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Two Cases Of Likely Paranoia ...

Question:

Is She Paranoid?

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p> My wife is 39 for awhile she has been thinking people are following her it was pretty mild about 5 years ago but since it has gotten worse. She doesn’t go shopping because people are at the store following her. Most of the time when she is home she is fine. She thinks people are listening in at home but i can’t find any evidence. Sometimes she better and sometimes she’s worse. Is she paranoid?

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p> Waiving at the TV

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p> My wife I believe is mentally ill. She actually accuses me and starts fights with me over scratching my face. She says when I am in bed and scratch my face I am waving to the TV set. She says I have a girlfriend that can see and hear me through my TV set. I cannot scratch my face when I am in bed watching TV because I am waiving to the TV. I work from home and with her 24/7. I never ever go out by myself. But yet I am accused of having girlfriends everywhere. My son has taken karate in to different locations. But at each I have a girlfriend that works at one of the stores in the shopping center because I look around the shopping center parking lot when I pull in. I belonged to the country club that I can’t go to anymore because the cart girl smiled at me one day so automatically I am sleeping with her. I have ignored this for a long time but this waiving at the TV stuff has me concerned. It first started with her accusing me entering codes in the cable remote and communicating with a girlfriend that way. Now that has stopped it is now I am waiving at the TV. My wife has severe mood swings and appears to be BI-polar. Should I be concerned and how do I get someone help who thinks they are perfectly fine.

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Answer:

It is actually likely on the face of it that there is some paranoia happening in both of these circumstances. In the first letter, the wife’s complaint that people are following her and spying on her appears to be the very textbook definition of a persecutory paranoid delusion; a case where someone complains of being persecuted, harrassed, followed, or otherwise spied upon in the absense of any evidence that this sort of thing is occuring, or reasonable. It is called a delusion exactly because the belief is maintained in the absense of evidence, and it is a persecutory delusion for obvious reasons ( because it involves the idea of being persecuted). It is not a delusion if there is any reasonable evidence supporting the idea that the spying is actually taking place. For instance, if the wife’s complaint about being followed was only the case inside stores, I wouldn’t think it delusional, because many shopkeepers do actually follow their customers around the store, or watch them with hidden cameras. However, the broadness of the complain would make it more likely that a delusion is occuring.

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p> In the second case where the husband’s hand waiving is interpreted as a message to a hidden girlfriends with whom he communicates through the television, we have an example of what is likely a different sort of erotomanic paranoid delusion. Erotomanic delusions consist of the unfounded idea that someone is having an affair (or multiple affairs) with others in the absense of any evidence (or even reasonability) that this is occuring. Even though the basic idea that the husband might be having an affair is a reasonable one, there is no evidence (we know of) that this is the case. Also, the delusion goes beyond any normal sort of reasonableness once the hand waiving is taken into account. This is frankly a bizzare conclusion to reach, but the wife apparently has no insight into this bizzareness.

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p> Delusions of this sort are often symptoms of a diagnosable mental health problem, although which problem might be on the table is up for grabs. Certainly schizophrenia, delusional disorder and similar illnesses (which are primarily about delusions) are possibilities, but substance abuse is also a contender, and even some unrelated medical problem could be at work (e.g., a brain tumor, or systematic illness that is upsetting normal brain functioning). I definitely recommend that both women be evaluated by a psychiatrist so that a reasonable diagnosis can be arrived at, if that is necessary and appropriate treatment started (which might include antipsychotic medication).

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