Psychiatrist Blog

Anxiety and Paranoia in Orange County

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Understanding Anxiety: Differentiating Normal Stress from Diagnosable Anxiety

Anxiety is a term that’s thrown around somewhat loosely today. Whether you’re a college student with finals coming up or your working towards a deadline at your job; anxiety seems to be the term people gravitate to when they want to describe how their feeling. What’s normal stress vs. diagnosable anxiety? Can anxiety change? Can it worsen other psychiatric conditions? These are some important questions to answer when you’re defining anxiety.  

Anxiety can come in several forms including panic disorder, agoraphobia, specific phobias, social anxiety, or generalized anxiety. Freud originally believed that anxiety was a physiological build up of libido but later redefined it as a signal of the presence of danger in the unconscious. Fear or stress is a typical response to a dangerous situation but anxiety is an over-reaction. An example of this would be the nervousness one might experience before jumping out of a plane the first time they are sky diving. This would be a normal response. Anxiety on the other hand would be someone having a panic attack over hearing a dog barking. It’s an abnormal fight-or-flight reaction to a situation (typically triggered by something). Signs and symptoms may include dizziness, sweating, palpitations, shaking, abdominal pain, and the list goes on. People who suffer from anxiety may have it so severely that it cripples their lives and others may be mildly affected.

When someone has their first panic attack it can be challenging to figure out what triggered it (remember Freud said it’s unconscious). It could be due to previous trauma or repressed emotions. This is why it is important to seek help if you’re experiencing anxiety. Figuring out what’s triggering the anxiety, working through therapy, and sometimes utilizing medication are the best ways to treat it. The fact of the matter is that anxiety can change. It can become worse or manifest itself in different ways. Untreated generalized anxiety could worsen and lead to panic attacks or agoraphobia later on. Conversely, it could get better. As we grow up we learn to cope with challenging situations. This may be enough to treat anxiety in some cases. Severe anxiety combined with other psychiatric disorders such as bipolar disorder, major depressive disorder, or schizophrenia can lead to paranoia and loss of reality contact.

Exploring the Relationship Between Anxiety and Paranoia

Paranoia, paranoia, everybody’s coming to get me! I used to listen to that Harvey Danger song on the radio on my way to elementary school. I would sing along, not really know what the lyrics meant. Now that I’ve been working in psychiatry, I have spoken to many people who suffer from these debilitating symptoms daily. What I have noticed is that anxiety is closely related to paranoia. Increasing anxiety is almost always an indicator that a patient is about to relapse with paranoid or psychotic symptoms. Schizophrenic patients will usually convey to me their increased anxiety levels due to external stressors prior to potential relapse. Even more interesting is the paranoid delusions usually play out as an over-amplification of the phobia. A common one is that “every one is against me” or “talking about me”. Humans are social so it would make sense that we want to be liked or accepted by the group. What starts out as an anxiety in some patients can lead to a full-blown psychotic break where they think they are being monitored by everyone and they have a microchip implanted in their neck.

Perspective is everything and when you’re dealing with how someone feels you have to listen to their side of it. Something you don’t think twice about could be another persons biggest challenge. So be kind, be patient, oh and don’t forget to breathe.

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