Imagine a life defined by the constraints imposed by fear and suspicion. Every waking hour is spent locked inside a prison of your own delusional making, seemingly safe from all the people perceived to be out to cause you harm. Trusting no one, life is devoid of relationships or emotional connections. Anger from long-lasting grudges held in retaliation for imagined wrongdoings colors your days. Unable to get along with anyone, your job tenure is short-lived. Like the lyrics from the Kinks’ song, “Destroyer,” your life message becomes “… paranoia, they destroy ya.” This is paranoia and its effects are destructive.
Paranoia symptoms can be caused by many things. Mild symptoms are normal and usually caused by stress, lack of sleep and the normal fears one might experience when walking alone at night, for example. These mildly paranoid feelings aren’t worrisome, as they will resolve once the situation has passed.
Paranoia’s connection to drugs
Problematic paranoia, however, is brought on by either mental illness or drug use. Marijuana is known for causing paranoia, because of THC’s effect on the brain’s cannabinoid (CB1) receptors. Findings published by the Journal of Neuroscience suggest that activity in the basolateral amygdala is involved in marijuana-induced paranoia. The THC seems to enhance a type of learning about fear, which leads the brain to jump to conclusions about certain non-threatening experiences, perceiving them as frightening.
Common feelings paranoid individuals experience include a sense that people are spying on them or out to get them. Other drugs commonly associated with paranoia are methamphetamine, cocaine and LSD. Drug use can actually trigger a dormant mental health problem.
When someone wants to detox from the drugs, intense paranoia feelings might emerge during the detoxification process. The more intoxicated or addicted to the drug the person is, the more exaggerated the paranoia presents, even becoming violent, which is why detox should take place in a monitored and controlled setting.
Diagnosing paranoid personality disorder
When patients become concerned about their paranoia symptoms and seek medical help, the doctor will first assess their physical status. Paranoid symptoms can be caused by dementia, for example. If the medical evaluation fails to identify a physical source for the symptoms, and the patient is not using illicit drugs, then a psychiatrist performs a mental health assessment. The psychiatrist will use specially designed interview and assessment tools to evaluate the patient for a personality disorder.
Paranoid personality disorder (PPD) is part of a group of mental health conditions called Cluster A personality disorders, which are characterized by eccentric, distorted thinking, and include schizoid personality disorder and schizotypal personality disorder. People suffering from PPD exhibit an unrelenting, though unwarranted or irrational, distrust and suspicion of others. Typical expressions of PPD include:
- Pathological jealousy
- Holding grudges
- Preemptively attacking others who are a perceived threat
- Reading malevolent intentions into harmless, innocuous comments or behaviors
- Putting a great deal of effort into protecting oneself from perceived attacks
- Hypersensitivity and taking criticism poorly
- Reluctance to form close bonds or to confide in others
- Hostile and argumentative behaviors
- Suspicions of spousal unfaithfulness
- Believing that others are deceiving or using the individual
- Failure to remain employed, because of an inability to get along with others in the workplace
Although the cause of PPD is yet unknown, it is likely caused by a combination of biological and psychological factors. Childhood traumas, including physical or emotional abuse, are suspected as having a role in the development of PPD. In addition, the fact that the condition is more common in people with relatives who have schizophrenia portends a genetic origin.
Treating paranoid personality disorder
People with PPD often do not seek help. They believe they are not the one with the problem, but that it is everyone else who is disordered. Treating people with PPD is difficult because, in their critical and litigious minds, they see fault with everyone else, but can’t see their own problematic behavior.
Psychotherapy is the most effective treatment protocol for PPD, especially cognitive behavioral therapy. However, because a relationship with a therapist is based on trust and people with PPD have trust issues, they might not cooperate in therapy or comply with treatment plans.
Medication benefits some patients with PPD. Certain anti-anxiety, antidepressant and antipsychotic drugs might be effective in treating patients with extreme symptoms or with an associated psychological disorder such as depression or anxiety.
Sovereign Health of California is an addiction, mental health and dual diagnosis treatment provider, offering several locations in California, as well as centers in Utah, Arizona and Florida. For more information on mental health disorders, including paranoid personality disorder, please call (866) 819-0427.
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