The Student Room Group

can somebody define paranoia?

Many of my posts are described as being paranoid, particularly those relating to my ex girlfriend or women's expectations of attractive men.
it's very likely I am a mild 'paranoid' since I have an anxiety disorder, but I don't think I'm a true paranoid . For example, it's only when my mind is really bad/overthinking or my mental health terrible, that I start to think somebody is out to kill me or a white van from the government is going to come and yake me away if I am a bad person (for example watching porn-or if I had an unwanted intrusive thought about taboos eg incest, child porn) the last time this happened I ended uo seeing a pyschiatrist.

I am just very confused and I don't want to annoy h+r with what may be no nore than delusional thinking. :-S

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Reply 1
Strictly speaking paranoia is a type of delusional thinking. That's if you use it as a psychiatric term. In lay man words it simply mean thinking that people are out to get you when there is no solid grounds to it. It doesn't automatically imply that it may be a symptom of mental illness when used that way.
Tis is a medical condition which is part of psychosis but doesn't have to be. It means you are constantly on edge, fearful that something will happen to you, thinking that everyone is conspiring against you etc.
Reply 3
Original post by Birkenhead
Paranoia is not 'strictly speaking' a type of delusional thinking. A delusion is a belief that is held with conviction despite evidence to the contrary. Delusions are possible, not essential, elements of paranoia.


If you hold a belief that people are out to get you, you are being followed etc with absolute conviction and despite evidence to the contrary this will be a paranoid delusion. Paranoia is usually an example of an overvalued idea in anxiety however when encountered in psychotic conditions it will commonly reach delusional intensity.
Original post by Birkenhead
Paranoia is not 'strictly speaking' a type of delusional thinking. A delusion is a belief that is held with conviction despite evidence to the contrary. Delusions are possible, not essential, elements of paranoia.


If you're talking purely Psychiatric terms then paranoia is a form of delusion - specifically a persecutory delusion
Original post by Chwirkytheappleboy
If you're talking purely Psychiatric terms then paranoia is a form of delusion - specifically a persecutory delusion


This is totally wrong. Paranoia is not a form of delusion; I suggest you refresh your memory of their respective definitions in the DSM-5. They are often linked but nonetheless distinct mental health issues. Similarly, persecutory delusions are a form of delusion, which is an extreme paranoia, but in no context does paranoia automatically = persecutory delusion. There is a substantial amount of turf inbetween paranoia and full-blown delusion. Delusion is a subset of paranoia; paranoia is definitely not a subset of delusion.

It frankly worries me that some people commenting here are studying medicine because they are demonstrating a poor understanding of mental health. No wonder GPs are so often criticised for their performance in this area.
Reply 6
Original post by Birkenhead
Well yes, obviously, since psychosis is at the extreme end of mental illness just as delusions are on the extreme end of paranoia. This doesn't change the fact that paranoia is not 'a type of delusional thinking' and I daresay the vast majority of those suffering from paranoia are not delusional.


It depends on where your sample comes from. I would say that 90% of paranoid people that I encounter are delusional because I work in secondary services and deal with severe end of the spectrum. When I hear or read, in referral for example, 'paranoid' 9/10 it will be a shorthand for a paranoid delusions. So I maintain that paranoia can be a type of delusional thinking but I agree that it isn't always. It means slightly different things to psychiatrists, psychologists and lay people.

Original post by Birkenhead
This is totally wrong. Paranoia is not a form of delusion; I suggest you refresh your memory of their respective definitions in the DSM-5.


That may explain the difference in opinions. In UK we tend to operate according to ICD10 and paranoia comes under delusional disorders (F 22) in this classification.

2014 ICD-10-CM Diagnosis Code F22
Delusional disorders


Clinical Information

A disorder characterized by the presence of one or more nonbizarre delusions that persist for at least 1 month; the delusion(s) are not due to schizophrenia or a mood disorder, and do not impair psychosocial functioning apart from the ramifications of the delusion(s).
A kind of psychotic disorder
A mental disorder in which a person has an extreme fear and distrust of others. A paranoid person may have delusions that people are trying to harm him or her.
Chronic mental disorders in which there has been an insidious development of a permanent and unshakeable delusional system (persecutory delusions or delusions of jealousy), accompanied by preservation of clear and orderly thinking. Emotional responses and behavior are consistent with the delusional state.
Disorder with presentation of a facade of coldness with characteristic pervasive mistrust and suspiciousness of others.
Gradual development of an elaborate and complex delusional system, usually involving persecutory or grandiose delusions with few other signs of personality or thought disturbance.
Mild paranoia in nonpsychotic persons.
Psychotic behavior accompanied by persecutory or grandiose delusions with few other signs of personality or thought disturbance.

Applicable To

Delusional dysmorphophobia
Involutional paranoid state
Paranoia
Paranoia querulans
Paranoid psychosis
Paranoid state
Paraphrenia (late)
Sensitiver Beziehungswahn


Things in psychiatry are fairly fluid and there is very little set in stone. DSM and ICD 10 are there to aid diagnosis and provide element of standardization to facilitate research for example. We are however not slaves to the classification system.
(edited 9 years ago)
Original post by Birkenhead

It frankly worries me that some people commenting here are studying medicine because they are demonstrating a poor understanding of mental health. No wonder GPs are so often criticised for their performance in this area.


top lel

Fairly sure I would take the insight of a practicing psychiatrist over some kid studying english.
Original post by Birkenhead
It frankly worries me that some people commenting here are studying medicine because they are demonstrating a poor understanding of mental health. No wonder GPs are so often criticised for their performance in this area.


I refer you to belis' response to your first comment.

To your second point about this argument reflecting on our understanding of mental health, I'd say that rote memorisation of a bunch of technical definitions in a manual which is constantly being updated serves no indication on the quality of someone's clinical practice. If you notice, the GMC's response to criticism of GPs is not to send them all a copy of ICD-10; it's to increase the exposure of junior doctors to clinical practice in Psychiatry. If you had any understanding of Medicine, I don't think you'd be using this particular discussion to comment on doctors' competence in real life
Original post by shiggydiggy
top lel

Fairly sure I would take the insight of a practicing psychiatrist over some kid studying english.


I for my part am fairly sure I would take the insight of pretty much anyone over some adult who can't spell or care for basic grammar.

Incidentally, this 'kid' has extensive personal experience of the matters and definitions under discussion, has done extensive personal research into it and also has a parent who spent two decades in this sector before her current career. The fact that someone is studying medicine does not automatically endow them with superior understanding in a specific subject such as paranoia within mental health. The medical industry has long been notorious for its shaky performance in mental health generally, and I fail to see how having a degree in memorising a large number of words and procedures across almost every area of human health makes it safe to assume they have a better understanding in this particular area than someone who has had intimate personal experience specifically with it and its treatment and has done research into its nature to rival and probably exceed that of medical students.

If a superior understanding is to be assumed from medical students despite this, then it would present itself nakedly in argument instead of implicitly through dickfaced comments like this that are better kept to themselves.
(edited 9 years ago)
Reply 10
Original post by Birkenhead
Putting aside the fact that I have responded only to medical students and not practising psychiatrists, I for my part am fairly sure I would take the insight of pretty much anyone over some adult who can't spell or care for basic grammar.


I happen to be a practicing psychiatrist. Passed membership exams and everything. :tongue: I don't proclaim to be an alpha and omega when it comes to diagnostic systems. I don't sleep with ICD-10 under my pillow. I think though that it's worth considering that there are some differences in a way that various classifications define psychiatric conditions and there is more fluidity here then when it comes to defining terms in physical health.
Original post by belis
I happen to be a practicing psychiatrist. Passed membership exams and everything. :tongue: I don't proclaim to be an alpha and omega when it comes to diagnostic systems. I don't sleep with ICD-10 under my pillow. I think though that it's worth considering that there are some differences in a way that various classifications define psychiatric conditions and there is more fluidity here then when it comes to defining terms in physical health.


My mistake, I assumed because of your membership of Med Students Soc and it being The Student Room.

With respect to your position, from my understanding and experience in this area I cannot see that paranoia can be joined so liberally with delusion. Delusion is surely a subset of paranoia but to say that paranoia is 'delusional thinking' surely ignores everything that manifests as paranoia without being delusional.
(edited 9 years ago)
Reply 12
Original post by Birkenhead
My mistake, I assumed because of your membership of med students soc and it being the student room.

With respect to your position, from my understanding and experience in this area I cannot see that paranoia can be joined so liberally with delusion. Delusion is surely a subset of paranoia but to say that paranoia is 'delusional thinking' surely ignores everything manifests as paranoia without being delusional.


I take no offense. I'm still a student, working towards MSc at the moment in my spare time. :P

I do see your point. I could have expressed it much better by saying that paranoia can be an example of delusional thinking rather then that it is since it can fall under other categories as well. ICD 10 classifies paranoia under delusional disorders, which combined with the kind of paranoia that I see in my day to day practice led me to make the generalization I did. No classification system is perfect and the way we join and group things is based purely on expert opinion. The way I see it there are no absolute rights or wrongs. The classification is there to guide us but it needs to be combined with clinical experience and judgement.
Reply 13
Hey guys, this is incredibly interesting :-o (incidentally Birkebhead, are you a psych too? I renember you trying to dissect my thread behaviour before)

So from this criteria, without me self- diagnosing, are many of my posts a form of delusional thinking? Reading back the likelihood that my ex is trying to manipulate me into being her personal slave by texting to ask how my pregnant sister is, is erm...a leap of faith? Or more aptly, a leap into the fire?
Reply 14
Original post by Birkenhead
My mistake, I assumed because of your membership of Med Students Soc and it being The Student Room.

With respect to your position, from my understanding and experience in this area I cannot see that paranoia can be joined so liberally with delusion. Delusion is surely a subset of paranoia but to say that paranoia is 'delusional thinking' surely ignores everything that manifests as paranoia without being delusional.


How does paranoia manifest when not delusional? If it isn't a delusion, surely it is plausible as a truth?
Reply 15
Original post by shiggydiggy
top lel

Fairly sure I would take the insight of a practicing psychiatrist over some kid studying english.


Aren't they both the psychs? I'm a kid studying english :-S
when you think your girlfriend is going to leave you; ahah :biggrin:.

using Myself as an example, I'd assume that its when a person truly believes that negative things happen to them. e.g. If someone says something or does something to you that is negative, you'd assume immediately that they have some for of dislike towards you.
Basically thinking that when people do things, you think they are picking on you!
Original post by Birkenhead
I for my part am fairly sure I would take the insight of pretty much anyone over some adult who can't spell or care for basic grammar.

Incidentally, this 'kid' has extensive personal experience of the matters and definitions under discussion, has done extensive personal research into it and also has a parent who spent two decades in this sector before her current career. The fact that someone is studying medicine does not automatically endow them with superior understanding in a specific subject such as paranoia within mental health. The medical industry has long been notorious for its shaky performance in mental health generally, and I fail to see how having a degree in memorising a large number of words and procedures across almost every area of human health makes it safe to assume they have a better understanding in this particular area than someone who has had intimate personal experience specifically with it and its treatment and has done research into its nature to rival and probably exceed that of medical students.

If a superior understanding is to be assumed from medical students despite this, then it would present itself nakedly in argument instead of implicitly through dickfaced comments like this that are better kept to themselves.


Original post by Riku
How does paranoia manifest when not delusional?


A delusion is a belief held with unwavering conviction despite any evidence, no matter how persuasive, to the contrary. Surely you can see that it is possible to be irrationally fearful without meeting this criteria?

If it isn't a delusion, surely it is plausible as a truth?


This implies that delusions are always untrue, which isn't the case, but even if a delusion later turns out to be true that doesn't mean it wasn't a delusion because it's the irrationality with which the belief was adopted and the way it remained despite any evidence to the contrary that defined it as delusional, not simply whether it was true or not.

Equally, something being 'plausible as a truth' doesn't mean it isn't irrational to be unhealthily suspicious and fearful of 'it' being true. Plausible is probably the worst word you could use in that sentence, though. It means anything from possible to probable, different meanings which are pretty important distinctions in this area.
Original post by shiggydiggy


If the conceit and flippancy you've demonstrated in this discussion surrounding both the OP's serious mental health issues and mention of my own are anything to go by then I sincerely hope you never qualify to be in any position of medical or pastoral authority.
(edited 9 years ago)

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