Do you worry too much?

By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Man worrying,

Do you worry too much?
Photo courtesy of Pixabay.com

Not everyone means the same thing when they say they worry.

Pretty much everyone “worries” at one time or another. When some people say worry, they mean they are concerned about something. People worry about having enough money for retirement, and that may motivate them to save more. It’s reasonable to be concerned and take action if you don’t have money or a job. People who are high in anxiety may worry unreasonably about everything. If you worry repetitively, and you worry about things that have a low probability of happening, you may be suffering from a serious mental illness called Generalized Anxiety Disorder.

Worry means more than just being concerned about something.

Dictionary definitions for the word worry include to give way to anxiety or unease, to dwell on one’s difficulties or troubles, a state of anxiety or uncertainty about one’s troubles, either actual or potential. Problematic worry involves worrying excessively about your problems rather than taking action to solve them or spending a great deal of time thinking about possible problems in the future even when the chances that will come to pass are very small. Ruminating about the future can make you more anxious and results in mental health problems.

Some worry is normal.

Doubts, worries, and anxieties are normal. Being concerned about something, having a real worry or anxiety, should motivate you to take action to prepare for possible negative outcomes. Buying insurance is one way of reducing your worries.

Worry and Anxiety can become your friends or your enemies.

How worry and anxiety affect you depends on your stress mindset. We all experience some stress before a novel experience. Going for a job interview, giving a speech, and athletic competition, taking a test, or a first date, can all be stressful. Some people interpret the butterflies in their stomach as excitement and the second themselves up to do better. Other people become so anxious they avoid these kinds of situations.

How can you tell if you’re worrying too much?

Constant or excessive worry takes its toll on your physical and emotional health. Worry can interfere with your sleep and your ability to relax. If you’re not able to rest up between episodes of stress, you’re at high risk of developing burnout. Uncontrolled excessive worry can leave you unable to cope with life.

One sign of excessive worry is having constant negative, unhelpful thoughts. If worry becomes persistent, you’re worrying too much. People with uncontrolled worry begin to worry about every possible what-if.

Using drugs and alcohol to treat worry makes it worse.

It’s easy to fall into the trap of thinking that alcohol or drugs can help you cope with worry and anxiety. Unfortunately, substances only work for a very short time. Once the alcohol wears off you will experience rebound anxiety, which will be stronger than before. Using substances may help you forget about your worries temporarily, but they will interfere with your ability to take action to solve those problems.

Unexplained physical ailments are a sign your worry is out of control.

Worry leads to anxiety, and anxiety leads to a host of physical ailments. Excessive worry is a common cause of tension headaches. Worry can also lead to gastrointestinal difficulties, both constipation, and diarrhea. Worry increases the stress hormones in your bloodstream. If you’re in real physical danger and need to run for your life those stress hormones can be useful. But if your worry is creating those stress hormones, you’re going to feel it everywhere in your body.

People worry excessively are more likely to experience muscle aches and pains even when they haven’t used those muscles. Worry can also impair your concentration leading to poor performance at school or work. Worry leads to irritability, which can damage your relationships with family, friends, and coworkers.

You can learn to control your worrying.

Somehow you learn to worry, and you learn to stop worrying so much. Changing the way you think about worry, and eliminating unhelpful thoughts will reduce your worry. If worry is impairing your happiness or making you sick you may want to work with a counselor who can teach you techniques to reduce unnecessary worries.

Staying connected with David Joel Miller

Six David Joel Miller Books are available now!

Dark Family Secrets: Some family secrets can be deadly.

What if your family secrets put you in danger?

Letters from the Dead The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead?

Casino Robbery is a novel about a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

SasquatchWandering through a hole in time, they encounter Sasquatch. Can they survive?

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Books are now available on Amazon.

Want the latest blog posts as they publish? Subscribe to this blog.

For videos see: Counselorssoapbox YouTube Video Channel

Want the latest on news from recoveryland, the field of counseling, my writing projects, speaking, and teaching? Please sign up for my newsletter at – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders, see my Facebook author’s page, davidjoelmillerwriter.

Why do you worry?

By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Man worrying,

Some things you do not need to worry about.
Photo courtesy of Pixabay.com

Excess worry damages your mental health.

Many people know that worry and rumination can damage their mental health. Those same people may hold contradictory beliefs that they must worry to prevent bad things from happening.

People who hold both positive and negative beliefs about worry are likely to be higher in anxiety, experience more depression, and have impaired physical as well as mental health.

Positive beliefs about worry encourage worrying.

People who are high in worry, often have firm beliefs about the positive consequences of worrying. The way you think about worrying plays a role in creating and maintaining that worry. It’s hard to give up worry, no matter how painful it is, if you have positive beliefs about the benefits of worrying. If you worry a lot, examine your beliefs about worry. You may be expecting worry to play a role in life; it’s not able to fill.

People who worry a lot believe Worry will keep them safe.

People who worry a lot, often have a belief that worrying will make possible future negative events less likely to happen or will prevent those bad results from happening altogether. People who worry a lot expect that worry will reduce the consequences should a bad event happened.

Some worriers believe that worry motivates them.

Humans tend to be loss averse. Most people will work a lot harder to avoid losing something they have then they will work to get an item of equal value. If you worry about flooding, you may buy flood insurance.

When they are unhappy with their current job, a worrier is likely to put more effort into avoiding the loss of the current job then they will put into securing a new better job.

People who frequently worry may believe worry helps analytic thinking.

At the beginning of a project, most people see only probable success. Worriers have the belief that by worrying about what could go wrong they will spot possible dangers.

Frequent worriers believe that they need to control their thoughts.

People who are high in worry often believe that their brains will think dangerous thoughts. Sometimes they confuse the difference between thinking about something and causing it to happen.

Worriers are intolerance of uncertainty.

People who have difficulty accepting that some things are out of their control are at increased risk to develop excessive, pathological worry. People who are high in worry and anxiety believe they are responsible for controlling outcomes. Not being able to predict what will happen coupled with the belief that with enough thought and effort you should be able to control the results, can result in debilitating worry and anxiety.

Worriers use the “as many as I can” worry stop rule.

People who plan focus on the high probability issues. Worriers attempt to anticipate everything that could go wrong. Because of their efforts to anticipate every possible negative outcome, worriers spend a lot of time focused on low probability events and often are unprepared for the things that do occur. People who are low in worry use the “good enough worrying” rule. They worry only about a few high probability outcomes.

Worriers believe they must have cognitive confidence.

People who worry a lot, value high levels of confidence. They’re uncomfortable with uncertainty. Many life events contain large amounts of uncertainty. Worriers try to reduce that uncertainty by turning the possibilities over and over looking for other things that could go wrong.

People who worry a lot tell themselves worry is uncontrollable.

The focusing for worriers is on preventing negative feelings and consequences rather than on preventing worry. If you believe worry is uncontrollable, then it is something you are required to do. Believing worry is uncontrollable, but that you are responsible for controlling what happens leads to superstitious beliefs and may result in repetitive obsessive-compulsive disorder behaviors.

High levels of negative feelings create worry.

Feelings of pessimism, personal inadequacy or incompetence, and personal despair and hopelessness make it more likely they will worry. People who are sad or depressed are likely to worry more.

Worry can be used to avoid facing unpleasant life events.

When you worry, you can stay focused on what might happen, and you don’t have to think about what is taking place in your life today. Studies have demonstrated that people use worry as a way of avoiding unpleasant situations and feelings. By staying “up in your head” in worry, you can block the part of the nervous system that processes feelings.

If you worry a lot, now might be a good time to challenge some of the beliefs you have about worry.

David Joel Miller, MS is a Licensed Marriage and Family Therapist (LMFT) and a Licensed Professional Clinical Counselor (LPCC.)  Mr. Miller provides supervision for beginning counselors and therapists and teaches at the local college in the Substance Abuse Counseling program.

Staying connected with David Joel Miller

Two David Joel Miller Books are available now!

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Casino Robbery is a novel about a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

For these and my upcoming books; please visit my Amazon Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

Want the latest on news from recoveryland, the field of counseling, my writing projects, speaking and teaching? Please sign up for my newsletter at – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.

Can you spot the paranoid person?

By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Grim Reaper

Paranoia.
Photo courtesy of Pixabay.

Paranoia comes in many shapes and sizes.

How paranoia looks depends on the group of people you’re looking at. Researchers who study paranoia believe it may have had an evolutionary advantage. Those who were too trusting did not survive. “It is important to ask why paranoia might be so common in the general population. One possible explanation is that paranoia is a trait that was selected and distributed in humans due to its adaptive value” (Ellett & Chadwick, 2003, 2007).

In many situations, it’s better to be suspicious and cautious, even if your wrong then to be trusting and end up harmed in some way. Being suspicious when in doubt kept our ancestors alive to reproduce. Trust issues seem to run on a continuum from mild suspicion to unhealthy, pathological paranoia. Recent research tells us that mild to moderate paranoia is a lot more common among nonclinical populations than has been recognized in the past. Most of these people who experience an episode of paranoia do not go on to develop a serious mental illness.

According to the Freeman brothers “paranoia is on the rise, fueled by disproportionate media coverage of the dangers we face from others; by increasing urbanization; and by a range of other social factors including fear of crime.”

Paranoia also depends on your viewpoint. If you have been the victim of violence or trusted when you shouldn’t have, you become less trusting. Groups who have historically suffered prejudice and violence, become more suspicious. Suspiciousness in women is likely to be diagnosed as anxiety. Wariness in men is more likely to suggest they will become violent and be diagnosed as some form of psychosis. Both Psychosis and Paranoia are much more likely to be diagnosed in males, particularly African-American males.

Definitions of paranoia.

Wikipedia defines paranoia as “an instinct or thought process believed to be heavily influenced by anxiety or fear, often to the point of delusion and irrationality. Paranoid thinking typically includes persecutory, or beliefs of conspiracy concerning a perceived threat towards oneself.”

Google defines paranoia as “a mental condition characterized by delusions of persecution, unwarranted jealousy, or exaggerated self-importance, typically elaborated into an organized system. It may be an aspect of chronic personality disorder, of drug abuse, or of a serious condition such as schizophrenia in which the person loses touch with reality.”

“Paranoia is defined as false beliefs that harm is occurring to oneself which is intended by a persecutor (Freeman and Garety 2000).”

The meaning of the word paranoia has changed over time. The Century Dictionary and Cyclopedia from 1890 defines paranoia as, “a chronic form of insanity developing in a neuropsychopathic constitution, presenting systematized delusions of more or less definite scope, while in other directions there may appear a fair amount of mental health. The prognosis is extremely bad.

Today in the field of psychology, paranoia is treated as a personality characteristic which can fall along a scale from extremely mild and rare to very high and constant. Ways psychologists measure paranoia are by using the Paranoia Scale (Fenigstein and Vanable 1992) or the Paranoia Suspiciousness Questionnaire (Rawlings and Freeman 1997.) When studying personality characteristics, it’s important to differentiate between traits, how paranoid a person is generally, and state paranoia, how paranoid the person may be thinking, feeling, and acting, at the moment.

In common usage, today when most people say someone is “paranoid” they are describing someone with excessive or unwarranted fears and beliefs that others dislike them, are out to get them or will betray them.

Paranoia along with excessive fear and suspiciousness are commonly associated with some of the more serious mental illness. Anyone with difficulty understanding what’s happening around them is likely to become fearful, suspicious, possibly even paranoid.

Subclinical paranoia.

Counselors see many clients with excessive, unreasonable fears. When those fears interfere with everyday functioning, they need to be treated. How much fear is warranted depends on your point of view. When someone has experienced infidelity, the belief that their partner may be cheating again may be very reasonable. If you have been the victim of violence, a heightened wariness is understandable. Life experiences, from your earliest years to the present taught you whether to be trusting or suspicious. Having been neglected or experiencing bullying increases the chances you will see the world as hostile and people as unreliable.

If, as far as you know, your partner has never cheated, but you spend hours each day checking their cell phone or social media for signs they are cheating, if you follow them or demand to know where they are every moment of the day, it’s likely your fears are about you rather than about their behavior.

According to paranoidthoughts.com, “around a third of the population regularly has suspicious or paranoid thoughts. In fact, paranoia may be almost as common as depression or anxiety.”

Subclinical levels of paranoia are associated with the anxiety disorders, depression, and with cognitive impairment. Excessive jealousy can become so severe that it needs to be treated as a “delusional disorder.”

Paranoia among people with substance use disorders.

There’s a significant presence of paranoid symptoms among people with a substance use disorder. Some substances increase the level of anxiety and cause paranoia. The substance using lifestyle includes people who are untrustworthy and can result in traumatic experiences. Using illegal substances involves criminal activity. Telling whether extreme fearfulness and the beliefs that others are out to get is paranoia or reasonable is difficult when you have a substance use disorder. The belief that the police are following you and people are watching you may not be paranoia when you have a kilo of dope in the trunk of your car.

The way you think about yourself affects your risk of developing paranoia.

High self-esteem, feeling good about yourself, has been shown to reduce your risk of developing paranoia. Several other personality characteristics such as optimism and pessimism are also related. There is still the question of whether paranoia causes low self-esteem and pessimism or whether paranoia is the result of those personality characteristics.

In upcoming posts, we will talk about clinical, mental health disorders which may involve paranoia, some of the substance use disorders which involve paranoia and those subclinical problems, which lie on a continuum between trust issues, suspiciousness, and diagnosable paranoia. We should also explore some of the personality characteristics which impact your level of trust issues, suspiciousness, and paranoia.

For more on this topic see:

Trust

Paranoia

Staying connected with David Joel Miller

Three David Joel Miller Books are available now!

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Casino Robbery is a novel about a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

SasquatchWandering through a hole in time, they encounter Sasquatch. Can they survive? The guests had come to Meditation Mountain to find themselves. Trapped in the Menhirs during a sudden desert storm, two guests move through a porthole in time and encounter long extinct monsters. They want to get back to their own time, but the Sasquatch intends to kill them.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Books are now available on Amazon, Kobo, iBooks, Barnes & Noble, and many other online stores.

Want the latest blog posts as they publish? Subscribe to this blog.

Want the latest on news from recoveryland, the field of counseling, my writing projects, speaking and teaching? Please sign up for my newsletter at – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.

Dextromethorphan and paranoia.

By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Grim Reaper

Paranoia.
Photo courtesy of pixabay.

Sometimes over-the-counter medications cause paranoia.

Dextromethorphan is a common antitussive (cough suppressant) medication found in over-the-counter medications. It is a common ingredient in over 140 over-the-counter medications. Unfortunately, Dextromethorphan has become an increasingly abused substance among those in the 18 to 25-year-old range. Abuse by younger teens is reported to be on the rise.

Because dextromethorphan can be purchased over-the-counter or stolen from grocery stores and pharmacies, many users have underestimated the serious, long-term effects of dextromethorphan abuse.

When taken according to directions most over-the-counter medications are relatively safe. Any medication, including over-the-counter medications, may result in side effects or allergic reactions. Abuse of Dextromethorphan can have some serious health consequences.

When Dextromethorphan is taken in larger than recommended amounts it can produce psychoactive effects. “Use in amounts exceeding those recommended, a practice which is known as “Robotripping,” may result in a toxidrome of psychomotor agitation, hallucinations and paranoia best characterized as Intoxication Delirium (Stanciu, C. et al., 2016.)

Dextromethorphan shares pharmacologic and neurobehavioral properties similar to opiates and phencyclidine (PCP.) Because of its cough suppression action is like the opiate codeine, as the dose increases it can produce dreamlike states and hallucinations somewhat like the “pipedreams” of opium smokers. As the dose increases significant unpleasant and health impairing results occur. At very high doses Delirium and misperceptions occur, resulting in paranoia and violent behavior similar to PCP intoxication.

“Intoxicated excited delirium describes the most serious and potentially deadly DXM-induced medical condition involving psychotic behavior, elevated temperature, and an extreme psychomotor agitation fight-or-flight response by the nervous system. Due to extreme violence frequently encountered such presentations, typically encountered in the emergency room setting with law enforcement involvement, have resulted in sudden death secondary to cardiac or respiratory arrest, an outcome associated with the use of physical restraints” (Stanciu, C. et al., 2016.)

One online user bulletin board, I will leave the website name out, included a number of user warnings. Users report tolerance to dextromethorphan happens rapidly, often after a single dose. Reports of paranoia were common, both paranoia caused by taking dextromethorphan and users reports of high anxiety which they called “paranoid” about the many other negative results from use.

Users have reported impaired daily functioning for as long as six years afterward.

On the way to psychosis and paranoia, users may experience a variety of alterations in perception. Commonly reported are auditory, visual, and tactile hallucinations. That may pass through a period of excitability and pressured speech which can easily be mistaken for bipolar mania. Nervousness, confusion, and disorientation can occur. A variety of physical symptoms are also likely, including tremors, slurred speech, and occasionally seizures. Some less pleasant symptoms include nausea, vomiting, respiratory depression, coma, and even death.

The particular gene responsible for metabolizing dextromethorphan is polymorphic meaning there are a number of different mutations of this gene in humans. Because of this a new user never knows just how dextromethorphan may affect them. Some people need to take a large amount to feel the effects while other people can have a serious adverse effect even at doses only a little above the label recommendations (Stanciu, C. et al., 2016.)

There are antidotal reports of serious interactions between dextromethorphan and commonly used substances such as alcohol and marijuana. In medical settings, life-threatening interactions between prescribed psychiatric medications and intentional overdoses of dextromethorphan-containing products.

Dextromethorphan is not the only drug of abuse which has been connected to an increased risk of developing paranoia. Reports of paranoia among drug users are common. Paranoia can be difficult to identify and diagnose. It is often only considered in the context of diagnosing the paranoid type Schizophrenia or Paranoid Personality Disorder. Recent studies have suggested that paranoia falls on a continuum and paranoia has rarely been studied outside the seriously mentally ill. Many things about the drug using lifestyle increase the risk of paranoia. Another reason for the shortage of information about rates of paranoia and its treatment among drug users has been the systematic exclusion of those with a substance use disorder from psychological research. Given the large overlap between those with a substance use disorder and a diagnosed mental illness, there’s a lot we haven’t learned about trust issues, suspicion, and various levels of paranoia among those with a co-occurring disorder.

I’ll continue to watch for and read research about the trust to suspicion continuum so watch for future posts on this topic.

Staying connected with David Joel Miller

Three David Joel Miller Books are available now!

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Casino Robbery is a novel about a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

SasquatchWandering through a hole in time, they encounter Sasquatch. Can they survive? The guests had come to Meditation Mountain to find themselves. Trapped in the Menhirs during a sudden desert storm, two guests move through a porthole in time and encounter long extinct monsters. They want to get back to their own time, but the Sasquatch intends to kill them.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Books are now available on Amazon, Kobo, iBooks, Barnes & Noble, and many other online stores.

Want the latest blog posts as they publish? Subscribe to this blog.

Want the latest on news from recoveryland, the field of counseling, my writing projects, speaking and teaching? Please sign up for my newsletter at – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.

What is Paranoid Personality Disorder (F60.0)?

By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Grim Reaper

Paranoia.
Photo courtesy of Pixabay.

There’s more than one kind of paranoia.

When you hear the word paranoid, most people think of the expression “paranoid schizophrenic.” Paranoia can be a part of several mental illnesses. Among the mental illnesses that include paranoia as a symptom of Paranoid Personality Disorder is the most common. According to the DSM-5, estimates for the prevalence of Paranoid Personality Disorder range between 2.3% and 4.4 %. The estimate for all types of schizophrenia is between 0.3% and 0.7%. Since there are several types of schizophrenia, my rough estimate tells me Paranoid Personality Disorder is probably 10 times as common as paranoid schizophrenia.

Paranoia can also be a part of several other mental illnesses including, depression, bipolar disorder with psychotic features, other psychotic disorders, delusional disorder persecutory type. Suspicion and even paranoia may also be features of cognitive dementia and substance use disorders.

There is also a condition known as “Subclinical paranoia” in which the person has milder forms of trust issues, suspicion, or paranoia. Symptoms that may cause them problems, but doesn’t quite meet all the criteria to be diagnosed as a specific mental illness. Professionals are beginning to believe that paranoia can exist on a continuum from occasional mild symptoms to the more persistent and serious symptoms that we see in those people diagnosed with Paranoid Personality Disorder.

Many cases of paranoid personality disorder do not get diagnosed. People with this disorder, whether in a mild form or more serious one, distrust others and believe people are out to harm them. As a result of these beliefs, they tend to avoid others, professionals in particular. Those with paranoid personality disorder are likely to only be diagnosed when they are involuntarily hospitalized for mental health issues or forced to be seen by professional because of criminal or legal issues.

How is Paranoid Personality Disorder diagnosed?

To receive the diagnosis of Paranoid Personality Disorder someone would need to exhibit the presence of at least four symptoms from a list of 7 possible symptoms. These symptoms involve suspiciousness, trust issues, beliefs that others are deliberately trying to harm them. The DSM calls for the symptoms to begin by early adulthood and happen in multiple contexts. This leaves us with a gray area in diagnosing paranoid symptoms which develop in senior citizens.

It’s easy to see that there can be a large mathematical number of combinations of having or not having the seven symptoms. My math tells me that there are over 5000 possible combinations of these symptoms with 840 of those combinations meeting criteria for a diagnosis of Paranoid Personality Disorder. Since we don’t have laboratory tests such as blood tests or x-rays to detect the symptoms, they are evaluated using symptom check-lists either from the patient’s reports or observations by others. Depending on how the client describes their feelings and the mood of the therapist’s that day it’s easy to call a particular symptom either in or out resulting in fuzzy diagnoses.

Many of these possible symptoms can vary in intensity. Deciding if someone has 3, 4, or 5 symptoms present can be very much a judgment call. Using more objective screening tools and checklists result in a large number of people who show some symptoms, but not enough to make the cut off for having Paranoid Personality Disorder. One commonly used instrument is the 20-question questionnaire, Paranoia Scale by Fenigstein and Vanable. Results from this scale vary from very low, occasional, symptoms of paranoid to extremely high and constant levels. In future posts, I want to talk about those people who fall in the middle of the score range on the paranoid scale, enough that they frequently experience trust issues and suspicion but don’t quite meet the cut off to be diagnosed with Paranoid Personality Disorder.

What are the 7 symptoms that may be present in Paranoid Personality Disorder?

  1. Being suspicious without good reason that others are trying to harm them, lie to them or take advantage of them. The presumption here is that the person can’t accurately perceive the actions of others. It can be difficult for the professional to determine whether these beliefs about others actions are accurate.
  2. They spend a lot of time thinking about their beliefs that others are not trustworthy, disloyal or have bad intentions.
  3. They do not trust anyone and avoid talking about their fears because of a belief that others will use what they say against them.
  4. They interpret normal, everyday events as threats or personal attacks.
  5. Holds onto the perceived attacks, may have grudges and be unwilling to forgive even accidental injuries because they believe others are deliberately trying to harm them.
  6. Gets angry and fights back because they believe others are attacking their character or reputation. The things they’re angry about most other observers don’t see as intentional attacks.
  7. Have unjustified suspicions that their regular sexual partner is unfaithful.

How does Paranoid Personality Disorder disrupt lives?

People with Paranoid Personality Disorder assume that others are out to get them. Sometimes these thoughts are totally unreasonable but other times there a matter of opinion or even experience. If someone has harmed you in the past, it’s not unreasonable to be on the lookout for other people seeking to harm you.

If your partner has cheated on you before, it’s hard to trust them again. Sometimes the mistrust makes sense but other times the injured spouse develops a persistent sort of paranoid jealousy, and no amount of checking will convince them that their partner is faithful.

People with varying levels of paranoid thoughts spend a lot of time doubting and worrying about whether the people around them are trustworthy and loyal. When you’re high in paranoia, you find it difficult to believe you can trust anyone.

Paranoia makes it harder to trust others and makes you reluctant to share personal information with others for fear they will use that information against you. They may be reluctant to answer personal questions and when asked to fill out forms may refuse to give answers to some questions saying that these things are “nobody’s business.” This high level of distrust leads them to believe that accidents were deliberate and that routine jokes were meant as personal criticism. The paranoid person is likely to take compliments as veiled insults.

There are some other characteristics of paranoia which aren’t included in the diagnostic criteria but are listed as associated features. It’s really hard to get along with people who have even moderate levels of suspicion and distrust. People who are high in paranoia are likely to be control freaks and have difficulty getting along with others.

Paranoid Personality Disorder is part of the “Cluster A Personality Disorders.” It’s common for people who are diagnosed with one of the Cluster A personality disorders to also have symptoms of several other personality disorders from this group.

Not everyone with trust issues gets diagnosed with Paranoid Personality Disorder.

As with the other things we are calling a mental illness this needs to interfere with your ability to work or go to school, your relationships, your enjoyable activities or cause you personal distress. Otherwise, you may have the issues, but you will not get the diagnoses if this is not causing you a problem. If the only time this happens is when you are under the influence of drugs or medicines, or because of some other physical or medical problem, this fear needs to be more than your situation would warrant. These other issue needs treating first; then if you still have symptoms, you could get this diagnosis.

In upcoming posts, we will look at the overlap between paranoia and substance use disorders, some possible causes for paranoia, some of the milder variations of fearfulness and trust issues as well as ways to reduce the impact of your trust issues on your ability to have a satisfactory life.

FYI These “What is” sometimes “What are” posts are my efforts to explain terms commonly used in Mental Health, Clinical Counseling, Substance Use Disorder Counseling, Psychology, Life Coaching, and related disciplines in a plain language way. Many are based on the new DSM-5; some of the older posts were based on the DSM-IV-TR, both published by the APA. For the more technical versions, please consult the DSM or other appropriate references.

See Recommended Books.     More “What is” posts will be found at “What is.”

Staying connected with David Joel Miller

Three David Joel Miller Books are available now!

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Casino Robbery is a novel about a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

SasquatchWandering through a hole in time, they encounter Sasquatch. Can they survive? The guests had come to Meditation Mountain to find themselves. Trapped in the Menhirs during a sudden desert storm, two guests move through a porthole in time and encounter long extinct monsters. They want to get back to their own time, but the Sasquatch intends to kill them.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Books are now available on Amazon, Kobo, iBooks, Barnes & Noble, and many other online stores.

Want the latest blog posts as they publish? Subscribe to this blog.

Want the latest on news from recoveryland, the field of counseling, my writing projects, speaking and teaching? Please sign up for my newsletter at – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.

Anxiety.

Sunday Inspiration.     Post by David Joel Miller.

Anxiety provoking.

Anxiety.
Photo courtesy of Pixabay.com

Anxiety

“Man is not worried by real problems so much as by his imagined anxieties about real problems”

― Epictetus

“Our anxiety does not come from thinking about the future, but from wanting to control it.”

― Kahlil Gibran

“Anxiety’s like a rocking chair. It gives you something to do, but it doesn’t get you very far.”

― Jodi Picoult, Sing You Home

Wanted to share some inspirational quotes with you.  Today seemed like a good time to do this. If any of these quotes strike a chord with you, please share them.

Fear and anxiety are not the same thing.

By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Fear.

Fear.
Photo courtesy of Pixabay.com

Confusing fear and anxiety cause you emotional pain.

When is fear real?

Fear, Anxiety, and Worry.
Photo courtesy of Pixabay.com

Many people are high in anxiety. They report that they are afraid of a great many things. To conquer anxiety, you need to learn the difference between the things you are afraid of, the ones you really should be afraid of, and the things that make you anxious for very personal reasons.

Recent research suggests that we may have been getting two different things confused.  While fear and anxiety may look a lot alike, the kind of behavior we do to defend ourselves, the circuits in the brain for these two things are quite different.

Fear is about an immediate danger.

Defensive behaviors are controlled in the human brain stem. The brainstem controls automatic reactions to things. It’s the part of the brain that keeps your heart beating when you fall asleep. Many fears are hardwired into the brainstem and function to protect humans from harm.

If you are too close to the edge of a cliff, and about to fall off, fear kicks in and tells you to step back. For most people avoiding falling off a cliff or from another high place keeps them from getting injured or even killed.

If you’re out in the wilderness, it is a good thing to be afraid of bears and lions, tigers and other wild animals. Most primates are instinctively afraid of snakes. Some steaks are poisonous and can kill you. Having an automatic fear eliminates the need to study the snake in front of you to determine if it’s poisonous. Experts, those who work with snakes on a regular basis, learn the difference between poisonous and non-poisonous snakes. Avoiding snakes, especially the poisonous ones, can save your life.

Anxiety is about distant possible dangers.

While fear is about a current immediate danger, anxiety is about future. The majority of things that anxious people worry about are things that are unlikely to happen. Often anxiety is related to rumination.

The part of the brain that appears to be involved in anxiety are the structures that should be used for thinking and planning as well as memory. People who are high in anxiety will attempt to improve results and keep themselves safe by trying to imagine all the things that could possibly go wrong.

The more you sit and try to think of things that might go wrong in the future, the more things you’ll find to be anxious about. It turns out that most of the things that we worry about will never happen. Anxiety is about trying to predict low probability events.

Planning for the future and for contingencies is a good thing. But if you find that you are spending a large amount of time trying to foresee everything that could possibly go wrong, you have moved from planning to trying to be a fortune-teller.

The more you try to be perfect and never make a mistake, to create a life in which nothing can ever possibly go wrong, the more you will worry. Unfortunately, the belief that you can somehow protect yourself from every possible catastrophe turns out not to be true.

Whenever you find that you’re worrying about something and it’s making you anxious, the first question to ask yourself is how close am I to this potential danger? Is this something that could happen in the next minute? The second question you should be asking yourself is how likely is this bad outcome to be.

Ask yourself do you want to give up 99% of your life to avoid the things that have a 1% chance of happening. Living, and having good things happen in your life, requires doing lots of things. Unless you really love your anxiety, consider adding more spontaneous, exciting things to your life. Try more things and pay special attention to the things that go well not the few things that don’t turn out the way you want them to occur.

Learning the difference between realistic fears and the high anxiety that worrying brings can result in a much happier life.

Staying connected with David Joel Miller

Two David Joel Miller Books are available now!

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Casino Robbery is a novel about a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

For these and my upcoming books; please visit my Amazon Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

Want the latest on news from recoveryland, the field of counseling, my writing projects, speaking and teaching? Please sign up for my newsletter at – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter. A list of books I have read and can recommend is over at Recommended Books. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.