Bipolar Disorder and Paranoia: Signs and Symptoms

The Definition of Paranoia – and Examples of It

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Paranoia can be a symptom of bipolar disorder, and it can also be a symptom of other types of mental health conditions, such as schizophrenia. Learn more about how it is defined and what it tends to look like and feel like.  

What Paranoia Means

Depending on whom you ask, paranoia is a term that has multiple definitions – some that are mild and some that are more intense. For instance, in common, everyday language, "paranoia" might mean feeling nervous about a person or a situation, or it might mean feeling convinced that somebody is out to get you.

In his song "Almost Cut My Hair," David Crosby expressed this common usage well when he said, "It increases my paranoia, like looking in my mirror and seeing a police car."

Clinical Paranoia

The clinical diagnosis of paranoia requires a more specific explanation. Psychiatrists use the term "paranoia" to describe a disordered way of thinking or an anxious state that attains the level of a delusion. For example, a person who believes that the FBI is tracking her every move through the fillings in her teeth is exhibiting paranoid behavior. 

The Key Symptom

The key to true paranoia is that the person exhibits an unreasonable and/or exaggerated mistrust and suspicion of others. This suspicion is not based on fact and often grows into delusions. Paranoia is a symptom that can be part of several syndromes, including delusional disorder, paranoid personality disorder, psychotic disorders such as schizophrenia, and mood disorders, including bipolar disorder, as well as other conditions (such as brain toxicity that may be caused by drug or alcohol abuse, types of poisoning, etc).

Real-Life Examples

These are some specific ways that paranoia might manifest. 

  • Loathing or hatred: A person with paranoia can't stand participating in activities that most people would usually feel comfortable in, such as parties, large crowds, or the mall. In fact, a person with this condition may actively avoid these situations and change up daily routines as a result. Through therapy and medications, these feelings can subside and should be less of a problem over time.
  • Excessive worry: A paranoid person may be very concerned about what people think about him, or that they are laughing about or whispering about him behind your back. This feeling may be accompanied by hallucinations. The person may also interpret certain facial gestures among others (strangers or friends) as some sort of inside joke that's all about him. He might feel that everyone is staring at him. The feeling may progress over time during social interactions and the person may feel the need to slowly move away from the group and assume that nobody will notice that he's left the room. There may be a breaking point where the person feels compelled to leave to avoid having a panic attack.

What to Do About It

If these scenarios describe anything that you're currently feeling, consider it a red flag and don't ignore it. It is important to discuss any feelings of paranoia with your psychiatrist and work toward methods to control them because symptoms like these are certainly unpleasant and could be very disruptive to your everyday activities and responsibilities. There are treatments that may make you feel better and less agitated, so seek medical help from a professional.