Paranoia in Schizophrenic Patients
Paranoid Schizophrenia: One Common Subtype in this Disorder
The onset of paranoid schizophrenia often begins anywhere from ages 15-35. Paranoia can be frightening and very real to the person who is experiencing it.
Diagnosing Paranoid Schizophrenia
According to the Counseling Resource, the DSM-IV-TR diagnoses schizophrenia having two or more of these present symptoms for more than one month:
- Hallucinations
- Delusions
- Disorganized speech
- Catatonic behavior
- Negative symptoms such as flattening
The DSM-IV-TR contains five sub-classifications of schizophrenia. These include disorganized schizophrenia, catatonic schizophrenia, undifferentiated schizophrenia, residual schizophrenia, and paranoid schizophrenia.
The DSM-IV-TR categorizes paranoid type schizophrenia as having "delusions and hallucinations" present but "thought disorder, disorganized behavior, and affective flattening are absent."
Common Symptoms of Paranoia
The paranoia specific to paranoid schizophrenia may manifest itself in the following:
- The individual may feel he is being singled out and persecuted.
- The individual may believe that harm will come to him, and that the persecutor is the one with violent intentions.
- The person may think that his every move is being followed.
- The person may believe that his food is being secretly poisoned.
- The individual may believe the FBI is monitoring him through the phone, radio, or other electrical devices.
- The individual may believe he has a disease or parasitic infection when he does not.
- The person may believe he has been chosen by God to bear the pain of humanity or to carry out a special mission. He may believe that God speaks to him and tells him to do things, even things that may cause harm to him or others.
- The person may hear voices in his mind that keep a commentary on his own thoughts or behaviors, or voices conversing with each other. These voices may laugh or whistle, or may threaten the person and give them commands. To the severely ill, these voices are real. If a person is treated, he may begin to recognize the voices as manifestations of the disease.
- The person may be anxious, fearful, depressed, hyperactive, anti-social or sexually dysfunctional.
- The person may act out in violence if he perceives a threat.
- The individual may also have "delusions of grandeur," believing that they are superhuman, are famous, or are a historical figure.
Tips for Family and Friends to Confront Paranoid Schizophrenia
Dealing with a paranoid schizophrenic can be frustrating. It may be difficult to know what to say. Here are some tips for any person who comes in contact with a paranoid schizophrenic who is actively suffering:
- It can be helpful to stand side by side rather than directly face a paranoid schizophrenic.
- Also avoid direct eye contact, as this increases their paranoia.
- Do not fight with them or contradict their radical views. Show understanding and compassion when they vocalize their mistrust of the world.
- Temporarily accept their reality as reality until they can get proper help to stabilize.
- Never say, "Don’t be so paranoid!"
- Realize that they have tunnel vision and can only see their point of view.
- Try to be positive and point out the person’s good qualities. Show that there is hope for a better future.
- Accept that the person may truly feel they are not sick and do not need help.
- Attempt to manage the illness with inpatient hospitalization; however, they can only be committed against their will if they are declared a danger to themselves or others.
- Do not worry about the social stigma of having a "mental illness." The pressing need for medical and mental help should surpass any concerns.
Treating Paranoid Schizophrenia
Paranoid schizophrenia can be treated with drugs such as Haldol, Risperdal, and Thorazine. Patients also require intense counseling to help them understand the nature of the disease and to learn to function more normally.
Patients with severe symptoms may need to be hospitalized. In the hospital, patients will undergo group and individual therapy, a strict medical regiment, and time in a "safe room" or in restraints for those who have more violent or suicidal impulses. For severely affected patients, electroconvulsive therapy (ECT) or shock therapy can help speed recovery.
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