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Symptoms
By Mayo Clinic staffSigns and symptoms of paranoid schizophrenia may include:
- Auditory hallucinations, such as hearing voices
- Delusions, such as believing a co-worker wants to poison you
- Anxiety
- Anger
- Aloofness
- Violence
- Verbal confrontations
- Patronizing manner
- Suicidal thoughts and behavior
With paranoid schizophrenia, you're less likely to be affected by mood problems or problems with thinking, concentration and attention. Instead, you're most affected by what are known as positive symptoms.
Positive symptoms
Positive symptoms are symptoms that indicate the presence of unusual thoughts and perceptions that often involve a loss of contact with reality. Delusions and hallucinations are considered positive symptoms of paranoid schizophrenia.
- Delusions. In paranoid schizophrenia, delusions are often focused on the perception that you're being singled out for harm. Your brain misinterprets experiences and you hold on to these false beliefs despite evidence to the contrary. For instance, you may believe that the government is monitoring every move you make or that a co-worker is poisoning your lunch. You may also have delusions of grandeur — the belief that you can fly, that you're famous or that you have a relationship with a famous person, for example. Delusions can result in aggression or violence if you believe you must act in self-defense against those who want to harm you.
- Auditory hallucinations. An auditory hallucination is the perception of sound — usually voices — that no one else hears. The sounds may be a single voice or many voices. These voices may talk either to you or to each other. The voices are usually unpleasant. They may give a running critique of what you're thinking or doing, or they may harass you about real or imagined faults. Voices may also command you to do things that can be harmful to yourself or to others. When you have paranoid schizophrenia, these voices seem real. You may talk to or shout at the voices.
When to see a doctor
If you have any symptoms of paranoid schizophrenia, seek medical help as soon as possible. Paranoid schizophrenia doesn't get better on its own and may worsen without treatment. However, if you're like most people with paranoid schizophrenia, you may not recognize that you need help or that you even have symptoms, especially because your delusions or hallucinations are very real to you. Family and friends, or people at work or school, may be the ones who initially suggest you seek help.
Getting treatment from a mental health provider with experience in schizophrenia can help you learn ways to manage your symptoms so that you have the best chance to continue on with a productive and happy life. If you're reluctant to seek treatment, try to work up the courage to confide in someone, whether it's a friend or loved one, a health care professional, a faith leader or someone else you trust. They can help you take the first steps to successful treatment.
Helping someone who may have paranoid schizophrenia
If you have a loved one you think may have symptoms of paranoid schizophrenia, have an open and honest discussion about your concerns. You may not be able to force someone to seek professional help, but you can offer encouragement and support and help your loved one find a qualified doctor or mental health provider. If your loved one poses a danger to himself or herself or to someone else, you may need to call the police or other emergency responders for help. In some cases, emergency hospitalization may be needed. Laws on involuntary commitment for mental health treatment vary by state.
Suicidal thoughts
Suicidal thoughts and behavior are common when you have paranoid schizophrenia. If you're considering suicide right now and have the means available, talk to someone now. The best choice is to call 911 or your local emergency services number. If you simply don't want to do that, for whatever reason, you have other choices for reaching out to someone:
- Contact a family member or friend
- Contact a doctor, mental health provider or other health care professional
- Contact a minister, spiritual leader or someone in your faith community
- Go to your local hospital emergency room
- Call a crisis center or hot line
- Schizophrenia and other psychotic disorders: Paranoid type. In: Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR. 4th ed. Arlington, Va.: American Psychiatric Association; 2000. http://www.psychiatryonline.com. Accessed Oct. 30, 2008.
- Minzenberg MJ, et al. Schizophrenia. In: Hales RE, et al, eds. The American Psychiatric Publishing Textbook of Psychiatry. 5th ed. Arlington, Va.: American Psychiatric Publishing Inc.; 2008. www.psychiatryonline.com. Accessed Oct. 7, 2008.
- Schizophrenia. National Institute of Mental Health. http://www.nimh.nih.gov/health/publications/schizophrenia/complete-publication.shtml. Accessed Oct. 27, 2008.
- Jibson MD, et al. Schizophrenia and related disorders. http://www.uptodate.com/home/index.html. Accessed Oct. 1, 2008.
- Schizophrenia and other psychotic disorders: Schizophrenia. In: Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR. 4th ed. Arlington, Va.: American Psychiatric Association; 2000. http://www.psychiatryonline.com. Accessed Oct. 30, 2008.
- Dyer JG, et al. Update on early intervention in schizophrenia. Journal of Psychosocial Nursing. 2008;46:19.
- Turkington D, et al. Cognitive behavior therapy for schizophrenia. American Journal of Psychiatry. 2006;163:365.
- Treating schizophrenia. A quick reference guide. Arlington, Va.: American Psychiatric Association. http://www.psychiatryonline.com/. Accessed Dec. 9, 2008.
- Schultz SH, et al. Schizophrenia: A review. American Family Physician. 2007;75:1821.
- Treatment of patients with schizophrenia, 2nd ed. Arlington, Va.: American Psychiatric Association. http://www.psychiatryonline.com/. Accessed Dec. 9, 2008.
