At what point does a fear become paranoia, and paranoia become delusion?

I really wonder if my fear of "they're coming to take me away" falls under this:

Delusional disorder is an uncommon psychiatric condition in which the patients present with delusions, but with no accompanying prominent hallucinations, thought disorder, mood disorder, or significant flattening of affect.[1][2] Delusions are a specific symptom of psychosis. Non-bizarre delusions are fixed false beliefs that involve situations that could potentially occur in real life; examples include being followed or poisoned.[3] Apart from their delusions, people with delusional disorder may continue to socialize and function in a normal manner and their behaviour does not generally seem odd or bizarre.[4] However, the preoccupation with delusional ideas can be disruptive to their overall lives.[4] For the diagnosis to be made, auditory and visual hallucinations cannot be prominent, though olfactory or tactile hallucinations related to the content of the delusion may be present.[5]

To be diagnosed with delusional disorder, the delusion or delusions cannot be due to the effects of a drug, medication, or general medical condition, and delusional disorder cannot be diagnosed in an individual previously properly diagnosed with schizophrenia. A person with delusional disorder may be high functioning in daily life, and this disorder bears no relation to one's IQ.[6] According to German psychiatrist Emil Kraepelin, patients with delusional disorder remain coherent, sensible and reasonable.[7] The Diagnostic and Statistical Manual of Mental Disorders (DSM) defines six subtypes of the disorder characterized as erotomanic (believes that someone is in love with him or her), grandiose (believes that s/he is the greatest, strongest, fastest, richest, and/or most intelligent person ever), jealous (believes that the love partner is cheating on him/her), persecutory (delusions that the person or someone to whom the person is close is being malevolently treated in some way), somatic (believes that he/she has a disease or medical condition), and mixed, i.e., having features of more than one subtype.[5] Delusions also occur as symptoms of many other mental disorders, especially the other psychotic disorders.

From Wikipedia.

No Mowtown, you are experiencing normal PTSD symptoms. You have some significant concerns and you were traumatized and confused when your onset of PTS took place in which you experienced a "stress breakdown".

((Mowtown)), you have some very "stressful" things taking place in your life right now, and you suffer from PTSD. It is important that you understand that when someone struggles with PTSD, they tend to "self blame" and even feel many of the things you have discussed. You have been feeding into the stress too much, which you really need to step back from. You are "not" delusional, you are under stress and have to slow down and take this one day at a time.

Hun, I have struggled with many of the symptoms you have been discribing and as you know I have also been under stress myself in my own situation. Yes, some days are damn hard, so you have to slow down and continue to do your best to not feed into the stress that is in your life right now. You are just "afraid" right now, that is "normal" Mowtown, I have dealt with that myself, not your fault and no, you are not a criminal either.

You need to stop looking for something else to add to your plate, you have typical PTSD symtoms, and you know what, these symptoms are challenging enough, no need to add to them.

OE, I really wonder. He was a paranoid delusional with both the jealous and persecution beliefs. His mother was every bit as nuts as he was.

Maybe I've got it, too. My fear of "they're coming to take me away" is so strong and so persistent. It sure sounds like the description in the snippet.

Does it matter if I know, recognize, and verbalized intellectually that it is not literally true? I know they can't lock me in the psych ward, but I fear it so intensely it makes me shudder just to think about it.

Not to scare you, but i think yes, we do internalize our parents to some extent, bad traits and good. Their voice remains in our head until we actively work to extract it. Dont let it carry you away like a riptide.

((Mowtown)),

Right now you have a big challenge in your life. Anyone would be stressing with the challenge you are sorting through. But, you also struggle with PTSD, from a trauma that took place which resulted in your experiencing a "stress breakdown". Right now, because you struggle with PTSD, things are magnified and you are very "sensitive", this is what everyone posting in this forum is dealing with, including myself.

When someone struggles with PTSD, they are much more sensitive to "stressors" and they are very confused about that challenge. So anything that stresses them is going to be difficult, so if a person is also dealing with a "real stressful" situation, that person is going to have a much more difficult time. That has been my problem too, not only did I have a trauma that lead to my experiencing a "stress breakdown", but I also was still consistently "stressed" by also having a lawyer who was failing mentally and a great deal of debt that I was left with and a very unsupportive family.

I never in my life imagined I would go through what I have been going through. Was I scared, you bet your life I was scared. Sometimes it seemed like I was paranoid, but, I was not paranoid, I was totally stressed and at times I could barely function.

What helped me? Well, what helped me was having a relationship with a therapist that kept me grounded and validated that I really was being challenged and that it was aggrivating the PTSD. I was also "retraumatized" in what I had been dealing with and I can honestly say, I think you are having that kind of challenge right now too. I think that what you need is to have a therapist that can help you stay grounded during this challenge tbh.

You have been doing everything "right" Mowtown, you have been working through the "stresses" that you have in your life right now, but that process is triggering you at times, and you need to have someone who can listen to you and just help you through this challenge. That is what my T does with me. He listens in a respectful way, actually as what a good caring parent would, or a good friend or mentor.

The therapist you have now, is he doing that with you? It's fine to identify these traumatic things you have been working on, but you need to also have help with what is in the "now" that is stressing you too.

If you notice, pretty much everyone interacting in this forum is struggling with stressors in "the now" too. A lot of it is slowly learning to manage the "stress' we are all dealing with while we are all working through PTSD. And quite honestly, every single one of us is scared in one way or the other and we all feel "alone" too.

BUT, we are not alone, because we do have each other here to lean on, others that can relate to everything we struggle with on some level, but on that some level that each of us is challenged with called "PTSD".

It is not "paranoia" or something that "is not real", we all experienced a "stress breakdown" and when we are stressed we "struggle" and we are all "scared" too.
There is not one person struggling here that is not a good person either, we are all good people, but we struggle and we all have to slow down and realize when "stress' is getting to us, and work on doing our best to reduce it in whatever ways we can.

You are going to work through this one day at a time. You have a challenge taking place right now, it's a stressful one and it's going to take time until you can settle down with it and move forward.

(((Caring and understanding Hugs)))
OE

No, you are not like him Mowtown, you are struggling with how he affected you. You were the only "voice of reason" in your home too. Your sisters and mother enabled your father.

I agree with Hankster, your father only instilled that in you, but you can work your way out of that.

I went through a period where I was very confused that way myself, it took me time to get past that, but I am on the other side of it with a much better understanding of how certain things affected me in ways I had not realized.

You are not the same as your father, my guess is you take after your mother's side, often the male child is more of the mother's genetics than the fathers. You are not exhibiting the same symptoms as your father, your father would not interact in this forum as you have either. Your challenges are "classic" of a child that endured the kind of abuse you experienced in your childhood.

OE

Mowtown,

Often with PTSD there is a main fear that someone is challenged by, that is the foundation for the wolf.

With myself, it was always my boundaries and protecting my things, things I had that were important to "me" as a person, things I managed to create on my own somehow.
I suffered through many bad experiences where things I had done/created/were important to me were either taken from me or badly jeopordized in some way. I know stress very well in my life, I suffered a stress break down because I stood and watched so much of what I worked so hard for just destroyed, damaged in so many ways I never even imagined tbh.

What I see about you is that your main "wolf" was failure and that was something your father constantly put upon you. How is any child supposed to grow up "stress free" after growing up that way? That is what you are struggling with the most right now and is your "main source of stress" where you get triggered Mowtown.

I am so sorry you experienced that troubled childhood, because you surely never deserved to have these deep fears instilled in you this way. You were never, nor are you now a "criminal" in any way. There is such a big part of me that wants to reach out to that little boy, pick him up and put on my lap and comfort him and tell him that none of his feelings or fears are his fault and that he is and always has been a good boy. That is what your mother should do, but, she just doesn't know how to do it. I am sure she loves you, but I don't think she really realizes the gravity of how you struggle, and unfortunately neither do your sisters.

I think it is important that you be able to vent this "main stress" that you struggle with, but what's more important is that you keep hearing "why" it is there and that it is not a reality with you, that you feel this way because of how your father kept throwing that at you and you did not have any help with that, but instead you had to keep quiet.

Off and on here in the forum we talk about "the wise mind", and you do have it too. But you have not truely stepped away from that hurt little boy's fears with this wise mind. Your circumstances right now are "stressful" and your wise mind is being drowned out by that "main stress" that you had always "feared" in your life.

You "have" survived in spite of growing up with a very "sick abusive" person. You have to finally grow past the "hurt" that caused you and I know that is "hard". When you have these strong feelings, it's ok to talk about them, but just because these strong feelings are there doesn't mean you have to "believe" them, it means you need to finally "heal" from experiencing them.

our preoccupations usually mean something. Delusions are usuall

Delusions may be like flashbacks. The man who was abandoned as a baby fears his wife is a no good ***** who wants to run off and abandon him too. The one who was hungry as a child is convinced there sulk he widespread food shortages soon. And so on.

I'd like the answer to this question as well. I often admit my paranoia because I know I could be wrong. Sometimes, I know I'm wrong but I can't believe it without doubt.

I'll give a little example~ This past weekend~ I was upset because (the person I believe to be )my enemy implied, on social networking, that he was down the road from where I live because his daughter is having a baby.

Yesterday, I went outside to do some yard work and I noticed something, white, laying on the ground. I'll admit, I was hesitant and automatically wondered if it was something specific. Something from the past. It wasn't, it was a dirty shredded diaper.

Logically~ I know it's just a coincidence. Emotionally~ it's hard to believe. Today~I work up fighting the sheets. It's gonna piss me off when I realize I was delusional because I couldn't dismiss the logic

hope things are going a little better for ya.

Thanks, Parley -

I am just having such a hard time doing my own "differential diagnosis" because the symptoms of so many things are basically all the same. And with this delusional paranoia, I am having a really hard time telling if it is that or if it's hypervigilance, as in the link below, which OE found originally, and which I think is awesome.

Complex post traumatic stress disorder (complex ptsd, pdsd, shell shock, nervous shock, combat fatigue), symptoms and the difference between mental illness and psychiatric injury explained

I have an appt in 2 weeks with the kind and gentle Pdoc who I think is awesome, I'll see what she has to say at that time.

Here is the chart:
Paranoia

Hypervigilance

paranoia is a form of mental illness; the cause is thought to be internal, eg a minor variation in the balance of brain chemistry
is a response to an external event (violence, accident, disaster, violation, intrusion, bullying, etc) and therefore an injury
paranoia tends to endure and to not get better of its own accord
wears off (gets better), albeit slowly, when the person is out of and away from the situation which was the cause
the paranoiac will not admit to feeling paranoid, as they cannot see their paranoia.
the hypervigilant person is acutely aware of their hypervigilance, and will easily articulate their fear, albeit using the incorrect but popularised word "paranoia"
sometimes responds to drug treatment
drugs are not viewed favourably by hypervigilant people, except in extreme circumstances, and then only briefly; often drugs have no effect, or can make things worse, sometimes interfering with the body's own healing process
the paranoiac often has delusions of grandeur; the delusional aspects of paranoia feature in other forms of mental illness, such as schizophrenia
the hypervigilant person often has a diminished sense of self-worth, sometimes dramatically so
the paranoiac is convinced of their self-importance
the hypervigilant person is often convinced of their worthlessness and will often deny their value to others
paranoia is often seen in conjunction with other symptoms of mental illness, but not in conjunction with symptoms of PTSD
hypervigilance is seen in conjunction with other symptoms of PTSD, but not in conjunction with symptoms of mental illness
the paranoiac is convinced of their plausibility
the hypervigilant person is aware of how implausible their experience sounds and often doesn't want to believe it themselves (disbelief and denial)
the paranoiac feels persecuted by a person or persons unknown (eg "they're out to get me")
the hypervigilant person is hypersensitized but is often aware of the inappropriateness of their heightened sensitivity, and can identify the person responsible for their psychiatric injury
sense of persecution
heightened sense of vulnerability to victimisation
the sense of persecution felt by the paranoiac is a delusion, for usually no-one is out to get them
the hypervigilant person's sense of threat is well-founded, for the serial bully is out to get rid of them and has often coerced others into assisting, eg through mobbing; the hypervigilant person often cannot (and refuses to) see that the serial bully is doing everything possible to get rid of them
the paranoiac is on constant alert because they know someone is out to get them
the hypervigilant person is on alert in case there is danger
the paranoiac is certain of their belief and their behaviour and expects others to share that certainty
the hypervigilant person cannot bring themselves to believe that the bully cannot and will not see the effect their behaviour is having; they cling naively to the mistaken belief that the bully will recognise their wrongdoing and apologise

See, I don't know.

I know my paranoia WOULD get better and go away if I didn't feel so threatened.

I definitely CAN see my paranoia, and I know it's delusional to a great deal, albeit based on a remote possibility that they COULD lock me up under the right (suicidal) circumstances.

Drugs - never had an anti-psychotic, so I dunno.

Delusions of grandeur, hardly. More like delusions of being the scum of the earth who deserves to be executed with a bullet to the brain stem.

Self importance - well, I feel like I am important to myself, which is why I fight to live. When I don't feel like the scum of the earth, I do know I contribute positively to society, and I help a lot of deserving people in my job.

Well, I have a lot of symptoms, definitely many of PTSD - like I said, is it paranoid delusion or hypervigilance???????? $64,000 question.

Well, true, probably no one is out to get me. No one IS out to get me at the moment, it just could happen if I were suicidal. The most delusional part is I think my family would be out to lock me away because it would be a way to make the problem of MotownJohnny "go away".

Constant alert - yeah, but that is paranoia AND hypervigilance, I see NO distinction except perhaps in the neurochemistry of the root cause.

Certain of my belief and behavior. I have been uncertain of NOTHING for 2 years and 2 months, and I question my sanity, my reality, and my worth constantly, not a day goes by when I wonder if I am actually way more insane than I think I am.

I'm curious how you feel you fall into the subtype array (though I'm not at all suggesting that you need to share that), because much of it seems to me could be quite difficult to filter for, for instance in the case of the last two, with persons who do encounter genuinely malevolent behavior and who do have medical conditions that are difficult to verify or which are simply not apparent to others:

Unfortunately, psych practitioners I've worked with in the past have been so vigilant about filtering for possible paranoia, that they ended up filtering out plenty of important reality. Something like how antibiotics kill off as many good cells as bad, but worse because eventually I have tired of encountering the same patent disbelief I had to contend with as a child, and which I find unreasonable as an adult who presents with a clear and strong presence of mind.

I think all we can do, ourselves, is keep asking the questions: is this really happening? what is my assessment of the evidence that I am basing this on? and, in the face of a lack of clarity, does it serve my best possible outcome to believe this is happening? and, a personal favorite of mine, where is that thought coming from?

(And Parley, I would have trouble with that too.. I live two doors down from a popular bar and am forever doing unreasonable garbage cleanup in my own yard, for the negligence of imbibed passersby.. but still have never had the occasion to come across what you did in your yard! I should think that would be unsettling regardless of who may have done it.. )

Mowtown, the difference in you is that you actually "did" experience a person who was a constant threat to you, that is real, not paranoia.

With PTSD the person does experience "heightened fears" and is very sensitive, that is the hypervigilance part. Your "fears" are deeply engrained in you from your father, that really happened, was nothing you ever made up.

I could "not" have my horses/ponies out at night after what they went through, as soon as it got dark they would get upset until I put them in, that is because they "feared" what already happened could happen again. My daughter's horse upon just seeing my neighbor's dog totally paniced and tried to jump out of his paddock and did not make it and bent a tubegate with plywood on it to make it solid, he bent it in half and when I rushed from the barn to see what the noise was about he was literally on the gate like sitting on a shelf. I was alone and he is a big horse, I did not know what to do but luckily he slid to the ground, slowly got up and walked and then trotted up a small incline and stood there frozen, staring at that dog shaking, just shaking in fear. I was lucky he had his winter blanket on otherwise he would have suffered lacerations to his body from the plywood he broke in half. Now this is a horse that NEVER cared a less about dogs, never cared a less about seeing my neighbors dog before their dog was loose and targeted all of them.

You need to understand the brain, these fears are "real" even in a horse, not imagined, but because something really "did" happen.

OE

I assume you are speaking for yourself.

No, I am referring to Mowtowns father who was very abusive towards him.

I guess I don't understand what you are saying. The difference in Motown's, real threat, is different compared to who/what? Someone who experiences paranoia/delusions?

I was just wondering about the difference.

Vonmoxie, I only exhibit the persecutory thing, and it is only about this one thing, being locked up in some psych facility. I've always had the "black sheep of the family" feelings, but I never felt persecuted, maybe a little picked on, mostly just not good enough for them.

None of the others - I may have secretly pined for Helen Hunt, Julia Roberts, and Jennifer Aniston but I know they aren't into me. Definitely not the jealous type, if anything I was too trusting and got hurt a couple of times, grandiose doesn't jive with feeling like the scum of the earth, and I do wonder at times if I am a bit of a hypochondriac since the breakdown 2 years ago, but the couple of things I wondered about turned out to be real - one was asthma, undiagnosed my entire life. Spirometry showed I have a pretty restricted ex flow, and I have responded well to inhaled and oral meds. So I wasn't crazy in that way.

Yup, I think it's only the persecutory.

Well, I don 't want to speak for OE, I will try to explain my views on the comparisons and contrasts between my fear of my father and my fear of being discarded into the mental health system.

With him, it was a legitimate fear, both my mom and myself felt it was a very real possibility he could kill us, he came close a couple of times. He threatened to shoot me, at gunpoint, when it was 14. He held a knife to my mom's throat when I was 7, for over an hour, and told her she had to confess to being a *****, then he cut her enough to make her bleed and told her it was a warning. And after he died, I felt a big sense of relief, and other than the PTSD thing, which it thought was long over until 2 years ago, I felt safe from him, although I had a lot of generalized fear and anxiety.

With the whatever this is re the fear of being locked up, I still am a bit unsure why it is so strong. I was threatened with lockup 2 years ago by the quack, it was NOT merited, and it IS, in my mind today, the most traumatic thing I have ever endured. Probably because the childhood things faded with time until they were brought back to life 2 years ago. But I know intellectually it is not really a legitimate fear, just a hypothetical or remote possibility. Which is why I am unsure if it is a paranoid delusion or hyper vigilance.

I was just reading through the list of differences you posted from that link, and it does sound like you a significant majority of aspects more in common with the hypervigilance construct. Just pulling a couple of the comparisons, really fairly randomly:

-the paranoiac is convinced of their plausibility
-the hypervigilant person is aware of how implausible their experience sounds and often doesn't want to believe it themselves (disbelief and denial)
-the paranoiac feels persecuted by a person or persons unknown (eg "they're out to get me")
-the hypervigilant person is hypersensitized but is often aware of the inappropriateness of their heightened sensitivity, and can identify the person responsible for their psychiatric injury

No contest, right?

One of the first things about what you were saying that I'd noticed is that your concerns are really specific, and that you're really examining them, really aware, which just doesn't seem like a fit for paranoid or delusional behavior to me; but seeing the comparisons side by side like that really helps to put some definition around it.

Since many people don't even know the term "hypervigilance", but are certainly familiar with paranoia, it's easy to understand how any of us could misattribute the behaviors as all being associated with paranoia. Enlightening. I'm starting to understand how my last psychiatrist, who did not specialize in trauma, seemed so convinced I was delusional.. while I just kept shaking my head thinking, why are we wasting time on this? Trying to figure out if the verifiable past really did occur?

do you physically resemble your father? Are you the age he was when he was so violent?

I've learned to work with dreams and fantasies at face value. You want to be taken away by the police. That's a very reasonable desire for a boy who sees his father assault his mother. Think about It. Are you in anyway like him? What if there were a mental illness that explained your symptoms and his. Could you tolerate having his disorder? Him being as blameless as you?

You are very concerned about your legal rights as a mentally ill person. Children also have very limited legal rights.

Remember, I had a crazy scary preoccupation with controlling a police weapon u.til I recalled a split second of my suburban life when I was poised to jump a cop and do just that...so he didn't shoot my demented father.