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My Friend Of 20 Years Is Suffering From Paranoia But

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Posted on Tue, 20 Aug 2019
Question: My friend of 20 years is suffering from paranoia but allow me to describe him by way of an analogy. There was a man on country walk over taken by a thunderstorm. He found shelter in the welcoming home of a stranger. As he entered there were pots and pans on the floor with water dripping in them from a leaky roof. The man asked the stranger why he didn't fix the roof,, to which the stranger looked at him askance as if he were crazy and replied," Fix the roof? It's raining outside". The man said "I know its raining. I mean fix it when its not." The stranger replied, "Why it don't need fixing then".

This is my dilemma . my friend is over all highly functional even brilliant but when a storm comes the roof leaks it seems essentially sound and house intact. My job has to put the buckets out. So now while overall nothing has changed , the roof is beginning to leak easily and the weather is a constant drizzle.

Any suggesstions

doctor
Answered by Dr. Dr. Ashok Kumar Choudhary (30 minutes later)
Brief Answer:
It is possible that he enjoys leaky roof

Detailed Answer:
Hello,
Thanks for using Healthcaremagic.

I read your query and understand your concerns.

Although it is does not make sense to have leaky roof when there is constant drizzle but from the other part of description it seems that your friend enjoys the drizzle and leaky roof and does not care much like you about this constant problem.

I do not think this is paranoia as there is no mention of any self reference or anything taking place in his own reference.

In my opinion there is need to put more situations with details to make out the possible thought process of your friend.

I hope this helps you.
Feel free to write back to me if you have more questions.
Thanks and regards.
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Dr. Ashok Kumar Choudhary (1 hour later)
Thank you.
I have actually respected and accepted him entirely as he is, leaky roof and all and I recognize I above all wish to do no harm which my story hopefully illustrates. I also I didn't give you a specific example, but only made an assertion.
He enunciates his fears to me where he believes he is always being followed by unknown strangers. the police etc. These fears are unfounded. We were driving when the engine light went off. He immediately catastrophized the event saying that someone sabotaged the car and that escalated to where everyone in the vicinity was suspect to the point he would follow them with his cellphone in hand taking pictures in an extremely agitated manner, it took me over an hour to calm him down and for him to accept a differential diagnosis , that just maybe the car had a normal defect.
Today he approached an innocent woman in a parked car saying that she had followed him and he went up to her car, knocked on her window and told her he was taking her license plate number etc, If I hadn't intervened the frightened woman would have called the police.
let me know if you need additional examples.
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Follow up: Dr. Dr. Ashok Kumar Choudhary (27 minutes later)
I took a little more time reflecting on your reply and the short answer is yes I believe he enjoys the "delusions" or let's say rather his interpretations.

The "beautiful mind" of the connections he pursues, ( without the imaginary friend in tow)

And those ingrained beliefs of harrassement and pursuit no matter how unfounded are not dislodged by my incomprehension or rebuttal. (I think all pschciatrists should hold a session with their clients as the client drives a car, surely the place where mental health is on fine display)
Nevertheless he doesn't enjoy the consequences which ironically serves to reconfirm and enhance his paranoia. He's agreed to CBT in that I have explained it will help him think clearly when confronted by threats (without me denying the threat) but agreement is not actual follow through.. getting an appointment is the tough part.
doctor
Answered by Dr. Dr. Ashok Kumar Choudhary (24 hours later)
Brief Answer:
CBT is helpful but with limited response

Detailed Answer:
Hello,
Thanks for follow up and providing close to real life examples.

After going through these examples I feel there is definite paranoia which could be attributed to paranoid personality disorder (Complete history and clear interview required for formal diagnosis). I feel there is little chance of psychosis causing these paranoia episodes as he is highly functional and carries out his work brilliantly.

Having said this I feel CBT is one such option which can be offered with limited to moderate effect. Since there is no engagement with mental health services so far I feel even one or two session of CBT can be quite useful in understanding the problem and formal engagement with mental health services.

I hope this helps you.
Feel free to write back to me if you have more questions.
Thanks and regards.
Note: For further guidance on mental health, Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Dr. Ashok Kumar Choudhary

Psychiatrist

Practicing since :2000

Answered : 3355 Questions

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My Friend Of 20 Years Is Suffering From Paranoia But

Brief Answer: It is possible that he enjoys leaky roof Detailed Answer: Hello, Thanks for using Healthcaremagic. I read your query and understand your concerns. Although it is does not make sense to have leaky roof when there is constant drizzle but from the other part of description it seems that your friend enjoys the drizzle and leaky roof and does not care much like you about this constant problem. I do not think this is paranoia as there is no mention of any self reference or anything taking place in his own reference. In my opinion there is need to put more situations with details to make out the possible thought process of your friend. I hope this helps you. Feel free to write back to me if you have more questions. Thanks and regards.