and is therefore a really useful means of self-help. CBT also helps people who hear voices to control them, change what they say, and cope better
Many others forms of psychotherapy are available, including psychoanalytical psychotherapy, transactional analysis and gestalt therapy. Although they have different underlying ideas, they generally involve talking over personal experiences, in detail, and exploring feelings.
Psychotherapy for paranoia is not commonly available on the NHS. There have been some positive reports from people who have been helped by it. However, if the client is highly suspicious of the therapist’s motives, it can be difficult to establish a good enough rapport between them, and therapy is likely to come to an early end.

Community services

People often benefit by getting away from their current circumstances, whatever they are, either temporarily or permanently. This can involve visiting day centers or day hospitals on a regular basis. Or it could mean a bigger move into a group home or some kind of sheltered housing, such as a psychiatric aftercare hostel.
Daycare provides an opportunity to mix with different people, some with similar problems, and the chance to join in shared activities. Inpatient facilities should, ideally, enable people to live in a supportive environment and develop the skills to live independently, eventually.

Hospital

It may be necessary to admit someone to hospital if he or she is very disturbed and a threat to themselves or others. Because they may have little insight into how unreasonable their beliefs are, they may be admitted involuntarily, under the Mental Health Act 1983.
The usual treatment in hospital is medication, but under the Care Programme Approach (CPA), people are entitled to an assessment and care plan, for support and treatment, once they leave hospital

Medications or substances causing Paranoia:

The following drugs, medications, substances or toxins are some of the possible causes of Paranoia as a symptom. This list is incomplete and various other drugs or substances may cause your symptoms. Always advise your doctor of any medications or treatments you are using, including prescription, over-the-counter, supplements, herbal or alternative treatments.

• Cannabis
• Marijuana
• Benzphetamine Hydrochloride
• Didrex
• Amphetamine Sulfate

Sources: Web4 Health, Wrong Diagnosis

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