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How to help people who may suffer from Paranoia?

How to help people who may suffer from Paranoia?

I am a very active member of the Information Security This Site site. Every now and then, I come across people who I believe may suffer from paranoia. They believe that "someone" is out to get them, and use techno-babble to make themselves sound legitimate. Here is an example post:

How to prevent attacker from viewing what's on my Android phone screen? Can someone give me advice or suggest apps to prevent this?

For example, if I write in notepad, and it's offline, they can read it. They know the time of my alarm. if I just set new random one they know. If I play some music, they know.

Another post by the same user:

they can read my screen, listen to my mic and even control my notification. both my rooted and unrooted phone. This happens when i just moved to new place im renting, it was bad neighborhood.

I'm not a psychiatrist, but I am very well-versed in security and I am 99.999999% certain that the things this person described are not real. I asked that person a few times who "they" were, and how he could know that someone was reading his messages. He claimed he didn't know who "they" were, but he was certain someone was watching him. As an example for "proof" he claimed that someone in his neighborhood was listening to the same song he was listening to a while ago.

The sad thing is, such users come to our site regularly and I am unsure how to best help them. What should I do when I come across a person who I suspect may suffer from paranoia?

What I've tried so far

So far, I have tried to tell those looking for help with their supposed hacker problems that they are likely not being attacked, and that it seems to me that they may be affected by paranoia. I tried to help them by adding links to credible organizations (like the Australian Better Health Channel), which was always countered by them claiming that they are not paranoid and that their problems are real.

I'm not sure if bluntly saying "I think you may have a mental health problem" is beneficial though, and if it may do more harm than good. For this reason, I am asking this question, how exactly I should act and how to best help people.


I'm not active on this board, so please forgive me if my answer is not up to community standards.

I am not a psychologist, but I have some experience with mental illness (maybe too much.)

True paranoia (or Paranoid Personality Disorder/PPD) is much more pronounced than thinking that people can spy on you through your mobile. Whether it's true or not isn't relevant, really. In this case, there is a kernel of truth to their fears, which becomes exacerbated.*

According to the DSM-5, persons with Paranoid Personality Disorder will have trouble operating with others in the workplace, educational or social settings (American Psychiatric Association, 2013). It is noted that people with PPD are more frequently unemployed or working more menial jobs than the general population (Mueser, Mischel, Adams, Harvey, McClure, Look, Leung, & Siever, 2013).They tend to be solitary, self sufficient, and secretive, and will have difficulty making or maintaining intimate relationships or close friendships. (American Psychiatric Association, 2013). Persons with PPD may experience a conflict, in that they want intimate relationships and friendships, but do not have a level of trust which is an essential element of such relationships.

If many of the other criteria aren't met, it's probably not paranoia. On the other hand, if your interactions are limited, you may not know about other criteria, so this might be paranoia.

How to help people who may suffer from Paranoia?

It's very difficult, even for therapists, because challenging their belief systems makes the person very defensive. They do not tend to have much self insight, which makes therapy challenging. Clearly you are not in a therapeutic relationship with the user; I would try to steer them in the right direction security-wise, and then (gently and respectfully) disengage.

So far, I have tried to tell those looking for help with their supposed hacker problems that they are likely not being attacked, and that it seems to me that they may be affected by paranoia.

I would definitely avoid this, as this is giving a diagnosis, which you should not do (I believe it's unethical) over a brief interaction on the internet. I'm not surprised they counter by claiming that they are not paranoid and that their problems are real. To someone who's paranoid, their problems are real.

In case my answer isn't well explained,

I'm not sure if bluntly saying "I think you may have a mental health problem" is beneficial though, and if it may do more harm than good. For this reason, I am asking this question, how exactly I should act and how to best help people.

Unless you are in a close personal relationship with someone, I think it's not in their best interests to tell them they may suffer from a mental illness, whether they do or not. First, you do not know. Second, they will most likely be defensive if not offended as well.

My reaction would be to be kind and gentle with the person, avoid overt confrontation ("That's not possible… ") and let people close to them tell them they need professional help.

*Laptop cameras have been hacked, and worse.

**I know people who believe Pizzagate was real. Te truth doesn't matter if you like conspiracy theories.

References

American Psychiatric Association. (2013). Diagnostics and Statistics Manual of Mental Disorders (DSM-5) Washington. DC: American Psychiatric Publishing.


Treating Paranoid Personality Disorder and Co-Occurring Substance Use Disorders

Many people with paranoid personality disorder receive treatment for the first time when they undergo addiction treatment. Clinicians may notice that they are guarded in group treatment and frequently express suspicion of others. This can lead to an individual’s first paranoid personality disorder diagnosis.

Outcomes are better for people with paranoid personality disorder and co-occurring substance use disorders when treatment focuses on factual information and rational insight. Cognitive behavioral therapy methods that emphasize learning how to avoid triggers, control cravings and challenge paranoid thoughts are more likely to resonate with people who have PPD.

It’s important for people with paranoid personality disorder and co-occurring disorders to receive integrated treatment that targets symptoms of both disorders. This means they ideally will be able to participate in coordinated individual, group and complementary therapy.

The Recovery Village operates rehab facilities across the United States that provide integrated treatment to people with co-occurring disorders. If you are concerned that you or a loved one is struggling with addiction and paranoid personality disorder, contact a representative from The Recovery Village for help locating a facility that can meet your treatment needs.

Medical Disclaimer: The Recovery Village aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.

Seeking addiction treatment can feel overwhelming. We know the struggle, which is why we're uniquely qualified to help.

Your call is confidential, and there's no pressure to commit to treatment until you're ready. As a voluntary facility, we're here to help you heal -- on your terms. Our sole focus is getting you back to the healthy, sober life you deserve, and we are ready and waiting to answer your questions or concerns 24/7.


Short People Got … Lots of Reasons to Legitimately Feel Paranoid

A virtual-reality study sheds light on the way non-tall people perceive the world.

Your physical height can affect your emotional state of mind, according to a new study.

We already know that language bestows positive value on people of tall stature: We look up to them rather than down. And various studies have found correlations between being taller and earning more.

Now virtual reality is adding to the understanding of the short state of mind. A study conducted at Oxford University and published in December 2013 used avatars to let participants go through the virtual experience of riding a subway at their normal height and then at that height reduced by ten inches.

For the study, 60 women—none with a history of mental illness, but all of whom had recently reported mistrustful thoughts—donned headsets and viewed monitors as they participated in two 3-D virtual-reality trips on the London subway system. They were able to move and interact with other virtual passengers, exchanging glances or looking away from others, for instance.

The virtual train trips journeyed between subway stations, took about six minutes each, and were programmed and animated identically except for one thing: In one ride, the avatar representing the participant was reduced in height by 25 centimeters—a little less than ten inches. That's "approximately the height of a head" in the words of Oxford clinical psychologist and lead researcher Daniel Freeman.

The results: Participants reported that during the ride in which they were made to feel shorter, they felt more vulnerable, more negative about themselves, and had a greater sense of paranoia. "The key to this study was there were no reasons for mistrust," says Freeman. Yet when the participants saw the world from a height that was a head shorter than usual, "they thought people were being more hostile or trying to isolate them."

That doesn't suggest that if you're short you're always less trustful or more paranoid, says Freeman. But the findings do reinforce common perceptions about height. "Height seems to affect our sense of social status," he says, and being taller tends to be socially desirable.

"The implication is that greater height can make you more confident in social situations," he says. "All of us can recognize that when we feel worse about ourselves, we can hunch up and stoop and take up less space, but when we feel more confident we feel taller and take up more space."

There may be some reality to the virtual reality, too, as expressed in a comment from a study participant. "I noticed the second time I was shorter. People, even suitcases, were feeling high. I was frustrated to feel like a child again, felt out of place on the tube, because I wasn't an adult." Being shorter, in other words, replicated the sense of vulnerability of a little child, not yet grown into the full height of adulthood.

Perhaps that's not so surprising if you think about how little children feel vis-à-vis taller grown-ups, says Denver clinical psychologist Susan Heitler. While two people of the same height literally will see eye to eye, if one is a foot taller than the other (say, six feet tall vs. five feet tall), one person actually must look up while the other looks down.

That unequal gaze is connected to the association of greater height with greater power. "It's not a perfect correlation," Heitler says, but when she asks depressed patients to close their eyes and imagine their situation, they tend to see themselves as very small in comparison to the seemingly much larger figures in their lives who are overwhelming them.

Tall Hunters Got More Game?

Clearly, our internal landscape is telling us something about how we compare and equate height and status. But how and why did our brains come to incorporate such meanings?

From an evolutionary perspective, "taller is better" may date back to when humans were nomadic hunters, explains Linda A. Jackson, a Michigan State University psychology professor who has studied height stereotypes. According to this view, being taller had reproductive advantages for capturing prey and avoiding predators, which provides a higher likelihood for survival for tall parents and their offspring.

Today's society is radically differently from the societies of the hunter-gatherer era. But height continues to have a small but measurable impact on how others view us, particularly for men.

"Taller men are perceived as having higher status, stronger leadership skills, and as being more occupationally successful than average or shorter males," Jackson wrote in an email interview. Men of average or shorter height also suffer in the realm of social attractiveness, which includes personal adjustment, athletic orientation, and masculinity. Her caveat: "What NONE of these studies establish is that it is HEIGHT per se that is responsible for these benefits or characteristics associated with height (strong leadership skills, self-confidence, professional development)."

Although the evidence that such stereotypes affect women is "weaker," she said, short females, too, are perceived less favorably in the occupational realm, she writes, adding, "The 4'8" manager may need to work harder to be taken seriously."

Moreover, how will such perceptions—and potential biases—in regard to height affect our interactions with one another as the baby boomers begin to shrink, losing inches, growing shorter with age? Will height perceptions have an impact as this large cohort grows older and also grow shorter? Jackson thinks not.

But Timothy Judge, a management professor at the University of Notre Dame who has also studied the impact of height on professional earnings, believes that studies correlating height with professional or personal success "highlight that we are a very appearance-based culture." Moreover, he says, "as we become more and more of a visual and technology-based society, there are reasons to worry that there won't be much to slow down appearance-based judgments." On the other hand, if we only get to know people via computer, perhaps height might become less important.

Judge further worries that this increased emphasis may not bode well for the little old lady—or little old man—who, in addition to being subject to stereotypes about aging may also have to contend with additional negative assumptions about height. "If we live into our 80s, we shave off about two- or two-and-a-half inches on average," says Judge, "and I think that is one of the factors that contributes to ageism."

The presence of such stereotypes makes it all the more important to be aware of and examine any biases we may harbor, says Judge.

But watching our elders shrink in size might also bring out positive, nurturing emotions, says Heitler. "My mother was always taller than me by about an inch until she began shrinking with age," she recounts. Eventually, the height roles were reversed and Heitler became taller than her mother—a transformation that made her feel all the more protective and nurturing.

Learning to adapt and grow in spirit even as we shrink in height—now that would be a reality worth simulating.


Barriers to Treatment for Paranoia

Individuals with paranoia may be reluctant to seek treatment. Those with mild or moderate paranoia may realize their thoughts don’t have much basis in reality. Yet they may worry about stigma or feel their fears aren’t severe enough for therapy.

People with more severe paranoia may not realize their symptoms are an issue. They may have trouble trusting a therapist enough to relay their thoughts and experiences. In some cases, an individual experiencing paranoia may believe the therapist is part of the threat.

Some individuals may be more willing to try therapy if accompanied by a loved one. Having knowledge about their diagnosis can also improve compliance. Although people with paranoia may be suspicious of their therapist at first, trust can build over time. As paranoia symptoms decrease, individuals will likely be more willing to participate in therapy.


You might do or feel specific things as a result of your paranoid thoughts. These things can feel helpful at the time – but in the long term they could make your paranoia worse.

Safety behaviours

Safety behaviours are things you do that make you feel safe. For example, you might avoid certain people or places, stay indoors a lot or wear protective clothing. These are also known as safety seeking behaviours.

Behaviour towards other people

If you think someone is threatening you or wants to harm you in some way, you may behave suspiciously or aggressively towards them. You might push them away or decide that you are better off without them.

But this means that people might start to treat you differently. They might try to avoid you too. It might become harder to make or keep friends. This can make you feel as if your beliefs were justified in the first place.

Safety behaviours can sometimes start to act as evidence for your paranoid thoughts. You might think that you are safe because you do those things and then do them even more. But this means you don't have a chance to try different ways of coping with scary situations or to test your beliefs and see if they are justified or not.

Talking therapies can help you test your thoughts and practise dealing with scary situations and people. This can be very uncomfortable at first but the therapist should offer you a lot of support and take things at a pace that you can manage.


Contents

Erotomania is more common in women, but men are more likely to exhibit violent and stalker-like behaviors. [3] The core symptom of the disorder is that the sufferer holds an unshakable belief that another person is secretly in love with them. In some cases, the sufferer may believe several people at once are "secret admirers". Most commonly, the individual has delusions of being loved by an unattainable person who is usually an acquaintance or someone the person has never met. The sufferer may also experience other types of delusions concurrently with erotomania, such as delusions of reference, wherein the perceived admirer secretly communicates their love by subtle methods such as body posture, arrangement of household objects, colors, license plates on cars from specific states, and other seemingly innocuous acts (or, if the person is a public figure, through clues in the media). Some delusions may be extreme such as the conception, birth, and kidnapping of children that never existed. The delusional objects may be replaced by others over time, and some may be chronic in fixed forms. [3] Denial is characteristic with this disorder as the patients do not accept the fact that their object of delusion may be married, unavailable, or uninterested. The phantom lover may also be imaginary or deceased.

Erotomania has two forms: primary and secondary. Primary erotomania is also commonly referred to as de Clerambault's syndrome and Old Maid's Insanity [4] and it exists alone without comorbidities, has a sudden onset and a chronic outcome. [3] The secondary form is found along with mental disorders like paranoid schizophrenia, often includes persecutory delusions, hallucinations, and grandiose ideas, and has a more gradual onset. [3] Patients with a "fixed" condition are more seriously ill with constant delusions and are less responsive to treatment. These individuals are usually timid, dependent women that are often sexually inexperienced. [3] In those with a more mild, recurrent condition, delusions are shorter-lived and the disorder can exist undetected by others for years. [4] Problematic behaviors include actions like calling, sending letters and gifts, making unannounced house visits and other persistent stalking behaviors. [3]

Erotomania may present as a primary mental disorder, or as a symptom of another psychiatric illness. With secondary erotomania, the erotomanic delusions are due to other mental disorders such as bipolar I disorder or schizophrenia. Symptoms may also be precipitated by alcoholism and the use of antidepressants. [5] There may be a potential genetic component involved as family histories of first degree relatives with histories of psychiatric disorders are common. Sigmund Freud explained erotomania as a defense mechanism to ward off homosexual impulses which can lead to strong feelings of paranoia, denial, displacement and projection. Similarly, it has been explained as a way to cope with severe loneliness or ego deficit following a major loss. [3] Erotomania may also be linked to unsatiated urges dealing with homosexuality or narcissism. [4] Some research shows brain abnormalities occurring in patients with erotomania such as heightened temporal lobe asymmetry and greater volumes of lateral ventricles than those with no mental disorders. [4]

Prognosis differs from person to person, and the ideal treatment is not completely understood. Treatment for this disorder gains the best results when tailored specifically for each individual. To date, the mainline pharmacological treatments have been pimozide (a typical antipsychotic which was also approved for treating Tourette's Syndrome), [3] [4] and atypical antipsychotics like risperidone and clozapine. [3] [4] Non-pharmacologic treatments that have shown some degree of efficacy are electroconvulsive therapy (ECT), supportive psychotherapy, family and environment therapy, [3] rehousing, risk management and treating underlying disorders in cases of secondary erotomania. [4] ECT may provide temporary remission of delusional beliefs antipsychotics help attenuate delusions and reduce agitation or associated dangerous behaviors, and SSRIs may be used to treat secondary depression. [3] In delusional disorder, there is some evidence that pimozide is more efficacious than other antipsychotics. Psychosocial psychiatric interventions can enhance the quality of life through allowing some social functioning, and treating comorbid disorders is a priority for secondary erotomania. [4] Family therapy, adjustment of socio-environmental factors, and replacing delusions with something positive may be beneficial to all. In most cases, harsh confrontation should be avoided. [3] Structured risk assessment helps to manage risky behaviors in those who are more likely to engage in violence, stalking, or crime. [4] For particularly troublesome cases, neuroleptics and enforced separation may be moderately effective. [2]

Early references to the condition can be found in the work of Hippocrates, Freud (1911), G.G. de Clérambault (1942), [3] Erasistratus, Plutarch and Galen. Parisian physician Bartholomy Pardoux (1545-1611) covered the topics of nymphomania and erotomania. [3] In 1623, erotomania was referred to in a treatise by Jacques Ferrand [3] (Maladie d'amour ou Mélancolie érotique) and has been called "erotic paranoia" and "erotic self-referent delusion" until the common usage of the terms erotomania and de Clérambault's syndrome. In 1971 and 1977, M.V. Seeman referred to the disorder as "phantom lover syndrome" and "psychotic erotic transference reaction and delusional loving". [3] Emil Kraepelin and Bernard also wrote of erotomania and more recently, Winokur, Kendler, and Munro have contributed to knowledge on the disorder. [4]

G. E. Berrios and N. Kennedy outlined in 'Erotomania: a conceptual history' (2002) [6] several periods of history through which the definition of erotomania has changed considerably:

  • Classical times – early eighteenth century: General disease caused by unrequited love
  • Early eighteenth-beginning of nineteenth century: Practice of excess physical love (akin to nymphomania or satyriasis)
  • Early nineteenth century – beginning twentieth century: Unrequited love as a form of mental disease
  • Early twentieth century – present: Delusional belief of "being loved by someone else"

In one case, erotomania was reported in a patient who had undergone surgery for a ruptured cerebral aneurysm. [7]

In his paper that described the syndrome, de Clérambault referenced a patient he had counselled who was obsessed with British monarch George V. [8] She had stood outside Buckingham Palace for hours at a time, believing that the king was communicating his desire for her by moving the curtains. [8] Many cases of obsession or stalking can be linked to erotomania but do not always necessarily go hand in hand.

Parallels were drawn between this and a 2011 case where the body of a homeless American man was found on a secluded island in St James Park, within sight of Buckingham Palace. The man had sent hundreds of "strange and offensive" packages to Queen Elizabeth II over the previous 15 years. [8]

The assassination attempt on the US President Ronald Reagan by John Hinckley Jr. has been reported to have been driven by an erotomanic fixation on Jodie Foster, whom Hinckley was attempting to impress.

Late night TV entertainer David Letterman and former astronaut Story Musgrave were both stalked by Margaret Mary Ray, who suffered from erotomania. [8]

Michael David Barrett allegedly suffered from erotomania, stalking ESPN correspondent Erin Andrews across the country, trying to see her and taking lewd videos. [8]


3. Child and Family Social Worker

A child and family social worker helps children and families to deal with emotional, mental and situational problems in their lives.

As a social worker, you will help children and families to cope with the many challenges in their lives. This can be due to many factors, such as a mental health problem, but just as often a highly stressful situation, such as the death of a child or sibling. You may also work with people who have serious physical problems and addictions.

Median pay for all social workers is $44,200, and people with a master&rsquos degree or PhD can earn up to $72,000.


Eight tips for talking about mental health

1. Set time aside with no distractions

It is important to provide an open and non-judgemental space with no distractions.

2. Let them share as much or as little as they want to

Let them lead the discussion at their own pace. Don’t put pressure on them to tell you anything they aren’t ready to talk about. Talking can take a lot of trust and courage. You might be the first person they have been able to talk to about this.

3. Don't try to diagnose or second guess their feelings

You probably aren’t a medical expert and, while you may be happy to talk and offer support, you aren’t a trained counsellor. Try not to make assumptions about what is wrong or jump in too quickly with your own diagnosis or solutions.

4. Keep questions open ended

Say "Why don’t you tell me how you are feeling?" rather than "I can see you are feeling very low". Try to keep your language neutral. Give the person time to answer and try not to grill them with too many questions.

5. Talk about wellbeing

Talk about ways of de-stressing or practicing self-care and ask if they find anything helpful. Exercising, having a healthy diet and getting a good nights sleep can help protect mental health and sustain wellbeing.

6. Listen carefully to what they tell you

Repeat what they have said back to them to ensure you have understood it. You don’t have to agree with what they are saying, but by showing you understand how they feel, you are letting them know you respect their feelings.

7. Offer them help in seeking professional support and provide information on ways to do this

You might want to offer to go the GP with them, or help them talk to a friend or family member. Try not to take control and allow them to make decisions.

8. Know your limits

Ask for help or signpost if the problem is serious. If you believe they are in immediate danger or they have injuries that need medical attention, you need to take action to make sure they are safe. More details on dealing in a crisis can be found below.

If it is a family member or close friend you are concerned about, they might not want to talk to you. Try not to take this personally: talking to someone you love can be difficult as they might be worried they are hurting you. It is important to keep being open and honest and telling them that you care. It may also be helpful to give them information of organisations or people they can reach out to. A list can be found below.


You may also like:

Sociopath Test: Do I Have Antisocial Personality Disorder?

Narcissistic Personality Disorder Test (Self-Assessment)

Avoidant Personality Disorder

Schizotypal Personality Disorder

Tell Me All I Need to Know About Narcissistic Personality Disorder


Paranoid Personality Disorder

Daniel B. Block, MD, is an award-winning, board-certified psychiatrist who operates a private practice in Pennsylvania.

PeopleImages / DigitalVision / Getty Images

Paranoid personality disorder is a chronic and pervasive condition characterized by disruptive patterns of thought, behavior, and functioning. This disorder is thought to affect between 1.21 to 4.4% of U.S. adults.   Individuals with paranoid personality disorder are at a greater risk of experiencing depression, substance abuse, and agoraphobia.