Paranoid psychosis is a break with reality that includes extreme fear and anxiety associated with delusions. Paranoia is a common feature of many delusions, especially in cases like persecutory delusions where people become convinced that they are under attack or someone is out to get them. A number of psychiatric conditions can contribute to the development of paranoid psychosis, and it can also develop in response to neurological disorders, certain medications, and some other causes. There are treatments available to help the patient address the delusions and associated paranoia.
Paranoia itself is fear and anxiety at an unreasonable level that may be exaggerated, and is often rooted in something not very believable. Informally, the term is often used to describe quite reasonable cautions, like being alert for police cars while speeding. In psychiatry, this would not be considered paranoia, but believing that the police were tracking a driver with a device mounted in the vehicle would be.
People in a state of psychosis can experience hallucinations, sensory experiences of things that are not actually there, along with delusions, beliefs about things that are not really happening. In paranoid psychosis, the hallucinations and delusions are accompanied by intense fear. This can cause the patient to behave suspiciously and to view anyone trying to help with extreme suspicion; a doctor may become an enemy agent, for example, or a family member may be possessed by aliens.
While in a state of paranoid psychosis, people genuinely believe that there is a credible threat and they may take steps to protect themselves. This can make interacting with and treating patients challenging. Treatments can include medications as well as psychotherapy. Medication to treat delusions and hallucinations may not be readily accepted by the patient while an episode of paranoid psychosis is occurring. Performing medical evaluations like imaging studies of the brain can be challenging with a paranoid patient, as the patient may not want to undergo medical tests.
If someone begins behaving erratically or unusually and appears to be experiencing a disconnect from reality, it can be a sign of psychosis. Some psychiatric conditions like schizophrenia do not onset until later in life and can appear in people who were previously healthy and emotionally balanced. It is important for people to receive treatment, as early intervention can help improve patient outcomes. People should try to remember that the patient's reality is real to the patient, and while it may seem irrational or ludicrous, it should be taken seriously. Expert psychiatric care may be needed.