Mental disorders not only cause great suffering but are also
often associated with the stigmatization of the people stricken with
them. People who suffer
from mental disorders are excluded from our society.
They are deprived from leading normal life.
They are treated differently and are not given equal
opportunities as other people. Not
only are these people suffering from their illness but also from the
judgemental eyes of the people who are bringing them down.
The mere presence of mental disorder should not lead to a
presumption that someone is incapable of doing anything
Until recent decades, little could be done to ameliorate the
symptoms of many mental disorders.
This is probably because of the nature of psychological
topics—they are highly debatable.
There would always be disputes about each aspect of a disorder,
topic, etc. However, in
recent years, there had been several strikes of success.
And now, the medical community is looking forward with optimism
concerning new approaches to these mental disorders.
As a result, biomedical and behavioral research involving people
with mental disorder, is now a growing field of scientific endeavor.
There are different kinds of mental disorders.
Some are of the mild side, which could still allow a person to
function normally, and some are so severe, the person affected could not
even think straight and make a decision for himself.
Paranoia is one kind mental disorder.
It is an illness, not a self inflicted disease.
The objective of this paper is to try and explain what Paranoia
is. A person cannot
confidently say that he is safe from it.
It chooses no gender. It
could happen almost anyone.
II.
Definition and Kinds of Paranoia
The word “Paranoia” is often used in
our daily conversations, sometimes out of frustration, we would call
other people “paranoid” just because we see them as someone who is
highly or easily suspicious of the things and events happening around
them. However, simple
suspiciousness is not Paranoia—not if it is based on a previous
experience or expectation learned through experience from others.
Paranoia
is a term used to describe suspiciousness or mistrust based on something
unreal. It could be based
on false sensory perception, delusion or possibly hallucination.
The delusions in paranoia should be persistent, unalterable,
systematized and logically reasoned.
This means that Paranoia involves delusions, which are the
misinterpretation of reality-- the persons affected believe that
whatever they saw or heard was real.
It is neither imaginary nor a dream.
The
term “paranoia” was actually first used by a German psychiatrist
Karl L. Kahlbaum in 1863. This
condition often happens to people suffering from Paranoid disorders or
to people of old age..
People suffering from Paranoia are usually suspicious of the
motives of others, causing them to be hypersensitive, tense and
argumentative. They are
easily jealous and angry. These
emotions, in most severe cases, could lead to violent confrontation.
The people affected also believe that there is a pattern to
random events happening around them and that they are somewhat related
to their life and existence.
Paranoia can sometimes be mild, allowing the individuals affected
to function normally in a society.
It could also be so severe that they become incapacitated,
allowing them to be excluded from society and be deprived of the rights
and obligations that a normal non-paranoid person has.
Paranoias could be classified into three main categories:
Paranoid Personality Disorder, Delusional Disorder and Paranoid
Schizophrenia.
II.A
Paranoid Personality Disorder
The
main hallmark of this disorder is the misinterpretation of other
people’s motives. A
person with Paranoid Personality Disorder consider the actions of other
people as debilitating and demeaning.
To further explain what PPD is, a sample story is presented
below. Take note of the
person’s attitude toward certain situations.
Consider how he reacted and what he felt during these situations.
“Derek
worked in a large office as a computer programmer. When another
programmer received a promotion, Derek felt that the supervisor
"had it in for him" and would never recognize his worth. He
was sure that his co-workers were subtly downgrading him. Often he
watched as others took coffee breaks together and imagined they spent
this time talking about him. If he saw a group of people laughing, he
knew they were laughing at him. He spent so much time brooding about the
mistreatment he received that his work suffered and his supervisor told
him he must improve or receive a poor performance rating. This action
reinforced all Derek's suspicions, and he looked for and found a
position in another large company. After a few weeks on his new job, he
began to feel that others in the office didn't like him, excluded him
from all conversations, made fun of him behind his back, and eroded his
position. Derek has changed jobs six times in the last seven years.
Derek has paranoid personality disorder. “ (http://www.mentalhealth.com/book/p45-para.htm)
The
Diagnostic and Statistical Manual of Mental Disorders fourth edition
(DSM-IV)- diagnostic standard for mental health professionals in the US,
lists similar symptoms for PPD.
Paranoid
Personality Disorder involves distrust in others, as indicated by the
following:
·
suspicious
without sufficient proof or basis
The
person believes that other people intend to deceive, exploit and harm
him without sufficient evidence and reasoning.
·
full
of doubts concerning other people’s loyalty and trustworthiness
The
person would always doubt a friend or loved one’s loyalty,
trustworthiness, and love for him.
·
afraid
to confide in other people due to unwarranted fear
He
is afraid to open up and become intimate with other people because he is
afraid that whatever information he discloses to other people would be
used against him. They fear
several things and events that normally have no ground or basis.
·
finds
hidden demeaning, insulting and threatening meanings harmless remarks.
He
would look at things differently. He
would find hidden meanings from other people’s words and actions.
He would sometimes see innocent remarks as insults or threats.
·
holds
long grudges and unforgiving
He
does not forgive easily. If
the individual is angered, he would most probably stay angry for a long
time.
·
believes
that other people are out to attack his character and reputation, easily
angered and is quick in reacting with his anger
He
believes that other people are going against him.
He thinks that other people are out to get him because they want
to “bring him down”. He
also gets angry quite easily which sometimes lead to violent episodes.
·
believes
without basis that his spouse is cheating on him
He
thinks that his spouse is being dishonest eventhough he does not have
any sufficient basis.
Aside
from being argumentative and uncompromising, people with PPD cut
themselves off other people thus causing them to be cold and aloof.
They pride themselves with their rationality and objectivity.
They are also hypersensitive because they are hyperalert of the
things happening around them.
Because
people with PPD are naturally suspicious, they try to avoid seeking
medical help, making it hard for clinicians to treat them.
II.B.
Delusional Disorder
Delusional
Disorder is more debilitating than Paranoid Personality Disorder (which
is a milder subtype of Paranoia). The
main hallmark of this disorder is the prescence of non-bizaare delusions
for at least a month without symptoms of other mental disorders like
Alzheimers and Schizophrenia.
To
understand delusional disorder better, a story is given below.
It shows how a person with Delusional Disorder think and what are
the thoughts going on his, in this case, her mind.
“Ruth
is a clerk typist who is efficient and helpful. Her employers and
co-workers value her contribution to the office. But Ruth spends her
evenings writing letters to State and Federal officials. She feels that
God has opened her mind and given her the cure for cancer. She wants
some leading treatment center to use her cure on all its patients so
that the world can see she is right. Many of her letters go unanswered,
or she receives noncommittal replies that only make her feel that no one
understands that she can save all cancer patients if only given the
chance. When one of her letters is answered by an employee of the
official to whom she wrote, she is sure that the official is being
deliberately kept unaware of her knowledge and power. Sometimes she
despairs that the world will ever know how wonderful she is, but she
doesn't give up. She just keeps writing. Ruth suffers from one of the
delusional disorders, grandiose delusion. “
(http://www.mentalhealth.com/book/p45-para.htm)
Non-bizaare
delusions are beliefs on something that could happen in a person’s
life that is not out of the realm of possibility.
For example, a certain person thinks that his spouse is cheating
on him, he thinks that a friend of his is going to die, his neighbour is
actually a secret agent for the government.
These things could either be true or not, but the person
suffering from this disorder believes in what his delusion tells him.
People
with Delusional Disorder could still function normally.
They are not impaired and they could still do daily chores and
activities. For example,
they could still go to work, go to school, go out of the house, etc.
Whatever is wrong with them could not be seen on their outside
appearance.
Delusional
Disorder should not be mistaken with Schizophrenia.
Schizophrenia is a severe disturbance in the brain’s
functioning. Although
Schizophrenia and Delusional Disorder share some similar
characteristics, they also differ in some.
One major factor is the type of delusion that is attributed to
the disorder. Schizophrenia
involves bizaare delusions. These delusions are highly unlikely to
happen. In other words, the
delusions are hard to believe in. The
chances of them happening are from slim to nil.
This
disorder usually happens to people between the age of 40 to 55, but it
may also happen to people of younger age.
It affects 1% of the population and is not determined by a
person’s gender. It
occurs equally in men and women.
Some
of the signs and symptoms of delusional disorder include:
- the
feeling of being taken advantage of by others
- doubting
the loyalty of friends and loved ones
- finding
hidden meaning into events
- having
trouble with social and marital relationship
- feeling
of being alone
- being
easily irritated
Delusional
Disorders could be classified into six major themes:
II.B.1.
Persecution
Persecution in Delusional Disorder is more elaborate than that of
Paranoid Personality Disorder. In
Paranoid Personality Disorder, the person affected would simply suspect
others of mild jokes and pranks as in making fun of him.
In Delusional Disorder, the person actually believes that other
people have sinister plans to poison, drug or kill him.
They would make heavy accusations against colleagues, friends and
family that the said people are threatening them.
Peole suffering from Delusional Disorder sometimes engage in
litigation in an attempt to redress imagined injustices.
II.B.2.
Jealousy
In delusional jealousy, a person believes that his spouse or
partner is cheating on him, based on meaningless pieces of evidences.
A good example of this is when a man doubts his wife of cheating
on him because she is late in coming home.
Even if the wife provides a valid explanation, the husband would
still insist his theory. Another
example would be when a woman doubts his husband of cheating on her
because she found a strand of hair (that didn’t belong to her or her
husband) on his clothes. There
are other different reasons but they are mostly senseless like blot on
shirt, smell of perfume, being well groomed, etc.
II.B.3
Erotic Delusion
Erotic Delusion involves the belief that an individual is
romantically loved by someone famous, oftenly an important public
figure. This could lead to
the obsession of the individual to the important person.
It could also cause harrasment and stalking.
An example of this is when a man with erotic delusion leaves lots
of messages on a famous celebrity’s answering machine just because he
thinks that the celebrity is in love with him.
Another possible example would be when a woman tells her friends
that she knows that a famous politician or even co-worker is in-love
with her.
II.B.4.
Grandiose Delusion
A person with grandiose delusion believes that he is jpgted with
special powers that if given a chance to put into use, could perform
extraordinary feats like ensuring world peace, banishing poverty, create
cure for AIDS, etc.
A good example of this is the previously given story.
II.B.5.
Somatic Delusion
An individual with somatic delusion is convinced that there is
something wrong with his body. He
believes that he is extremely ugly or that he emits foul odors, have
bugs crawling all over his body, etc.
Because of these, people with somatic delusion avoid other
poele’s company and spend more time consulting physicians insisting
that there is something very wrong with them.
II.B.6.
Mixed Type
A
person with this type of delusion suffers from one or more of the
delusions listed above.
II.C.
Paranoid Schizophrenia
Paranoid Schizophrenia is a type of schizophrenia that involves
the feeling that one is being persecuted or plotted against.
Affected individuals may have delusions of grandeur connected to
the protection of themselves from the perceived plot.
The story below will provide a clearer picture of what a person
suffering from Paranoia Schizophrenia goes though.
“Steven had not liked high school very
much and was glad to graduate and get a job. But when he realized he
needed more education to reach his goals, he applied for admission into
a nearby college. He rented a house with several other young men and did
well in his studies. Near the end of his second year, Steven stopped
eating with the others and ate only food directly out of a can so he
could be sure it wasn't poisoned. When he crossed the campus, he tried
to avoid girls as he felt they shot poisoned webs at him that
encompassed his body like a giant spider web. When he began to feel that
his housemates had put poisoned gas in his room, he dropped out of
school and returned home. He cleaned up his room at home and put a lock
on the door so his parents could not enter it and contaminate it. He
bought a small electric hot plate and prepared all his own food. If his
mother urged him to eat a meal with the family, he accused her of
wanting to poison him. His parents finally were able to convince him to
see a psychiatrist who diagnosed "schizophrenia, subtype
paranoia." With medication, individual and group therapy, Steven
has improved enough to work in an office under the supervision of an
understanding and supportive employer.”
(http://www.mentalhealth.com/book/p45-para.htm)
Paranoid
Schizophrenia is the most severe case of paranoia among the other two
subtypes mentioned above. It
causes an individual to lose touch with reality.
They begin to hear, see, and feel things that do not really
exist. They could also
become convinced of things that are not true.
They also have delusions that are usually of the specific theme.
The hallucinations involve mostly both the visual and auditory
senses. Some examples of
the this is when the affected people think that they are hearing voices
or that their thoughts are being broadcasted out loud.
In addition, their performance at home and at work is
deteriorating.
In other milder paranoid disorders, people only have mild
delusions like that of persecution and jealousy.
They are still able to function normally in their society.
And although they are having delusions, they react to these
delusions appropriately. Unlike
in Paranoid Schizophrenia wherein they have prominent hallucination that
are often bizaare in nature. Their
thinking is often disorganized and are oftenly confused.
As of now, there is still no cure.
Symptoms usually develop gradually, although onset could be
sudden. The symptoms could
be seen in acute stages but these do not prevent the diagnosis of
hallucinations. Family
members and friends are usually the first ones to notice the first
changes before the victim does. The
first signs appear between the age of 15 to 34.
Here
are some possible signs and symptoms:
- Confusion
- Inability
to make decisions for themselves
- Hallucinations
- Delusions
- Nervousness
- Noticeable
changes in eating, sleeping and other habits
- Strange
behaviour
- Staying
away from friends, work and school
- Negligence
of personal hygiene
- Unexplained
and often sudden bursts of anger
- Indiffernce
to the comments of other people
- Tendency
to argue
- Belief
that he is better than other people or that other people are out to
get him
III.
Possible Causes
The
exact cause of Paranoia is unknown.
Some possible factors are genetics, neurogical abnormalities,
changes in brain chemistry, concusion, old age and stress.
It could also be caused by a side effect of drug abuse (i.e.
marijuana, amphetamines, alcohol, cocaine, PCP).
Short termed Paranoia may also happen to some individuals who
undergo great amount of stress.
Genetic
Contribution
Little
research has been done and it is still unclear if paranoia can be
inherited. Scientists found
out that families of paranoid patients do not have abnormal rates of
either schizophrenia or depression.
However, there is some evidence that symptoms in schizophrenia
could be genetically influenced. Recent
research also shows that paranoid disorders are more common to relatives
of people with schizophrenia. It
is also said that if a twin has paranoia, the other pair is most likely
to have paranoid disorder too.
Biochemistry
Paranoia has not yet been directly examined except as a subtype
of schizophrenia. The
causes of schizophrenia are still being debated.
It is also said that the abuse of drugs such as amphetmines,
cocaine, marijuana, PCP, LSD, and other stimulants could lead to
symptoms of paranoid thinking or behaviour.
The situation of people with severe mental disorder could get
worse by taking these drugs.
Stress
Some
scientists would like to believe that paranoia is caused by high level
stress. In support to this,
people undergoing large amount of stress (i.e. prisoners of war,
businessmen, immigrants, etc.) are more prone to paranoia.
Considering this information, other factors could not be ruled
out. Genetic defect, brain
abnormality, an information-processing disability or all these could
predispose a person to paranoia and that stress merely acted as a
trigger.
IV.
Possible Treatment
The
treatment for people suffering from Paranoid Personality Disorder and
Delusional Disorder are similar. However,
because of the complexity and the amount of damage it inflicts,
treatment in Paranoid Schizophrenia is different.
IV.A.
Paranoid Personality Disorder and Delusional Disorder
Because
of a patient’s mistrustfulness and suspiciousness, it is hard to treat
a person with Paranoid Disorder. Rarely
will they talk casually in an interview.
They are suspicious of the kind of questions a therapist may ask.
They would also try to avoid taking drugs and hospitalization
because they are afraid that they may lose control in other dangers.
IV.A.1.
Drug Treatment
A
patient’s condition may be improved by treating him with appropriate
antipsychotic drugs like thioridazine (Mellaril), haloperidol (Haldol),
chlorpromazine (Thorazine), clozapine (Clozaril), or risperidone (Risperidal).
However, the paranoid symptoms still remain intact.
Some studies show that the symptoms improve right after the drug
treatment, but the same results could be seen on patients who received a
placebo. A placebo is a
“sugar pill” without active ingredients.
A patient’s medication should be closely monitored because
their suspiciousness could cause them to refuse treatment. (i.e. hiding
the medicine in their cheek and spit it out when nobody is looking.)
IV.A.2.Psychotherapy
Some
reports state that the oppurtunity to express one’s feelings (i.e.
suspicion, self-doubts) afforded by psychotherapy, can help the patient
to function in a community. Although
paranoid ideas still exist, they seem to be less disruptive.
They could function normally but the delusions are still there.
IV.B.
Paranoid Schizophrenia
An
acute attack may recquire full time hospitalization in a locked
inpatient unit. When the
symptoms subside, the person may be transferred to a partial care
program in which they could return home after each day’s therapy.
Although inpatients are allowed to wear their own clothes, they
would still be searched for sharp objects.
Patients who present danger outside the hospital may be
involuntarily hospitalized. While
spending time there, patients may encounter the one or more of the
following:
IV.B.1
Group Therapy
It
is ran by a medical staff wherein patients share their ideas.
It is more like a support group session.
IV.B.2.
Individual Therapy
Patients talk to the therapist alone.
They discuss their ways of dealing with their disease.
IV.B.3.
Family Meetings
In these sessions, medical staff will prepare you and your family
for your return home.
IV.B.4.
Time Out
If
you seem dangerous, medical staff may separate you from other patients
and put you in a “safety room”
IV.B.5.
Restraints
Those
who pose danger to other people and himself will be tied up with leather
bands.
IV.B.6.
Electroconvulsive Therapy
This is also known as ECT or Shock Therapy.
It applies mild electric current.
The memory is temporarily disrupted but it usually comes back in
2 weeks. This is done to
patients who become very depressed.
This helps in speed recovery.
IV.C.
Risks
If a patient fails to get medication, he
may not function in the real world.
And when he falls into hallucination and delusion, he may endager
himself and the people around him.
V.
Conclusion
Paranoia is now known as a disorder, not just a word we call out
to people we consider crazy. It
is not a colloquial term we use that is inline with “geeks” and
“nerds”. It is an
illness that nobody wanted or chose to have.
People who have these disorders should not be laughed at.
They are already undergoing tremendous amount of pain and
confusion. They do not need us teasing them because they are already
deprived of the chance to live normally.
Most narrow-minded people shove them away from their lives and
consider them as weirdos.
Eventhough
this is the case for some people, it is good to know that man and
science are working together to determine the root and possibly the
ultimate cure for these illnesses.
A day would come when medical science will finally find the root
and treatment for these disorders.
References
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Barrett,
James Francis. Elements of Pschology, Miluaukee: The Bruce Publishing
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Coleman,
Andrew. What is Pschology, USA
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James. A Dictionary of Psychology,Canada: Penguin Reference Books,
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Reaney,
Patricia. “New Key to schizophrenia treatment studied”, Manila
Bulletin, Vol.325 #26, J 26, ‘00
“Treatment-
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