When you bring up the general topic of schizophrenia to those who aren’t very familiar with the illness you can almost guarantee yourself that they are thinking of paranoid schizophrenia without realizing it. However, paranoid schizophrenia is just one of the types of schizophrenia that manifests itself symptomatically. The reason people make this connection is largely due to the media sensationalizing the paranoid sub-type because it features the most outwardly noticeable positive symptoms, which as you can imagine, make for the most interesting movie characters. So in this article we are going to forget about catatonic and disorganized schizophrenia for the moment and just focus on the specifics pertaining to paranoid schizophrenia, including the symptoms and the treatment modalities available.
Paranoid Schizophrenia Symptoms
What sets the paranoid type of schizophrenia apart from the others is the type of symptoms experienced. There is a set of symptoms that are referred to as “negative” because they feature a reduction of outwardly perceivable actions such as physical movements, an emotional affect, and a dampened thought process. Paranoid schizophrenia in it’s pure form is confined to a set of symptoms that classified as “positive.” This does not mean they are better in some fashion, but that they produce activities in the sufferer that others can notice from an outsider perspective. They are an addition rather than a subtraction of functioning.
Obviously, due to the label of this type of schizophrenia, one of the main features of paranoid schizophrenia is paranoia. Paranoia can lead a person to believe that they are being persecuted in some manner, which in turn can lead to jealousy and other types of inflated self-importance, making one feel as if they play a larger role in events than they actually do. This paranoia arises specifically out of the symptoms related to delusions. Delusions are a problem of misperception in regards to thinking. These distortions do not always make a person feel paranoid, but in paranoid schizophrenia it constantly does.
Throughout this site we’ve mentioned examples of the delusions that can arise, and while the details often change the complexity and resistance to self-awareness is always present. In regards to persecution, a person might find themselves at the center of a vast conspiracy. Whether this be the government, aliens, demonic forces, or any number of metaphysical entities, unrealistically it all revolves around the individual suffering from the delusion. Their self-importance is lifted beyond any reasonable measure endowing them with secret knowledge or messianic powers and therefore they must be stopped by this large group of conspirators. Unfortunately, delusions are a distortion of the mind and prevent the sufferer from obtaining a self-awareness of the situation. Anyone who tries to explain to them that the plot against them is not real will also be considered a conspirator, sent to confuse and disseminate false information. Medication becomes a must in this situation in order to curb the symptoms enough that the person can understand that they need help.
Another problematic symptom surrounding this type of schizophrenia is that of the hallucination. Hallucinations, as opposed to delusions which are a distortion of thinking, are distorions of perception. Normal perceptions are somehow filtered and become quite disturbing. Since they are unsettling, they cause the experiencer a certain amount of anxiety which usually leads to the hallucinations to take on a sinister tone. These can affect any of the five external senses and even the internal sense of thinking. A person may see objects that do not exist or will see distorted versions of objects that are verifiably there. The same goes with hearing in which a person may hear a running commentary in their head, criticizing all of their actions and thoughts. They may also hear music or other noises that are either not there or are distorted versions of real sounds. Smelling strange smells such as decomposing flesh, burning hair, or unidentifiable odors is common, along with feelings along the skin which can lead to the delusion that one is covered or has bugs crawling underneath their skin. This, combined with a delusion of persecution, can lead one to believe that the government or extraterrestrials have implanted devices under their skin in order to track their location or read their minds. Hallucinations can become very severe and will also require medication in order to cease their activity.
Paranoid Schizophrenia Treatment
There are many angles that this psychological difficulty should be approached from.
The first step in treating paranoid schizophrenia should be the administration of medication. Unfortunately, this may require an intervention by family members and professional members of the medical and psychiatric society. Having a police officer present is important to ensure everyone’s safety and that the individual suffering from these symptoms does not have his or her personal rights violated. Because the individual may not realize there is a problem arising in their cognition, they will fight the need for treatment, but once the person can be made to be medicated the symptoms will subside enough for them to regain self-awareness. Even then, a maintenance level of medication will be involved.
Beyond this, some form of therapy will be required. I am a large proponent of cognitive-behavioral therapy which emphasizes the behaviors of the mind. A person should be prompted to begin keeping a journal of when and where their symptoms flare up in order to understand what could be triggering them in the environment or mind. This is the first step in gaining self-awareness. Once this is understood and a person can begin monitoring and managing their environment, then they can be trained to watch out for “red flags.” When a symptom of delusion or hallucination begins to rear it’s ugly head, the person should immediately notice it and then perform certain de-escalation techniques they have learned from their therapist. In this manner, they can keep their anxiety levels low and their symptomatic expressions under control.
Conclusion and Summary
Paranoid schizophrenia is one of the several types of schizophrenia, however it is the type that most people think of when considering the topic. It features certain positive symptoms that are termed delusions and hallucinations which are distortions of thinking and perception, respectively. Due to the lack of self-awareness in the paranoid schizophrenic, an intervention may be required first before beginning a regimen of medication. Once self-awareness is regained, cognitive-behavioral therapy support can occur. This is a horrifying experience for people, quite otherworldly, and will be difficult to integrate even after treatment. Family and social support is a must to help the sufferer stay on the track to recovery.