Category: schizophrenia

Medical: Paranoia & Delusions

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Delusional 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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A Very English Pigeon

“I will instruct you and teach you in the way you should go; I will counsel you with my eye upon you.”

Psalm 32:8

In April 2002, I was sitting in a cavernous waiting room at King’s Cross in London, England.  I was waiting for a bus to Cambridge, UK.  I sat all alone and stared at the tiled floor at my feet.  The doctors had warned me not to travel alone, but I ignored their advice.

And now I was starting to really unravel.

Depression had followed me all the way from Alaska to England. I had pushed my limits and was completely drained and was becoming very confused.  I began to cry out to the Lord, very desperately. Sometimes madly. (Read Psalm 88.)

As I sat there staring intensely at the floor, several pigeons seemed to put on a show, just for me. They were fat little guys, apparently scratching out a good living. Several very large windows were open, and these pigeons seemed to have no fear as they took advantage of a meal from bored travelers.

All of a sudden something very odd happened. 

A pigeon came across the floor and “presented” himself, right square in front of me.  I watched him intently and saw that he was crippled, one of his feet was nothing more than a twisted claw.  He had been profoundly injured in such a way, that he would never be the same.  He was damaged, and yet somehow he was surviving, but even more, and he was thriving!

It was like experiencing a lightning bolt. God’s own light switch was being flipped.

I saw that pigeon, and I saw myself, and it was a moment of clarity, a shining grace.  In the mega-hustle of 13.6 million people in London, and in the midst of my own profound mental crisis, I knew God’s caring touch and it gave me real grace, love, and goodness–far greater than all my sin and confusion. He was just letting me know that He was very, very close. (See Psalm 34:18.)

I had seen my damaged pigeon, completely oblivious to self-pity.

I started to call out to the Father out of my confusion.  Within a few minutes, I found myself sitting on the top level of a double decker bus, with the driver aware of my problems and who specifically drove me to the place I was staying. 

I was being cared for. Between a crippled pigeon and the dutiful ministrations of a bus driver, I’d finally found my hotel. (See Matthew 6:26.) 

I have come to realize that this trip to England was not for me to see Big Ben, Parliament, or wander the academic schools of Cambridge University.  Rather I was brought there to make contact with a certain pigeon, who was waiting to meet me and pass on vital instructions. 

The Father shared things that I need to know.  British castles and churches are beautiful and worth seeing but I must admit I’ve forgotten much. I hope I can return someday.

But on this trip, all I really needed to see was a crippled English pigeon who was just waiting to meet me.

In Need of Grace–Quotes

I’ve put together a collection of quotes one of my favorite authors, Brennan Manning.  I have found that when he writes, he penetrates.  What he writes goes deep into the soul of losers: junkies, drunks, and mentally ill people–he tells us of God’s love like few have ever done. 

To Manning, every person is redeemable, none are too far gone.  Brennan Manning was a strong voice to the weak, the lame, the mentally challenged, and for the prodigal.

I blame him for the theme of this post–that brokenness is our path out of depression: Bipolar, Schizophrenia, OCD, PTSD, Schizoaffective disorder, and addictions.

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“There is a beautiful transparency to honest disciples who never wear a false face and do not pretend to be anything but who they are.”

“My deepest awareness of myself is that I am deeply loved by Jesus Christ and I have done nothing to earn it or deserve it.”

 “To live by grace means to acknowledge my whole life story, the light side and the dark. In admitting my shadow side I learn who I am and what God’s grace means.”

“To be alive is to be broken; to be broken is to stand in need of grace.”

“Christianity doesn’t deny the reality of suffering and evil… Our hope… is not based on the idea that we are going to be free of pain and suffering. Rather, it is based on the conviction that we will triumph over suffering.”

“I am what I am in the sight of Jesus and nothing more. It is His approval that counts.”

“[Be] daring enough to be different, humble enough to make mistakes, wild enough to be burnt in the fire of love, real enough to make others see how phony [you] are.”

“The blood of the Lamb points to the truth of grace: what we cannot do for ourselves, God has done for us. On the cross, somehow, someway, Christ bore our sins, took our place, died for us. At the cross, Jesus unmasks the sinner not only as a beggar but as a criminal before God.”

“Do the truth quietly without display.”

“It is for the inconsistent, the unsteady disciples whose cheese is falling off their cracker.”

“The dominant characteristic of an authentic spiritual life is the gratitude that flows from trust—not only for all the gifts that I receive from God, but gratitude for all the suffering. Because in that purifying experience, suffering has often been the shortest path to intimacy with God.”

“The greatest single cause of atheism in the world today is Christians, who acknowledge Jesus with their lips and walk out the door and deny him with their life style. That is what an unbelieving world simply finds unbelievable.”

“The saved sinner is prostrate in adoration, lost in wonder and praise. He knows repentance is not what we do in order to earn forgiveness; it is what we do because we have been forgiven. It serves as an expression of gratitude rather than an effort to earn forgiveness.”

“In essence, there is only one thing God asks of us–that we be men and women of prayer, people who live close to God, people for whom God is everything and for whom God is enough. That is the root of peace.”

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I really hope some of these quotes have connected.  Brennan Manning has authored several books all of which I can heartily recommend. 


Delusions of the First Person Variety

I need to briefly share what delusions are like.  I’m going to flip the switch and flood the room with light, and watch the “critters” scuttle to find a hiding place. 
I’m doing this to help heal myself, and for you to understand this awful state of mind.
First of all, let’s define things. 

Delusion n.
A false belief held despite strong evidence against it; self-deception. Delusions are common in some forms of psychosis. 

Delusion de·lu·sion n.
A false belief strongly held in spite of invalidating evidence, especially as a symptom of mental illness.

Typically, my delusions have a common core of pride or self-centered thinking. For instance, I have experienced all of these to a degree:

  1. A woman loves me and she is secretly trying to be with me. This is very flattering and egocentric.  This  one can really mess with your thought-life. (Ego.)
  2. I’m the center of the universe, people really do not exist, except when they come into my life or influence.  [This one is a bit metaphysical.] See #7.
  3. I have special powers that ‘know” a person’s motives, plans and heart.  I am hyper-discerning.  The opposite can be true at times, where I become exposed to people, which necessitates me never leaving my room. I feel “naked” and of course, very uncomfortable.
  4. I get paranoid, thinking people are plotting with each other behind my back, working to destroy me.  Chat rooms, and Facebook are focal points for me with this one, but not always.  With this one I get really verbal, and I start zapping people.  I guess because it’s the internet I can do this with impunity.
  5. Clocks are always at the top of the hour, like- 7:00 am.  Or they are at the bottom of the hour, like 11:30 pm.  I call this “chronosynchronism.” I believe this is evidence that my life is orchestrated, purposeful, and this is evidence I am very significant.  This is my latest.  And it really isn’t super disruptive.
  6. I can read secret messages in books meant for me.  I also line up spaces in what I’m reading to form an unbroken line.  I compulsively do this.
  7. The big one is this, I am in my form of “The Truman Show”.  The universe is just a set and I am the only living thing out there.  Everything is focused on me (of course).
  8. I hear voices sometimes, but mostly a radio or sometimes the “dot-dash-dot” of a telegraph.  I think its trying to warn me in some code.  It can be persistent. And it can be disruptive. Paranoid because my giftedness is the primary reason for the NSA to control me.
  9. My wife intends to poison me.
  10. Personal hygiene issues. Afraid of being murdered in the shower creates a super-phobia. I once went 6 weeks without showering. (I made my own eyes ‘water’, lol).
I guess all of these have one thing in common. 

They are self-centered.  They are unreasonable and illogical.  They are compulsive. And yes, meds do work.  And the above list?  The delusions are only mild-to-moderate issues of delusional paranoia.  There are so many Christians and non-Christians who have worse. I once met a man who seriously believed he was Jesus. (And no, I didn’t worship him).

As a believer working out his discipleship, I’ve discovered that humility and openness is always the way of keeping one tethered to reality.  However, I have a fear that I will break loose and never come out again.  I MUST live in “brokenness”.  (So in a strange way, following Jesus Christ is easier.)

Also, I must be open to things that will invalidate my delusion.  Even if I’m 99% convinced, that 1% will cause me to consider thinking through a scenario.  Truth is your best friend when you are challenging a delusional paranoid.  But it has to be gently applied. Life doesn’t have be lived this way. Also, delusions will often ‘morph’ and change and take on modified characteristics. This seems to be part of the mental illness, but can also indicate demonic oppression (or both even).

A psychiatrist should be informed in most cases. Very often meds will be necessary to get you through this time, but not always. But sometimes.

Praying for delusional behavior

People have prayed for me, more then I have prayed for myself.  Your intercession bridges a gap over this illness.  When you pray, you power up the energy cells and get instructions.  It may mean wait, or proceed.  Every person and situation is different.

“Do not believe that he who seeks to comfort you lives untroubled among the simple and quiet words that sometimes do you good. His life has much difficulty and remains far behind yours. Were it not otherwise he would never been able to find these words.”
Rainer Maria Rilke
Prayer is always the best approach.

So many delusions and so little time. They will vary from person-to-person. An active prayer may help, “Lord, may it be the real me who touches the real You.” Remember, Jesus stands at the right hand of his Father praying for you [which can’t be all bad].

 
 “Who is to condemn? Christ Jesus is the one who died—more than that, who was raised—who is at the right hand of God, who indeed is interceding for us.”

Romans 8:34

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