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Dr. Mark
Dr. Mark, Psychotherapist
Category: Mental Health
Satisfied Customers: 5170
Experience:  Dr. Mark is a PhD in psychology in private practice
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i am always paranoid and its very hard to live a normal life.

Resolved Question:

i am always paranoid and its very hard to live a normal life. whats wrong w me
Submitted: 3 years ago.
Category: Mental Health
Expert:  Dr. Mark replied 3 years ago.

Hi! You know, to give you the best answer, I think I should ask you a few questions first that will help define the problem and the situation.



We need to determine if the problem is paranoia or a phobia. A phobia is generally a situation where you feel anxiety about being in public or around people or other things. It's a nervousness you feel that makes you avoid these situations. Paranoia is where you believe that someone or people are going to do something harmful to you. Which of these most accurately describes your situation?

If neither, what does describe your situation?

How long has this problem been going on?

Was there a specific event that triggered this problem?

Are you being treated or in the past have you been treated for any mental health issues?

Any extra information that will help, feel free to share.

Let's go forward from the answers to these questions.

Please go ahead and post your response. I may be away from the computer for the night before you respond. If so, would tomorrow be okay for me to respond?

 

Dr. Mark

Customer: replied 3 years ago.
when i go into public i feel like everyones looking at me and saying mean things and laughing at me. I feel like people are going to follow me home and hurt me or worse. When i am not in public i think of everything that could possibly go wrong all the time. I still think people are trying to find me and hurt me even when i dont leave the house for days. Right now im so scared im shaking and my hearts pounding because i feel like people are going to break down my door. I do not have any enemies that i know of and i dont have many friends. I have severe ocd, i dont know if it is causing it but my paranoia is so bad tonight my heart is pounding and im scared out of my mind.
Expert:  Dr. Mark replied 3 years ago.

Hi! Thanks for the extra information. I think I can now be of help with this issue.


First let me say that I can imagine how difficult and frustrating this situation must be for you. You are clearly distraught and need professional help to deal with the paranoia. This problem is more severe than any self help techniques can address.

It is unclear if the paranoid anxiety is symptomatic of an independent co-disorder or if it is the Obsessive Compulsive Disorder that is most likely at work here. And certainly, the anxiety is acute. So I will also at the end of the posting give you a technique you can use on your own as well for when you are in the throes of anxiety or obsessive thoughts.

I do not know if you are getting adequate treatment for the OCD itself. Or any treatment at all. So I will proceed as if not and you can disregard any part of my answer then that is not applicable, okay?

The pharmacological treatments for OCD today are much better than in the past. But still, the most effective way to deal with OCD is Behavioral Therapy or Cognitive Behavioral Therapy. If you are not seeing a psychologist who is experienced in these treatments for OCD, you must get to one. Your symptoms are also acute enough (at least the paranoia) that you may need to take medications as well. That would be through a psychiatrist. The psychiatrist and psychologist need to evaluate the paranoid symptoms and determine if this is part of the OCD. So you need to take charge of getting to an experienced psychiatrist and psychologist and communicating totally with them.

I want to give you some books you can use to help you work on this on your own as well. Now here is the important part: you can't expect OCD to get better suddenly. It is going to take methodical work and effort on your part to deal with the behavioral changes you are trying to make. So the key in OCD work is to not get frustrated because it is slow going. But to keep working at it and to keep trying and to keep using the techniques. All this, though, is NOT to take the place of getting to a psychologist and working on the OCD and paranoia with him or her. Okay?

Here are the books:

Stop Obsessing:? How to Overcome Your Obsessions and Compulsions by Foa and Wilson. Make sure to get the revised edition. Dr. Edna Foa is a renowned expert.

The OCD Workbook by Hyman and Pedrick. The exercises here are excellent.

Brain Lock: Free Yourself from Obsessive Compulsive Behavior by Schwartz. He's purely cognitive in approach and I've had some people really like his approach though some find it a little too vague. See what you think.

Tormenting Thoughts and Secret Rituals by Osborn. Dr. Osborn has OCD. The book is based on his group therapy and the techniques may appeal to you very much.

Now, I want to give you a tool to use for when the obsessing is overwhelming or there is anxiety like tonight. Here are instructions on a therapeutic protocol called Progressive Muscle Relaxation (PMR). It's really quite easy to do almost anywhere. My patients suffering from depression or anxiety, when I teach them PMR at first are amazed how simple it is and that it is a psychological protocol. It was first used in the 1920s! Since then, of course, it has been refined and many studies have been done showing its effectiveness. You will practice PMR at first when you don't wake up with an attack so that you will be familiar with it. I want you to practice the PMR at least 5-6 times before an attack or feeling acute anxiety. Why? Because when you're in the throes of anxiety, you will only remember to do something you are very familiar with it. So practicing 5-6 times is really a minimum.

I want to stress the importance of breathing as well. Part of the physiology of what is happening to you in anxiety is that your breathing is getting shallower. This reduces the oxygen in your blood to your brain. That increases the anxiety reaction, which strengthens the attack and you are in a vicious cycle! Not good. So breathing is the primary tool. I have found in my practice that learning breathing techniques can be helpful. But some of my patients are not interested in learning more than one thing at the beginning, so I have found that just reminding you to BREATHE deeply at the same time you are doing PMR is almost as good. If you are willing to take a yoga class and learn breathing techniques, that's the best. But, breathing deeply with your PMR will help.

So, we're ready for learning PMR. I want you to print my instructions below my signature and have a copy in each of the rooms of your home where you may be when you have an attack. And again, you need to practice this easy technique at least 5-6 times as soon as you can. It needs to become as natural to you as breathing. Ah, remember breathing?


INSTRUCTIONS:

  1. After finding a quiet place and several free minutes to practice progressive muscle relaxation, sit or lie down and make yourself comfortable.
  2. Begin by tensing all the muscles in your face. Make a tight grimace, close your eyes as tightly as possible, clench your teeth, even move your ears up if you can. Hold this for the count of eight as you inhale.
  3. Now exhale and relax completely. Let your face go completely lax, as though you were sleeping. Feel the tension seep from your facial muscles, and enjoy the feeling.
  4. Next, completely tense your neck and shoulders, again inhaling and counting to eight. Then exhale and relax.
  5. Continue down your body, repeating the procedure with the following muscle groups:
    • chest
    • abdomen
    • entire right arm
    • right forearm and hand (making a fist)
    • right hand
    • entire left arm
    • left forearm and hand (again, making a fist)
    • left hand
    • buttocks
    • entire right leg
    • lower right leg and foot
    • right foot
    • entire left leg
    • lower left leg and foot
    • left foot
  6. for the shortened version, which includes just four main muscle groups:
    • face
    • neck, shoulders and arms
    • abdomen and chest
    • buttocks, legs and feet

Quickly focusing on each group one after the other, with practice you can relax your body like ‘liquid relaxation’ poured on your head and it flowed down and completely covered you. You can use progressive muscle relaxation to quickly de-stress any time.

What You Need:

  • A comfortable place.
  • Some privacy.
  • A few minutes.

Again:

Dr. Mark, Psychotherapist
Category: Mental Health
Satisfied Customers: 5170
Experience: Dr. Mark is a PhD in psychology in private practice
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Dr. Mark is a PhD in psychology in private practice