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What Is Paranoia?

Psychotic Features of Bipolar Disorder

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Updated February 19, 2013

A community member voiced this question about paranoia in our forums:

"Is anyone else extremely paranoid? I always think someone is talking about me, and I think they all laugh behind my back and everyone has these elaborate schemes that are made to get me .... So my question is, does anyone else experience this, and if so, is paranoia part of being bipolar?"

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.

People may call that type of experience paranoia, but medically, the definition of paranoia is more precise. 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.

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. Thus, paranoia is a symptom that can be part of several syndromes, including delusional disorder, paranoid personality disorder, psychotic and mood disorders (including bipolar disorder and schizophrenia), as well as other conditions (such as brain toxicity that may be caused by drug or alcohol abuse, mineral poisoning, etc).

The community member who asked about paranoia may be experiencing these symptoms due to bipolar disorder, but they could be indicating another condition. 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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