Paranoia & Delusions

superhero_400pxDelusional disorder, (previously called paranoid disorder,) is a type of serious mental illness called a “psychosis in which a person cannot tell what is real from what is imagined. The main feature of this disorder is the presence of delusions, which are unshakable beliefs in something untrue.

People with delusional disorder experience non-bizarre delusions, which involve situations that could occur in real life, such as being followed, poisoned, deceived, conspired against, or loved from a distance. These delusions usually involve the misinterpretation of perceptions or experiences. In reality, however, the situations are either not true at all or highly exaggerated.

People with delusional disorder often can continue to socialize and function normally, apart from the subject of their delusion, and generally do not behave in an obviously odd or in a bizarre manner. This is unlike people with other psychotic disorders, who also might have delusions as a symptom of their disorder. In some cases, however, people with delusional disorder might become so preoccupied with their delusions that their lives are disrupted.

Types of delusional disorder

There are different types of delusional disorder based on the main theme of the delusions experienced. The types of delusional disorder include:

  • Erotomanic — Someone with this type of delusional disorder believes that another person, often someone important or famous, is in love with him or her. The person might attempt to contact the object of the delusion, and stalking behavior is not uncommon.
  • Grandiose — A person with this type of delusional disorder has an over-inflated sense of worth, power, knowledge, or identity. The person might believe he or she has a great talent or has made an important discovery.
  • Jealous — A person with this type of delusional disorder believes that his or her spouse or sexual partner is unfaithful.
  • Persecutory — People with this type of delusional disorder believe that they (or someone close to them) are being mistreated, or that someone is spying on them or planning to harm them. It is not uncommon for people with this type of delusional disorder to make repeated complaints to legal authorities.
  • Somatic — A person with this type of delusional disorder believes that he or she has a physical defect or medical problem.
  • Mixed — People with this type of delusional disorder have two or more of the types of delusions listed above.

Basic Principles

There are no systematic studies on treatment approaches and results in Delusional Disorder. The patient’s distrust and suspiciousness usually prevents any contact with a therapist.

Hospitalization

Hospitalization is indicated if a potential for danger is present; otherwise outpatient management is advisable. Unfortunately, involuntary hospitalization may increase distrust and resentment and increase the patient’s persecutory delusions.

Antipsychotic Drugs

Antipsychotic medication may be useful, particularly for accompanying anxiety, agitation, and psychosis. Because patients may be suspicious of medication, depot forms may be helpful. Although antipsychotics may have a good response, they are often only marginally effective for specific forms of Delusional Disorder.

Other Therapies

Other treatments have been tried (electroconvulsive therapy, insulin shock therapy, and psychosurgery), but these approaches are not recommended.


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Helpful Links:

http://www.mentalhealth.com/rx/p23-ps02.html

http://my.clevelandclinic.org/disorders/delusional_disorder/hic_delusional_disorder.aspx

 

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Understanding Schizophrenia

Symptoms

By Mayo Clinic staff

There are several types of schizophrenia, so signs and symptoms vary. In general, schizophrenia symptoms include:

  • Beliefs not based on reality (delusions), such as the belief that there’s a conspiracy against you
  • Seeing or hearing things that don’t exist (hallucinations), especially voices
  • Incoherent speech
  • Neglect of personal hygiene
  • Lack of emotions
  • Emotions inappropriate to the situation
  • Angry outbursts
  • Catatonic behavior
  • A persistent feeling of being watched
  • Trouble functioning at school and work
  • Social isolation
  • Clumsy, uncoordinated movements

Schizophrenia ranges from mild to severe. Some people may be able to function well in daily life, while others need specialized, intensive care. In some cases, schizophrenia symptoms seem to appear suddenly. Other times, schizophrenia symptoms seem to develop gradually over months, and they may not be noticeable at first.

Over time, it becomes difficult to function in daily life. You may not be able to go to work or school. You may have troubled relationships, partly because of difficulty reading social cues or others’ emotions. You may lose interest in activities you once enjoyed. You may be distressed or agitated or fall into a trance-like state, becoming unresponsive to others.

In addition to the general schizophrenia symptoms, symptoms are often categorized in three ways to help with diagnosis and treatment:

Negative signs and symptoms
Negative signs and symptoms represent a loss or decrease in emotions or behavioral abilities. They may include:

  • Loss of interest in everyday activities
  • Appearing to lack emotion
  • Reduced ability to plan or carry out activities
  • Neglecting hygiene
  • Social withdrawal
  • Loss of motivation

Positive signs and symptoms
Positive signs and symptoms are unusual thoughts and perceptions that often involve a loss of contact with reality. These symptoms may come and go. They may include:

  • Hallucinations, or sensing things that aren’t real. In schizophrenia, hearing voices is a common hallucination. These voices may seem to give you instructions on how to act, and they sometimes may include harming others.
  • Delusions, or beliefs that have no basis in reality. For example, you may believe that the television is directing your behavior or that outside forces are controlling your thoughts.
  • Thought disorders, or difficulty speaking and organizing thoughts, such as stopping in midsentence or jumbling together meaningless words, sometimes known as “word salad.”
  • Movement disorders, such as repeating movements, clumsiness or involuntary movements.

Cognitive signs and symptoms
Cognitive symptoms involve problems with memory and attention. These symptoms may be the most disabling in schizophrenia because they interfere with the ability to perform routine daily tasks. They include:

  • Problems making sense of information
  • Difficulty paying attention
  • Memory problems
When to see a doctor:

People with schizophrenia often lack awareness that their difficulties stem from a mental illness that requires medical attention. So it often falls to family or friends to get them help.

Suicidal thoughts and behavior

Suicidal thoughts and behavior are common among people with schizophrenia. If you have a loved one who is in danger of committing suicide or has made a suicide attempt, make sure someone stays with that person. Call 911 or your local emergency number immediately. Or, if you think you can do so safely, take the person to the nearest hospital emergency room.

 

For more info, Mayo Clinic has more on its website: http://www.mayoclinic.com/health/schizophrenia/DS00196/DSECTION=symptoms

 

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Bedlam: Prisons and the Mentally Ill

Taking a Stand for Our Brothers and Sisters

 By Mark Earley, Christian Post Guest Columnist, Wed, Aug. 08, 2007
The least of these is my brother
The least of these is my brother

In the 16th century, London’s mentally ill were often kept at Bethlem Royal Hospital. The conditions inside the hospital were notoriously poor. Patients were often chained to the floor and the noise was so great that Bethlem was more likely to drive a man crazy than to cure him. The conditions were so infamous that the nickname locals gave the hospital—Bedlam—has come to mean any scene of great confusion.

Unfortunately five hundred years later, we’re still treating the mentally ill more like prisoners than patients. Fifty years ago, more than 550 thousand people were institutionalized in public mental hospitals. Today, only between 60 and 70 thousand are, despite a two-thirds increase in the country’s population.

Since there’s no evidence that the incidence of mental illness has dropped precipitously, the mentally ill who previously had been institutionalized had to have gone somewhere. While some are being treated successfully in their communities, at homes and groups homes, but for many that “somewhere” is behind bars. This last part shouldn’t come as a surprise.

Five years ago, the Washington Post told the story of “Leon,” a one-time honor student, who had 17 years in and out of jail on various drug-related charges. It was only after several suicide attempts, including drinking a “bleach-and-Ajax cocktail,” that Leon was diagnosed with bipolar disorder. Leon’s story was a microcosm of a larger problem: “Prisons and jails are increasingly substituting as mental hospitals.”

As one advocate for the mentally ill told the Post, “a lot of people with mental illness are charged with minor crimes as a way to get them off the streets.” In effect, they are behind bars for “being sick.” Fast forward five years and little, if anything, has changed. A few weeks ago, another piece in the Post discussed the same problem.

Psychiatrist Marcia Kraft Goin told readers something that should shock and outrage them: “The Los Angeles County Jail houses the largest psychiatric population in the country.” As with the earlier Post piece, the conclusion was inescapable: “People with [untreated] mental illnesses often end up with symptoms and behaviors that result in jail time.” You don’t have to be a “bleeding heart” to understand that this is an injustice—any kind of heart will do.

Not only are the mentally ill not getting the help they need, they are as lambs to the slaughter in our crowded and violent prisons. They are being victimized twice over. They’re not the only ones being victimized.

At a time when most state prisons are unlawfully overcrowded, there are better uses for prison beds than as makeshift mental hospitals. As Goin wrote, “treating” mental illness as a criminal justice problem costs “more than treating patients appropriately in their community.”

As part of its ministry to prisoners and their families, Prison Fellowship supports community-based alternatives to incarceration. Not only because it makes “financial sense” but because it’s what Christ would have done. In Matthew 25 he called the ill and the prisoner his “brothers” and he expects us to offer them something more than bedlam.

“There but for the Grace of God go I…” –Bryan

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From BreakPoint®, August 6, 2007, Copyright 2007, Prison Fellowship Ministries. Reprinted with the permission of Prison Fellowship Ministries. All rights reserved.  “BreakPoint®” and “Prison Fellowship Ministries®” are registered trademarks of Prison Fellowship.

Good Links:

http://en.wikipedia.org/wiki/Bethlem_Royal_Hospital

http://www.bethlemheritage.org.uk/

http://www.pbs.org/wgbh/pages/frontline/shows/asylums/etc/faqs.html

http://www.afscme.org/publications/6042.cfm