Medication to treat schizophrenia and other mental illnesses does not completely alleviate all symptoms. Thus, people on medication to treat paranoid psychosis still live with low-level symptoms. Someone with paranoid illness or other illnesses may need to receive psychotherapy and perhaps cognitive therapy to deal with residual problems.
In this insane decade, some amount of paranoia is merely accurate. We are living in times of massive surveillance, of overzealous law enforcement, and of life imitating bizarre fiction.
However, the expectation is foisted upon persons with mental illness that we should be naïve, docile, and cooperative. In fact, maybe a certain amount of naiveté is better than having paranoid tendencies. When we act paranoid, it can frighten people and it can get us locked up.
The dangers created by inaccurate paranoia are usually worse than those of not being vigilant. While certain areas of life require caution, we must be careful not to overreact, and sabotage our life situation or our status of having liberty.
It usually helps to talk about the things that we perceive as threatening. The listener could provide reassurance, or might agree with you that a real danger exists. While fear is usually an unnecessary and uncomfortable sensation, certain things in life must be addressed.
If you are in your car and the gas gauge is on "E," you need to stop at a gas station rather than shrugging off the anxiety. If you get a letter from the IRS that is marked, "official business," you need to read the contents of such a letter and heed what it says.
When frightened or feeling threatened by something, it is important to distinguish between a real threat versus an illusory one created by a brain malfunction.
If you are frightened because you perceive that there is a conspiracy to do something to you, it is important to realize this is probably your psychotic mind playing tricks on you.
I have gone through much of my life oblivious to authentic concerns while feeling alarmed by imagined threats.
The content of delusions doesn't always have to be impossibilities. You could get a delusion concerning something rare or even common--it is only a delusion if the thought is false.
One difference between having psychotic delusions versus acknowledging an instance of genuine oddness is that there is a difference in the usage of the brain. I am making an educated guess that delusions are produced by a different part of the brain compared to perception of realities.
Beliefs that make you special in some way are suspect as being possibly delusional. Beliefs of an elaborate conspiracy to do something to you are likely to be delusions. Beliefs that you are being experimented upon, or unusual beliefs about the content of your medication, are also questionable thoughts--that are likely to be delusions.
Sometimes delusions are on the borderline, and are an exaggeration of something that has a grain of truth. Someone could be overly panicked about something essentially real, when in fact, it is far more worry than necessary. Sometimes it is helpful when our fears become mentally downplayed. This can happen through someone giving us reassurance or from us reassuring ourselves.
Sometimes, we may have a persistent irrational thought, which, although we know it is inaccurate, it keeps reoccurring in our thoughts. Our minds don't follow our expectations of how we think our minds ought to be.
A delusion that occurs in spite of being medicated may cause unclear thought processes that can lead to noncompliance. If more than one psychiatrist believes someone ought to be treated for a mental illness, there is a good chance of this assessment being accurate. It is always good to at least get a second or third professional opinion rather than deciding on your own that your mental illness doesn't exist.
It has taken me literally decades to arrive at this level of understanding. I hope you will go to Amazon and purchase one of my books so that you can help support this column, and the good it does for numerous readers.