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Includes Expert Content
Is paranoia a symptom of BP?
bipolargal posted:
I notice I get paranoid a lot, is this a BP symptom? My mom was/is a paranoid schizophrenic. Is it my BP, or this is carried over from what my mom has, or am I just a paranoid person? Is paranoia just another name for an excessive worrier?
maddie8415 responded:
I don't know but I'm kind of curious about the answer to this as well!
bpcookie responded:
Im not sure, but I have paranoia probs. too.
bipolargal responded:
I didn't know if other were experiencing this too. If Dr. G doesn't see this post, I will repost it with his name on it.
Joseph F Goldberg, MD responded:
Hi Bipolargal,
Paranoia is an exaggerated and unfounded sense of mistrust. It may involve false beliefs that someone or something has harmful intentions toward you. If someone has trouble telling whether their perception is real or not, that is called impaired reality testing. If someone is utterly convinced that others are against them and they cannot fathom alternative explanations for how they feel, then paranoia is said to be delusional in its intensity, and that is the same thing as psychosis (literally, the inability to distinguish what is real from what isn't).

Paranoia is a symptom that can occur in a wide variety of conditions, including bipolar I disorder (half or more of people with bipolar I disorder have psychotic symptoms -- delusions or hallucinations -- when manic); it is also quite common in schizophrenia, or as a result of drugs that can induce psychosis (e.g., cocaine, marijuana); and, paranoia can also be a general way in which people see the world, without it becoming delusional -- that would be a description of "paranoid personality disorder." Also, people who have been trauma survivors may become unduly suspicious of others' intentions toward them at times, and elements of paranoia can occur without necessarily reaching psychosis in intensity. People with borderline personality disorder, when under stress, are said to have "micropsychotic" periods when they may become quite paranoid and mistrustful -- reflecting the concept that the "border" in borderline is between reality and psychosis.

Paranoia is more than excessive worry if it involves more of a deep-seated sense of mistrust (in contrast to worry, which is more a sense of anxious uncertainty and apprehension without necessarily thinking or believing that others have malicious intentions), and also, worry usually has normal reality testing. If a concern is not a conviction, and if you can honestly preface a concern by being able to say, "I know this may sound crazy, but....." then chances are the concern reflects more anxiety than psychosis. Paranoid psychosis is a false, fixed belief that doesn't budge even when confronted with evidence that should disprove the belief.

- Dr. G.
snowyowl33 replied to Joseph F Goldberg, MD's response:
Hi Doc,

Does it also include ruminating about something or an issue or something that occured that you know was meant one way but can't get it out of your mind that it "feels" like it might have been meant another way, and you then obsess about it over and over? Thanks

Joseph F Goldberg, MD replied to snowyowl33's response:
Sounds more like you are describing a rumination or a preoccupation, unless the theme involves mistrust or a hidden meaning in someone's words or actions that you suspect involves malicious intent.
- Dr. G.
snowyowl33 replied to Joseph F Goldberg, MD's response:
Gotcha! thanks....
ibex7 replied to Joseph F Goldberg, MD's response:
Dr. G,

Along with this discussion, we should also remember that paranoia is a cleansing term that is used all to frequently in the workplace today. Bipolars are often justified by malicious intent, when their superiors direct them to the Human Resources Department or the Equal Opportunity Office for psychiatric review.

Anyone who is in an "invited out" category will be "decontaminated" by a professional and paperwork falsified in order to disguise or cleanse the reason that person is being shown the street. BTDT. Bipolar is real life.
erica22042010 replied to Joseph F Goldberg, MD's response:
I am scared to eat things that my bf fixes and brings home from work he works at a restaraunt and then im scared to eat their food bc i think they will put sumthing in it to harm me but i know they wont but it still scares me and i have panic attacks and been diagnosed with ptsd, anxiety, bipolar 2 disorder, agoraphbic and alot more i just want to be normal again i hate living in fear and panic
jbitt03 replied to Joseph F Goldberg, MD's response:
Is hearing things, like for example I hear something speaking (I hear the words clearly) to me when I'm alone, a sign of Paranoia? Or is it something else? I'm confused b/c I read in a book that Bipolar can sometimes mimic Schitsophrenia.
Joseph F Goldberg, MD replied to jbitt03's response:
Technically, hearing something that is not there is a hallucination (false perception). A paranoid belief, if it is a strong conviction and not based in reality, is a delusion (false idea). Hallucinations and delusions are different phenomena -- but both can be signs of psychosis. Psychosis is a defining feature in schizophrenia, and in fact the main feature. In bipolar disorder, psychosis can occur as a related symptom during mood episodes, but by definition, and unlike schizophrenia, psychosis does not occur in the absence of mood symptoms.
- Dr. G.
jbitt03 replied to Joseph F Goldberg, MD's response:
Thank you!
ADDgirl1213 replied to Joseph F Goldberg, MD's response:
I have a question, how would I be able to convince my doctor that I have ADD problem he seems not to believe me and says that its depression affecting my concitration, now I think I would know if i was depressed which I am not I know whats wrong with me I have a major learning problem that was the cause of me dropping out in the 7th grade because I never understood what the teacher was talking about and now I want to get my GED and get into college but I get frustrated when I do school work because I have to study harder then the average person and I always give up and tell myself that im never going to be able to do anything with my life because of this condition . So would you please let me know thank you.
hope7951 replied to ADDgirl1213's response:
I thought the doctor's suggestion that you work with a cognitive therapist might help you identify precisely where your concentration difficulties are coming from. It may not be ADD but some other condition effecting you.

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