Bipolar Disorder and Paranoia: Signs and Symptoms

Psychotic Features of Bipolar Disorder with Signs and Symptoms

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Bipolar disorder and paranoia are linked but there are distinctions that people suffering with bipolar should know about.

Paranoia Defined

Paranoia is a term that in common, everyday language is used to mean everything from feeling nervous about a person or situation to being convinced that somebody is "out to get you." In his song "Almost Cut My Hair," David Crosby expressed this common usage well when he said, "It increases my paranoia, like looking in my mirror and seeing a police car." I'll wager almost everyone feels uneasy (and watches speed, signals and everything else) when police officers are right behind them.

Clinical Paranoia

People may call that type of experience paranoia, but the clinical diagnosis of paranoia requires a more specific explanation. Psychiatrists use the term paranoia to describe a disordered way of thinking or an anxious state that attains the level of a delusion. For example, a person who believes the FBI is tracking her every move through the fillings in her teeth is exhibiting paranoid behavior. On the other hand, a criminal who believes the FBI is listening in on his telephone calls is not likely paranoid, because it may well be true.

True Paranoia: Unreasonable and Exaggerated Mistrust

The key to true paranoia is that the person exhibits an unreasonable and/or exaggerated mistrust and suspicion of others. This suspicion is not based on fact and often grows into delusions. Paranoia is a symptom that can be part of several syndromes, including delusional disorder, paranoid personality disorder, psychotic disorders such as schizophrenia, and mood disorders, including bipolar disorder, as well as other conditions (such as brain toxicity that may be caused by drug or alcohol abuse, types of poisoning, etc).

Here are some other specific examples of paranoia:

  • Loathing or hatred of activities you or normal people would usually feel comfortable in, such as parties, large crowds, and the mall. Feelings that everyone is staring or talking about you. Through therapy and medications, this can subside and should be less of a problem over time.
  • Excessive worry about what people think about you, or that they are laughing about or whispering about you behind your back. Hallucinations or thoughts that they make facial gestures to each other with some kind of inside joke about you are also associated with paranoia. This could be with strangers or with a group of good friends. The feeling may progress over time during social interactions and you may feel the need to slowly move away from the group, and may think they will not notice you've left. There may be a breaking point where you feel compelled to leave to avoid a panic attack.
  • A fixation on whether or not others are speaking about you or making fun of you behind your back would be debilitating and make you avoid social interactions altogether if it's at the level of paranoia. While some people have these passing thoughts, someone who is paranoid would avoid this feeling at all costs even to the point of changing their daily interactions to avoid it. 

It is important to discuss feelings of paranoia with one's psychiatrist and work toward methods to control them, as symptoms like these are certainly unpleasant and could be disruptive.

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