As the type of schizophrenia most commonly portrayed in television shows and movies, the paranoid subtype is what comes to mind when many people think about the condition. People with paranoid schizophrenia tend to be high-functioning but experience hallucinations, delusions or paranoia. They may think they are being watched, that voices are speaking to them, that someone is out to get them, or that they are involved in a vast conspiracy. Many can manage or hide their symptoms for years before they emerge in times of stress, while for others, symptoms are disabling from the onset of the disorder.

Symptoms of Paranoid Schizophrenia

Although how each person experiences paranoid schizophrenia will vary, the core symptoms are:

  • Delusions, or closely held beliefs that are not grounded in reality: They often have elements of paranoia, such as the belief that one is being monitored by the government, or elements of grandiosity, such as the belief that one has been specially chosen to save the world from destruction. Other common themes are religion, jealousy or changes to one’s body.
  • Hallucinations, particularly auditory hallucinations, which often present as voices murmuring, whispering, or talking to or about the person: The voices may be telling the person that they are in danger, or they might provide a running commentary on the person’s actions. Voices may also order the person to engage in specific tasks, like ceasing taking medication or committing suicide. Research in the British Journal of Psychiatry found that the quality of the voices people heard varied by culture. Americans were more likely to experiences voices as harsh, unpleasant, or attacking, while people from India and Ghana were more likely to find the voices they heard positive or comforting, such as messages from elders or from God.
  • Grandiosity and condescension: The person may feel like they are superior to those around them or like they have special information that everyone else lacks. They may seem patronizing, impatient, reserved, or aloof.
  • Anxiety, anger, detachment or quarreling: People with paranoid schizophrenia are also commonly tense, guarded, or suspicious.
  • A lack of symptoms in areas related to other subtypes of schizophrenia, such as emotional blunting, disorganized speech and behavior, movement problems, or catatonia

Treating Paranoid Schizophrenia

Fortunately, the symptoms of paranoid schizophrenia respond well to medication, according to the National Institute of Mental Health (NIMH). Although in the past, medications for schizophrenia carried a high risk of side effects (particularly disordered movement), the newest generation of medications is much safer. Called atypical antipsychotics, these medications include:

  • Aripiprazole (Abilify)
  • Quetiapine (Seroquel)
  • Lursasidone (Latuda)
  • Risperidone (Risperdal)
  • Olanzapine (Zyprexa)

Medication is the frontline treatment for paranoid schizophrenia, but other therapies can also be useful.

  • Life skills training can help people with schizophrenia improve how they communicate, take care of themselves, function at school and work, and form and maintain relationships.
  • Disorder management skills teach people how to manage their own disorder, such as how to spot and prevent triggering situations.
  • Family education helps families best support their loved one through their recovery, including helping them adhere to medication regimens.
  • Coping skills help people to deal with having symptoms that medication doesn’t clear away.
  • Cognitive Behavioral Therapy (CBT) delves further into symptom management. People in CBT learn to challenge the validity of their thoughts and perceptions and learn how to block out the voices they may hear. According to NIMH, CBT reduces the severity of symptoms and the likelihood of relapse.
  • Self-help groups offer a social support network of peers who are going through a similar struggle. For any condition, it can be helpful to know that you’re not alone.
  • Rehabilitation helps people who have stabilized get job training and reintegrate into their communities. NIMH reports that most people experience the onset of schizophrenia when they are 18 to 35, disrupting the formation of their careers. Rehabilitation gets people back on track.

Compared to people with other types of schizophrenia, people with paranoid schizophrenia are most likely to recover and lead a healthy life, according to an article in FOCUS.

If you are, or a loved one is, living with schizophrenia, we can help here at Black Bear Lodge. Call now.