Learning From Paranoia as an LGBTQ+ Person (Part 2)
Also from Dwight Long: Coping With Paranoia as an LGBTQ+ Person (Part 1).
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What have I learned in the past 40+ years of having a paranoid condition? The answer is multi-faceted. There is no single all-encompassing cure to my diagnosis of schizoaffective disorder, bipolar type. I don’t think the problem is going to just disappear and go away in my lifetime. But that’s ok. There are many healthy ways to navigate and manage having a paranoid condition and there is a great deal to learn from it.
What is a Paranoid Disorder and What is Schizoaffective Disorder?
Schizoaffective Disorder is so named because it has symptoms common to Schizophrenia. Mental health professionals currently believe that schizoaffective disorder is a kind of schizophrenia. Both disorders feature psychosis with visual and/or auditory hallucinations and embracing false beliefs, called delusions. Also present in Schizoaffective, however, is a mood disorder, hence “affective”, influencing “affect” or mood. Such mood disorders include bipolar disorder, which features cycles of depressive states (low mood) and manic states (excited mood). Another type of mood disorder that Schizoaffective disorder can have along with the psychotic features is unipolar depression, or low mood.
Some people believe Schizoaffective disorder can start after a traumatic event or following a very stressful period in your life, such as abuse or neglect. It can have similar symptoms to PTSD. My experience with it followed a traumatic college fraternity initiation week that went badly for me. I remember the day I first met with a truly wonderful psychiatrist who told me that my initiation week experience, or more accurately its aftermath, was “shattering”. And it truly was, as I discussed in my previous posted article, “Coping with Paranoia as an LGBTQ+ Person (Part I)”. The main point of the first article was to spread awareness of the issues involved in being both paranoid and gay. I wanted to promote kindness, civility, empathy, and compassion, not so much for me, but for the 1 in 5 adults in America who experience a mental illness, and the 1 in 25 (10 million) adults in America who live with a serious mental illness. Schizoaffective disorder occurs in about 0.3% of the population.
Discussing my paranoid condition openly in my first public post was a kind of relief and release. I know there are many others who also deal with similar mental health conditions. Every adult should know that these conditions exist. They can and should be rationally discussed so that the stigma of having them is erased. They may not disappear and go away, but I do think that the stress of having them can be greatly lessened by people opening up about them instead of brushing them aside or “sweeping them under the carpet”. Our communities are now more enlightened about mental health conditions than in past decades that followed 1981, when I learned I had schizoaffective disorder.
It costs nothing to be kind. People can quite easily stop making unkind homophobic comments in public. I know comments like these don’t happen frequently, but you can check with any LGBTQ+ person that they do happen. Publicly ridiculing and insulting a person’s very identity in public can cause a lot of stress for LGBTQ+ people. I think statements like these are damaging. Maybe that’s the reason some people make them. They may not realize, however, the cost to the mental health of those who may take these statements they hear personally. The negativity, shame and fear this causes can result in developing actual hallucinations and delusions as symptoms of a mental illness.
Hearing Voices, Paranoia, and LGBTQ+ People
Mental Health America (MHA) found that 4.5% of the U.S. population identifies as Lesbian, Gay, or Bisexual. Of those, over 39% reported having a mental illness in the past year. That’s nearly 5.8 million people — more than the entire population of Kentucky. [1] Further information can be found at:
A 2019 web site article cites an interesting study very relevant to my own life.
The article cites a psychological study on Gay, Lesbian, and Bisexual (LGB) people and paranoid psychosis. I encourage you to read the article. I have listed a few key quotes from it here: “Sexual minority status appears to have a specific association with paranoia symptoms”. The article further states, “Maybe Joseph Heller was right when he wrote that ‘just because you’re paranoid doesn’t mean they aren’t after you’ , because …. research suggests that if your non-heterosexual, maybe they are after you.” “Bullying and discrimination appear to be associated with experiencing paranoia.” “There was a significant indirect effect ( in the study) between sexual identity and hearing voices.” “Total , direct and indirect effects ( in the study) were significant for sexual identity and paranoia symptoms”.
In music, “audiation” is when you are imagining or remembering music and listening to it in your mind’s ear. This is a lot how my auditory hallucinations work when I am on medications, but they are involuntary and can be intrusive. When I came back home from a work trip to San Francisco, I remember having a bad relapse. This was one of the first times I figured out that I was hearing voices. I was sitting on a couch with my Dad and I hallucinated a voice from him, in his voice, that was very much too many words to have possibly fit into the time he had to speak, and I could see that his mouth was stationary. I told him exactly what I had just heard him say to me and he said, “No, I definitely did not say that.” I remember getting pretty teary-eyed as I realized, for the first time in my life, that I was doing this. Previously that day, I remember taking a cracker & cheese from a plate my Mom had just set down and I clearly heard her say accusingly, “you took the last one”. I checked with her later and she told me that she didn’t ever say that. Those two are just examples of many, many over the years.
During a relapse, the “episodes” of increased symptoms may last from a few days to a couple of weeks during which I hallucinate voices more clearly and frequently. Otherwise, a lot depends on who I’m with and how comfortable I’m feeling around them. Also, if I’m not on my meds, the voices sound more clear and seem to come much more clearly from my ears and not just thoughts in my head of people talking. I often don’t really have a sense of hearing it, but only a memory of just having heard it about a second or two ago. I’m often wondering, “What did she just say?” or, “Did he just say that?”. This disconnect can often be a tell-tale sign that what I heard was a hallucination. This happens fairly regularly when I’m in public by myself and I’m within earshot of strangers. When I’m around friends and people I trust, it doesn’t seem to happen as much. Sometimes this happens at home when the weather’s nice and we’re outside and I hear the neighbors talking next door. This has happened even while I was inside my house and couldn’t possibly have heard the next door neighbors talking from their yards.
FINDING SOLUTIONS FOR THE PROBLEM
Medications and Therapy
The biggest solution for myself in dealing with this condition for the past 40+ years has been taking my prescription psychiatric medicine very regularly and steadily over many years, as I have discussed in my previous post. In my experience, the meds are crucial and I believe that they are the main reason that I have been able to remain stable and cope with the condition as well as I have over the years. This has involved regular appointments with a Board Certified Mental Health Psychiatric Nurse Practitioner or a Psychiatric Specialist who is a Medical Doctor. I also started therapy with a licensed counselor and highly trained social worker a couple of years ago. I wasn’t quite up to it mentally at the time as I was transitioning to some of the newer style second generation antipsychotic meds and newer atypical depression meds, so I took a break from the therapy. I do plan to get back to talk therapy soon and I would recommend it.
Many psychiatric doctors still believe that schizophrenic spectrum illnesses with symptoms like paranoia don’t respond well to talk therapy. I hesitate to call it “talk” therapy because there is a lot more thinking, awareness, and learning involved than just talking. My limited experience with therapy has been that it can definitely stir up a lot of thoughts and emotions, and you should be in a relatively stable emotional space to be able to deal with them. So my advice would be to stabilize first with meds and then try to work on yourself with therapy. When you are stable enough, I think it’s an awesome thing to do and I believe everyone should do it if possible. I will tell you that in even just a few months with an excellent therapist, I learned so much about myself. When I started with my first psychiatrist back in 1981, he didn’t believe in therapy, and that probably kept me away from it for many years. The mainstream view these days in medical science is that both meds combined with therapy can work together and be ideal.
Wisdom and Learning from Paranoia
Paranoia is one of the human psyche’s innate survival mechanisms, that in our evolution has developed along with and adapted to our instinct for self-preservation. Learning from paranoia can include studying what triggers it, what thought patterns it creates, its root causes, how we react to it, and how we manage it. These can all provide valuable insights and lessons that all of us can use to navigate life’s challenges in our decision-making, risk assessment, coping strategies, emotional resilience, self-awareness, empathy and compassion for others, and our growth as human beings. I strongly believe that learning from paranoia can lead us to greater emotional well-being, better inter-personal relationships, and more fulfilling and satisfying lives.
How to Manage and Cope with Paranoia
I believe in taking a holistic and multi-faceted approach to treating and managing mental illness. Holistic well-being involves our physical, mental, emotional and spiritual health. This can involve regular exercise, good sleep habits, healthy eating, hobbies (which for me are music, writing and reading), being social and having fun with others, sharing our feelings with others, lifelong learning, using your mind, and celebrating your spiritual beliefs.
Here are some common and effective strategies for coping with paranoia:
- Reality Testing: Check the evidence for your paranoid thoughts. Are they based on facts or assumptions?
- Mindfulness: Practice staying present in the moment to reduce excessive worrying about the past or the future.
- Positive Self-Talk: Challenge negative thoughts with positive and realistic affirmations.
- Social Support: Reach out and share your feelings with someone you trust to gain perspective and reassurance.
- Professional Help: Consult a mental health professional for guidance and support tailored to your specific situation.
- Stress Management: Learn and practice stress-reduction techniques like deep breathing, meditation, or yoga.
- Medication: I strongly believe that medication prescribed by a psychiatrist or psychiatric nurse practitioner should be considered.
I am a big believer in psychiatric meds — I know they have their drawbacks and side effects, but the newer meds have improved in the past few decades to be effective with much less of the troubling side effects, like sedation, that the older drugs had. Like I said in my first post, just simply changing my meds to their newer generation alternatives, has allowed me to pursue things like studying jazz piano, writing and reading instead of sleeping too much and being tired all the time. I think Invega has strengthened my motivation, and helped foster a sense of purpose. Prestiq has made me feel less angry and much more in control when I feel anger. I could not sustain these hobbies for many years on my older meds. These newer meds like Invega control the “positive” symptoms of the paranoid auditory hallucinations and delusions. The newer med Prestiq also lifts the depression. These meds have almost no side effects as far as I can tell. And thirdly, I believe both of them together have lifted some of the so-called “negative” symptoms of schizoaffective disorder — the loss of motivation and sense of purpose. Invega and Prestiq have restored some ambition and passion for my life.
I would like to recommend an article written by one of the commenters to my last posted article about the many things we may be doing (without realizing it) that can damage our mental health. It is called, “You Won’t Believe How These Everyday Habits Are Destroying You Brain Function”, by Contentcrafter on Medium. I think this is an excellent article. and I would recommend reading it to anyone, whether you have mental health issues or not. It is good advice.
Some of My Personal Coping Strategies, Like My “Go-To” Notebook, Activities, and Favorite Music
Here are some of my coping strategies that I have personally tried. Sometimes I just have to stop what I’m doing and focus on self-care. I can take some time out, such as take a nap or have a healthy snack, and it does wonders for how I think and feel. There are many positive affirmations you can tell yourself to mitigate the stress of having a mental health condition. I remind myself often that perfection is unattainable. My desire to attain it and my inability to attain it do not determine my worthiness and innate goodness. I acknowledge and accept that it is OK for me to feel anger and frustration when these thoughts and voices pop up. It is very much OK to allow myself to feel paranoid sometimes. I remind myself that the feelings are temporary and will go away usually in a couple of hours or so, and if I’m feeling angry or persecuted I just wait it out. In the coming months, I want to write down some “go-to” thoughts I can read to feel better when I feel bad. I’m building a large collection of inspirational quotes, articles, pictures, etc. that I collect on “Google Keep” and on my “Day One” online journal. I have printed these out and I keep them in a “go-to” binder that I can pull out and read. Sometimes when I’m not feeling inspired to practice music, I read this notebook and listen to my favorite music to get inspired. I believe it’s important to have some structure and routine in your life, especially if you’re dealing with emotional instabilities. This means organizing your life, and having “go to” activities that repeat over time. This can provide stability and help reduce stress.
While you are feeling persecuted and when you are waiting for the emotions to dissipate, you want to challenge your paranoid thoughts at this time. Don’t let your brain just run on autopilot. Recent studies show that a wandering mind is an unhappy mind. Pay attention and focus on challenging your paranoid thoughts and feelings — ask yourself the who, what, where, when, why, and how of the situation. Consider the evidence and think rationally, would most people likely behave this way? Could this have been a hallucination or delusion? We should all challenge irrational thoughts. This therapy approach is called cognitive restructuring. In this way the brain can heal by rewiring its negative (in my case paranoid) thought patterns through the science of Neuroplasticity. This is because your brain is constantly changing and rewiring its billions of connections. It is strongly influenced by its environment and by what you are thinking. We are often saying things to ourselves as we think and feel things. Experts call this self-talk. What we tell ourselves is actually quite important to our mental health.
I try to focus on facts and challenge what my mind’s ears are telling me. Are my thoughts full of assumptions about what other people around me may be thinking about me? Are my thoughts based on facts? I can discuss my specific concerns with a trusted friend or my mental health care professional and often gain a valuable and different perspective. Sometimes I write down my thoughts and the things I hear. They lose their power over me when I see how ridiculous they look on paper. When you do this, you can flip your thoughts around to be more positive and realistic. Write down positive affirmations about the good things about you and the good things in your life. Be specific about exactly what you’re hearing and ask yourself, “Why am I thinking this and feeling the way I feel? Does this make sense to me? Does this same thing always happen? Do I see any patterns? Do I think I could be over-reacting again? It can be tough when you’re feeling strong emotions, but if you calm yourself down, you can start to challenge your thoughts and feelings and begin to think more rationally.
Sometimes I see my paranoia as a kind of “autocomplete” function in an app with a negative bent to it. It’s always listening and seeking to predict what negative thought someone might be saying to me. My autocomplete takes bits and pieces of what I’m actually hearing and “fills in the blanks” with some horrible story. It really can surprise you sometimes. You can sometimes tell yourself not to care about the thoughts at all — if I prepare myself before going out in public and EXPECT to hear some insults, I can avoid being surprised and overcome by my emotions. You want to avoid worrying about yourself and making your thoughts worse. This can be where being in the present moment can lead you away from the worrying and ruminating over your thoughts. Just be present. Allow yourself to feel your emotions, how you are reacting to them physically, and eventually get over them.
It’s also very much OK to ignore your thoughts and move on. A psychologist once told me that everyone has odd negative thoughts that pop into their head and that they are just thoughts — they don’t need to have any power over us. We may have grown up listening to them in our youth, but we certainly don’t have to listen to them as adults with a free will. We don’t need them and we can disregard them. I used to wonder if I must really hate myself to be thinking these thoughts of persecution and hearing insults in my mind’s ear. I don’t personally buy this argument because I generally feel pretty good about myself. I believe the content of these thoughts are being skewed by a physical, bio-chemical imbalance in my brain. I also believe that negative thoughts are a natural part of being human, developed over many years of evolution to protect us from harm.
Causes of Mental Illness
The “why” and the “how” metal illness is perplexing. Most experts think that about 50% of why these conditions exist and how they get started are from the genetics of the person afflicted, and the other 50% is from the influence of the person’s environment. Thoughts and emotions can be skewed toward mental illness because of physical, electrical, biological, and chemical processes in the brain that are imbalanced. An imbalance of the neurotransmitters dopamine, glutamate, norepinephrine, and serotonin are biological factors linked to schizoaffective disorder. Doctors are understanding more and more about mental illness. Through graphic images of scans of the brain’s blood flow activity in various regions, brain activity can be mapped. The use of these scans in diagnosing and treating mental illnesses is controversial, but significant differences appear in the scans of healthy brains versus non-healthy ones. Although this is controversial, and I’m not making any endorsements of this, I’ll go ahead and provide a link to a sight where you can see some scans. I’ll leave it to the reader to decide as to their use in treating mental illness. Discussions of SPECT (Single-Photon Emission Computed Tomography) scans have appeared on several PBS specials in the past several years, complete with books on the subject and clinical services by Dr. Daniel Amen.
https://www.amenclinics.com/services/brain-spect/
My hope is that someday researchers will discover a cure for mental illness and some of these new technologies may provide us with hope.
Conclusion
I often tell myself not to take things too seriously in life, to relax more often, and to try to enjoy life because it truly is short. I believe that human beings are natural “manufacturers of meaning” or “meaning machines”. Our brains are constantly trying to relate things together in meaningful ways, whether the meaning is there or not. We will always long for meaning in our lives and that is our very nature. I do have faith and hope that someday, perhaps when we die, we will each find out what life really means.
My future plans for continuing my learning journey with paranoia are to devise a rescue plan, and to come up with a mental health plan, a routine that I can perform regularly to stay healthy and happy so that I’m less bothered by the condition and less apt to be triggered and upset by it. I also want to start with a therapist again. My previous therapist advised me that I need to gradually expose myself more and more to triggering situations so that I can learn to deal with things better and not avoid them. Exposure therapy is based on the theory that the more you are exposed to your feared stimuli, the less you will react to it as you get used to it and its effect on you is dulled. The stimuli is in my case the paranoid thoughts and feelings, along with hearing insulting or accusatory voices from people around me.
My own personal theory on getting better involves reaching out to more people I don’t know and being more positive socially. I almost always find that when I do that, I realize that people aren’t persecuting me. I find that many times we actually like each other. I would recommend this practice to everyone. I have spent a lot of time during the COVID-19 pandemic and in the time following it, isolating myself from being in public. I do get out and have some friends, but I have not done this as much as in past years. So in the coming months, I hope to restart therapy, do the exposure method, be more proactive socially, and continue trying to hone my skills at dealing with this mental condition. I will keep you posted on how it turns out.
