PARANOIA

Most of us occasionally feel persecuted. The victim of paranoia, however, suffers from the delusion that he is being systematically menaced by a sinister group who may be his neighbours, midgets - or even Martians

Paranoia is a complex mental illness, the most striking symptoms of which are the delusions experienced by the sufferer. The paranoid person believes he or she is being persecuted by other people, outside agencies such as beings from Mars, by spies from another country, by people appearing on television and so on.

The sufferer may experience vivid hallucinations or hear voices or see things which are not there. The victim may also develop what are termed ‘ideas of reference’: he or she may read enormous personal significance into everyday events, chance happenings and the trivial activities of others. The paranoid person may, for example, think that a casually overheard piece of conversation applies directly to him and that this is evidence that others are in league against him. The sight of two similar people in the street may produce a conviction of being watched. As a result, paranoid people are often afraid, confused and agitated.

However, they may show no other disorders in their thought processes and their ability to cope is often better than victims of other mental disorders.

Feelings of persecution can develop as part of other mental conditions such as pre-senile dementia, epilepsy and as the result of taking amphetamines. In the latter case, however, the feelings are only temporary and last only while the drug is active in the body.

CAUSES

Paranoia is usually a symptom of psychosis and the cause is thought to be partly genetic and partly due to environmental factors. Identical twins - those who share the same gene patterns - are either both liable to paranoia or both free from it, while fraternal twins - those who have different gene patterns - show this similarity much less. This seems to suggest a genetic influence.

On the other hand, environmental stresses, certain forms of family interaction and certain lifestyles have also been shown to increase the likelihood of paranoia: it seems probable, however, that without genetic predisposition this liability is not very great.

WHO IS AT RISK ?

Research suggests that the children of parents who develop paranoia are more at risk of developing the disorder than children of normal parents. However, virtually anyone has a very slim chance of developing this condition.

Paranoia seems to be associated with the later years of life and is found more often among those of lower social status. Careful research has shown that as the condition becomes more serious, it is easy for the sufferer to slide down the social ladder both as a result of the illness and in order to escape the close relationships which may intensify his feelings of persecution.

DANGERS

Paranoia is not so much dangerous in itself as it is a warning of possible dangers to come: it can develop into paranoid schizophrenia.

Sometimes the feelings of persecution produce a wish to retaliate or threats to ‘get even’ or to ‘deal with the situation as it must be dealt with’. If a person has delusions, say, that people are being taken over by electric waves from their radios, he may feel that he has a duty to prevent this from happening and violence may be threatened or even carried out. But there is seldom any real danger, for the sufferer is also anxious and afraid and the result may be merely all words. Nevertheless the situation is not easy to cope with and the warning signs of clear paranoia should not be lightly dismissed.

TREATMENT AND OUTLOOK

Paranoia is a serious condition and its treatment is not easy. Unfortunately, the symptoms are often disregarded in the early stages: the sufferer tends to be merely regarded as someone with a chip on his shoulder. This is reinforced by the fact that the rest of the victim’s behaviour, attitudes and beliefs seem largely rational and unexceptional.

In its fully fledged form as paranoid schizophrenia the condition is generally treated with drugs. About a quarter of patients treated by both drug regimens and psychotherapy recover completely after some time. The reality is probably better then this, however, for mild attacks of paranoia may disappear completely without the sufferer ever coming to medical attention.