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Paranoia or Schizophrenia?

by Kristina Randle, Ph.D., LCSW

I am trying to figure out if certain problem I am currently experiencing is social phobia, paranoia, or it is something serious like schizophrenia. It started when I (age 26) went on a trip to Europe with my brother and I got a terrible flu, and on our tour bus I began having a psychosis. I thought I could hear the whole bus talking about me being stupid and ugly. Even outside where we couldn’t find people from our tour bus, I heard them talking about me, it freaked me out so much I had to ask my brother if he could hear it too , which he said no. I did have a high fever so that could have explained what was happening, but even after that occurrence there are times, not every day, I go out and I feel like I can hear people calling me ugly and stupid, or if they are laughing I think they are laughing at me. I moved to the city and I rarely want to go out because I’m afraid I will have an episode again. My boyfriend knows when I have these episodes because I become quiet and disoriented. That is because I try to listen to peoples conversations and find out if I’m going crazy or they are talking about me. Also, I do not hear voices when I am alone but only when there are people around talking so I do not know if it is because I keep mishearing or interpreting the wrong way. I am worried and not sure if I need to seek help from a therapist. Thank you for your help. I would like to add that I do not take any medications or drugs.

Your psychosis may have been the result of your high fever. That experience was frightening and caused great anxiety. You now seem to be living in fear of it happening again.

Your hyper-focus on that one event is likely contributing to your current state of anxiety. You “feel like” people are heckling you but you don’t actually hear them. In that case, fear may be the problem, not psychosis.

Seeing a therapist would be a wise decision. A therapist can review the events causing you distress and determine if your thinking is realistic. Counseling can also teach you more effective coping skills for handling your anxiety.

Choose a therapist who specializes in cognitive behavioral therapy (CBT). CBT is an effective treatment for anxiety disorders. Medication might be helpful but it may not be necessary. That is something you can review with your therapist. Please take care.

Dr. Kristina Randle

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