Filed under: Amazing Mind
Paranoid schizophrenia is one of several types of schizophrenia, a chronic mental illness in which a person loses touch with reality (psychosis). The classic features of paranoid schizophrenia are having delusions and hearing things that aren't real.
With paranoid schizophrenia, your ability to think and function in daily life may be better than with other types of schizophrenia. You may not have as many problems with memory, concentration or dulled emotions. Still, paranoid schizophrenia is a serious, lifelong condition that can lead to many complications, including suicidal behavior.
With effective treatment, you can manage the symptoms of paranoid schizophrenia and work toward leading a happier, healthier life.
Signs and symptoms of paranoid schizophrenia may include:
With paranoid schizophrenia, you're less likely to be affected by mood problems or problems with thinking, concentration and attention.
Delusions and hallucinations are the symptoms that make paranoid schizophrenia most distinct from other types of schizophrenia.
When to see a doctor
If you have any paranoid schizophrenia symptoms, seek medical help as soon as possible. Paranoid schizophrenia doesn't get better on its own and may worsen without treatment. However, if you're like most people with paranoid schizophrenia, you may not recognize that you need help or that you even have symptoms. This is because your delusions or hallucinations seem very real to you. Family and friends or people at work or school may be the ones who initially suggest you seek help.
Getting treatment from a mental health provider with experience in schizophrenia can help you learn ways to manage your symptoms so that you have the best chance of leading a productive and happy life. If you're not ready to seek treatment, try to work up the courage to confide in someone, whether it's a friend or loved one, a health care professional, a faith leader or someone else you trust. They can help you take the first steps to successful treatment.
Helping someone who may have paranoid schizophrenia
If you have a loved one you think may have symptoms of paranoid schizophrenia, have an open and honest discussion about your concerns. You may not be able to force someone to seek professional help, but you can offer encouragement and support and help your loved one find a qualified doctor or mental health provider.
If your loved one poses a danger to himself or herself or to someone else, you may need to call the police or other emergency responders for help. In some cases, emergency hospitalization may be needed. Laws on involuntary commitment for mental health treatment vary by state.
Suicidal thoughts and behavior are common when you have paranoid schizophrenia. If you're considering suicide right now and have the means available, talk to someone now. Call 911 or your local emergency services number.
If you simply don't want to do that, for whatever reason, you have other choices for reaching out to someone:
Although the precise cause of paranoid schizophrenia isn't known, certain factors seem to increase the risk of developing or triggering paranoid schizophrenia, including:
Signs and symptoms of schizophrenia typically develop between the teenage years and the mid-30s.
Left untreated, paranoid schizophrenia can result in severe emotional, behavioral, health, and even legal and financial problems that affect every area of your life. Complications that paranoid schizophrenia may cause or be associated with include:
In some cases, a health care provider, family member, friend or another acquaintance may ask about your behavior, thoughts and mood or suggest that you be evaluated by a mental health provider. Or you may decide on your own to schedule an appointment with your family doctor or mental health provider to talk about your concerns. In some cases, you may be taken to a hospital for an emergency psychiatric evaluation.
What you can do
Being an active participant in your care can help your efforts to manage your condition. One way to do this is by preparing for a planned medical or psychiatric appointment. Think about your needs and goals for treatment. Also, write down a list of questions to ask. These questions may include:
In addition to your prepared questions, don't hesitate to ask questions during your appointment if you don't understand something.
What to expect from your doctor
During your appointment, your doctor or mental health provider is likely to ask you a number of questions about your thoughts, behavior and mood. You may be asked such questions as:
If your doctor or mental health provider believes you may have paranoid schizophrenia or another mental illness, he or she typically runs a series of medical and psychological tests and exams. These can help pinpoint a diagnosis, rule out other problems that could be causing your symptoms and check for any related complications.
These exams and tests generally include:
Diagnostic criteria for paranoid schizophrenia
To be diagnosed with paranoid schizophrenia, you must meet the symptom criteria spelled out in the Diagnostic and Statistical Manual of Mental Disorders (DSM). This manual, published by the American Psychiatric Association, is used by mental health providers to diagnose mental conditions and by insurance companies to reimburse for treatment.
Diagnostic criteria for paranoid schizophrenia include:
It can sometimes be difficult to diagnose paranoid schizophrenia, especially because other conditions may have similar symptoms. Be sure to stick with it, though, so that you can get appropriate treatment.
Paranoid schizophrenia is a chronic condition that requires lifelong treatment, even during periods when you feel better and your symptoms have lifted. You may feel as if you don't need treatment, and you may be tempted to ignore treatment recommendations. But effective treatment can help you take control of your condition and enjoy a happier and healthier life.
Treatment options are similar for all types of schizophrenia. But the specific treatment approach that's best for you depends on your particular situation and the severity of your symptoms.
Paranoid schizophrenia treatment is usually guided by a psychiatrist skilled in treating the condition. But you may have others on your treatment team as well because the condition can affect so many areas of your life. Your treatment team can help make sure that you're getting all of the treatment you need and that your care is coordinated among all of your health care providers.
The team involved in treatment of paranoid schizophrenia may include your:
Main treatment options
The main treatments for paranoid schizophrenia are:
Medications for paranoid schizophrenia
Medications are a key paranoid schizophrenia treatment. Among the medications most commonly prescribed for paranoid schizophrenia are:
Choosing a medication
In general, the goal of treatment with antipsychotic medications is to effectively control signs and symptoms at the lowest possible dosage. Which medication is best for you depends on your own individual situation. It can take several weeks after first starting a medication to notice an improvement in your symptoms.
If one medication doesn't work well for you or has intolerable side effects, your doctor may recommend combining medications, switching to a different medication or adjusting your dosage. Don't stop taking your medication without talking to your doctor, even if you're feeling better. You may have a relapse of psychotic symptoms if you stop taking your medication. In addition, antipsychotic medication needs to be tapered off, rather than stopped abruptly, to avoid withdrawal symptoms.
Medication side effects and risks
All antipsychotic medications have side effects and possible health risks. Certain antipsychotic medications may increase the risk of diabetes, weight gain, high cholesterol and high blood pressure, for instance. Others can cause dangerous changes in your white blood cell count or cause health problems in older adults.
Be sure to talk to your doctor about all of the possible side effects and about being routinely checked for health problems while you take these medications. Antipsychotic medications can also have dangerous interactions with other substances. Tell your doctor about all medications and over-the-counter substances you take, including vitamins, minerals and herbal supplements.
Psychotherapy for paranoid schizophrenia
Although medications are the cornerstone of paranoid schizophrenia treatment, counseling (psychotherapy) also is essential. Psychotherapy may include:
Individual therapy. Psychotherapy with a skilled mental health provider can help you learn ways to cope with the distress and daily life challenges brought on by paranoid schizophrenia. One approach, called cognitive behavioral therapy, has proven to be especially helpful in the treatment of paranoid schizophrenia. In cognitive behavioral therapy, a mental health provider helps you recognize — and change — harmful ideas and behaviors. As part of this process, your therapist will help you look back on your personal history. Together you're likely to gain insights into when, and why, you may have started to form those ideas and behaviors. Then, building from this new understanding, your therapist can help you start to change those patterns.
Psychotherapy can help reduce the severity of your symptoms and improve communication skills, relationships, your ability to work and your motivation to stick to your treatment plan. Learning about paranoid schizophrenia can help you understand it better, cope with lingering symptoms and understand how medications could be helpful. Therapy can also help you cope with stigma surrounding paranoid schizophrenia.
Hospitalization for paranoid schizophrenia
During crisis periods or times of severe symptoms, hospitalization may be necessary. This can help ensure your own safety and that of others, and make sure that you're getting proper nutrition, sleep and hygiene. Partial hospitalization and residential care also may be options.
Electroconvulsive therapy (ECT) for paranoid schizophrenia
Electroconvulsive therapy (ECT) is a procedure in which electric currents are passed through your brain to trigger a brief seizure. This seems to cause changes in brain chemistry that can reduce symptoms of certain mental illnesses such as paranoid schizophrenia. Because ECT can provide significant improvements in symptoms more quickly than can medications or psychotherapy, electroconvulsive therapy may be the best treatment option in some cases. Deciding whether electroconvulsive therapy is a good option for you can be extremely difficult. Make sure you understand all the pros and cons.
Social and vocational skills training for paranoid schizophrenia
Training in social and vocational skills to live independently is an important part of recovery from paranoid schizophrenia. With the help of a therapist, you can learn such skills as good hygiene, cooking and better communication. Many communities have programs that can help you with jobs, housing, self-help groups and crisis situations. If you don't have a case manager to help you with these services, ask your doctor about getting one.
Paranoid schizophrenia isn't an illness that you can treat on your own. But you can do some things for yourself that will build on your treatment plan:
Coping with an illness as serious as paranoid schizophrenia can be challenging. Medications can have unwanted side effects, and you may feel angry or resentful about having a condition that requires lifelong treatment. During periods when you feel better, you may be tempted to stop treatment, which can trigger a relapse. Here are some ways to cope with paranoid schizophrenia:
There's no sure way to prevent paranoid schizophrenia. Evidence shows that some signs of schizophrenia may be present from early childhood or even infancy. Early identification and treatment for people at risk of schizophrenia, perhaps starting in childhood, may help get symptoms under control before serious complications develop and may help improve the long-term outlook. Also, sticking with your treatment plan can help prevent relapses or worsening of paranoid schizophrenia symptoms.