What's the difference between severe anxiety and paranoia?

Question

I'm looking for something from DSM or a person with expertise in psychology. Thanks.

Answer 1

Paranoia involves a sense of being specifically targetted in some way. Anxiety has a real life counterpart (e.g., with a socially anxious person, it is actually possible that they would do something to make themselves look foolish). In paranoia, there is no real life counterpart (e.g., no one is following them, they are not being tracked or targetted for mal treatment).

Consider anxiety regarding taking an important exam.

An anxious person might feel sweaty, have a racing heart, and worry that they will not do well on the exam. Their anxiety might even culminate in a panic attack. The perceived threat (i.e., test failure) is real (though possibly remote).

A person with paranoia might think that the exam was developed for the purpose of tracking their whereabouts, and if they were to put a wrong answer on the exam, the powers that be would surely find them and punish or kill them. The perceived threat (i.e., being tracked) is not real.

Answer 2

If the anxieties are realistically and usefully directed at the prevention of actual dangers, it is not paranoia.

The key words are 1) realistically, 2) usefully, 3) actual.

Taking them in reverse order, is there an actual threat...? If not, it may be paranoia. I realize that sometimes you must read into what others say, but if you are dealing with a person (not a secret government agency or faceless corporation) you can and should ask them to clarify what they mean rather than interpreting statements you disagree with as threats.

BTW, unless a person has broken the law, it is not likely that they are going to have government agencies or corporations after them. Those are big red flags warning that the danger is not an actual one.

Second, usefully directed. An aluminum foil hat may keep your head from getting sunburned, but if it is intended to keep out microwaves AND has not been professionally tested in a standards laboratory (Underwriters, etc.) it may not be useful but may only be a symptom.

Of course, this ties back into the actuality of the claimed danger. A foil hat is as good as a shielded underground laboratory against a threat that cannot be demonstrated (i.e., does not exist.)

It is analogous to the man who was told "99 percent of the things you worry about never come to pass!" and he replied, "See how effective worrying is...?"

Finally, realistic application of anxieties. The man who fears another and tells people that the other means him harm-- but DOES NOT TAKE SIMPLE PRACTICAL STEPS-- such as seeking police protection, speaking to an attorney to learn his legal rights, becoming licensed to carry a handgun for personal protection, taking karate lessons, buying a bullet proof vest... such a man is doing nothing to protect himself and is only damaging the other man's reputation.

There is a large difference between simple realistic precautions and voodoo-science (like the foil hat.)

I hope this helps to clarify the issue.

31 OCT 07, 0012 hrs, GMT.

Answer 3

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Answer 4

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