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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Welcome to Schizophrenia

Do you know someone who seems like he or she has “lost touch” with reality? Does this person talk about “hearing voices” no one else can? Does he or she see or feel things that others can’t? Does this person believe things that aren’t true?

Sometimes people with these symptoms have schizophrenia, a serious illness.

What is schizophrenia?

Schizophrenia is a serious brain illness. Many people with schizophrenia are disabled by their symptoms.

People with schizophrenia may hear voices other people don’t hear. They may think other people are trying to hurt them–we call this paranoia. Sometimes they don’t make any sense when they talk. The disorder makes it hard for them to keep a job or take care of themselves.

Who gets schizophrenia?

Anyone can develop schizophrenia. It affects men and women equally in all ethnic groups. Teens can also develop schizophrenia. In rare cases, children have the illness too.

When does it start?

Symptoms of schizophrenia usually start between ages 16 and 30. Men often develop symptoms at a younger age than women. People usually do not get schizophrenia after age 45.


What causes schizophrenia?

Several factors may contribute to schizophrenia, including:

  • Genes, because the illness runs in families
  • The environment, such as viruses and nutrition problems before birth
  • Different brain structure and brain chemistry.

Scientists have learned a lot about schizophrenia. They are identifying genes and parts of the brain that may play a role in the illness. Some experts think the illness begins before birth but doesn’t show up until years later. With more study, researchers may be able to predict who will develop schizophrenia.

What are the symptoms of schizophrenia?

Schizophrenia symptoms range from mild to severe. There are three main types of symptoms.

Positive symptoms refer to a distortion of a person’s normal thinking and functioning.

They are “psychotic” behaviors. People with these symptoms are sometimes unable to tell what’s real from what is imagined. Positive symptoms include:
  • Hallucinations: when a person sees, hears, smells, or feels things that no one else can. “Hearing voices” is common for people with schizophrenia. People who hear voices may hear them for a long time before family or friends notice a problem.
  • Delusions: when a person believes things that are not true. For example, a person may believe that people on the radio and television are talking directly to him or her. Sometimes people believe that they are in danger-that other people are trying to hurt them.
  • Thought disorders: ways of thinking that are not usual or helpful. People with thought disorders may have trouble organizing their thoughts. Sometimes a person will stop talking in the middle of a thought. And some people make up words that have no meaning.
  • Movement disorders: may appear as agitated body movements. A person with a movement disorder may repeat certain motions over and over. In the other extreme, a person may stop moving or talking for a while, a rare condition called “catatonia.”

Negative symptoms refer to difficulty showing emotions or functioning normally.

When a person with schizophrenia has negative symptoms, it may look like depression. People with negative symptoms may:
  • Talk in a dull voice
  • Show no facial expression, like a smile or frown
  • Have trouble having fun
  • Have trouble planning and sticking with an activity, like grocery shopping
  • Talk very little to other people, even when they need to.

Cognitive symptoms are not easy to see, but they can make it hard for people to have a job or take care of themselves.

Cognitive symptoms include:
  • Trouble using information to make decisions
  • Problems using information immediately after learning it
  • Trouble paying attention.

Helpful Links for Further Thought

The Mayo Clinic: Good, solid and trustworthy, a great introduction.

WebMd: Early Signs to look for.

World Health Organization: More advanced, but still accessible and understandable.

 

God’s Broken Ones, Quotes

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.

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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. 


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.