Bipolar Disorder and Psychosis: Yes, we can have paranoid delusions!

Here is an example the Newsletter   

Today’s Topic:  Bipolar Disorder and Paranoid Delusions


by Julie A. Fast

Paranoia is a type of psychosis called a delusion. A delusion is a false belief.

For example, paranoia can be the belief that you have done something wrong and that a person or an organization is upset with you. This is a scary experience as it feels so real.

Paranoia used to really cause me a lot of trouble. I’ve worked hard so that I can at least recognize paranoia before it makes me do something stupid.

I often get the feeling that my friends are ignoring me and that they have met friends they like a lot better than myself. It’s a terrible experience. Luckily, I know the signs of paranoia and don’t act on them, instead I call my friends and ask them to hang out.  When they say yes, I know that all is fine. My friends are the type who will tell me if something is wrong- so my paranoia is always rooted in bipolar disorder and not reality.

Paranoid delusions are FALSE, but you have to be careful because they are VERY sneaky. 

– Paranoid worry is often based on at least some factual evidence which makes it hard to figure out what is really happening. 

– Paranoia does not stand up to factual questioning- but for the person in the paranoid episode, it feels more real than anything they have ever experienced. If you try to talk a paranoid person out of their beliefs, it won’t work.  It’s like trying to convince someone that the sky isn’t blue.

Here are some examples of paranoia. Have you seen these in yourself or your loved ones?

1. Believing that someone is standing across the street staring at you through your apartment window, but when you look outside, there is no one there.

2. Feeling with great certainty that your coworkers have a plan to get you fired. You know this because when they are in a group and you walk up to them, they all scatter in different directions without saying hi.

3. Once, when my former partner Ivan was in the hospital, he was very, very paranoid. I went in one day to say hello and he looked at me and said, “Why is your face so red? Have you been doing something wrong that you aren’t telling me?” True paranoia. He told me later that he really believed  I was seeing someone while he was in the hospital. 

When you are well, these thoughts never even come up. You know there is no one outside and you know that your colleagues wouldn’t have time to plot against you even if they wanted to! They simply go back to their desks when they finish a conversation. You are not the focus of their day.

Paranoia is dangerous when the person takes action such as calling the cops on a neighbor or trying to break into their own office building to find cameras directed at their desk. 

What is the best treatment for paranoia? The first step is a symptom management plan like I teach in the Health Cards and Take Charge of Bipolar Disorder. Once you have identified the symptoms, you can get help.  I use a combination of my trigger management plan, lifestyle changes and medications to manage my psychosis. Anti psychotics work well- the lower the dose the better due to the side effects. Paranoid symptoms must be caught early so they don’t move into destructive behavior.

Education and prevention are key!

This is what I have done, so it’s possible to stay stable and steady when you live with psychosis. 


PS: There is a nice man I sit next to in Starbucks who has a lot of paranoia. It mostly comes out when he is reading the paper. He says all of this very quietly. 

They are rearranging everything to see you.  It’s the big pharmaceutical companies. What are they not telling you? Look at that picture all of those men. Too much stuff. It’s garbage. It’s all it can be. There is no reason to be there anyway. There is no reason to be there. It’s a prison.  All that stuff- 10s of billions. (Laughs.)  I’m not gonna hang around for Obama Clinton.  They do not acknowledge a single one- not one. Like the Tea Party. My mind is made up.

When he talks with friends- he still has the paranoid thinking, but it sounds more like an average conversation. His paranoia is around big pharma and I can understand that! 






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