Paranoia Versus Social Anxiety

As if people were not confused and idiotic enough about the mental disorders. This is one of my pet peeves. Even very educated people don’t seem to know the slightest bit fuck-all about mental illness. I’m not really sure why this is. Most of them don’t have a dx, but many others do. Typically, the ones that do have never been formally diagnosed or treated by a clinician. This is really unfortunate. There’s nothing really wrong with having a mental dx. If you have one, you have one, right? Isn’t it best to know, and to treat it as best you can, than to go on in denial, screwing up your life by acting crazy, denying that you have a problem, and not doing anything about getting better? I am always stunned at the number of educated people who don’t even know the difference between neurotic and psychotic disorders. In addition to the third way split with the personality disorders, these are three of the top splits in mental illness. If you don’t understand the nature of these splits, you don’t know fuck-all about mental illness. If you don’t know anything about it, you have no right to talk about it, and you need to STFU. This is a painful subject to me. I have OCD. That’s a neurotic illness, or more precisely an anxiety disorder. Anxiety disorders have a certain flavor about them, but the main one is that the person with the neurotic illness is still in touch with reality, that is, he is not crazy. Even Freud recognized this. In fact, he isn’t the tiniest bit crazy in any way, shape or form, which is what makes these illnesses so puzzling to deal with. In general, neurotics are not the slightest bit dangerous either. I’m not sure why this is. Perhaps it is because of the nature of the person who gets these illnesses. This is often a very nice person. Nice, fearful, cautious, conservative. They are do-gooders. I’m told that people with OCD have the lowest rate of violence of anyone else, much lower than any random person. So why are they non-violent? In addition to the reasons above, all of the energy is directed inwards, not outwards. This is characteristic of the introvert, and it why introverts are so nonviolent. The beloved extrovert externalizes most of his energy and almost all of his problems and issues, putting them onto other people. Hence, the average extrovert is many times more dangerous than the average introvert. Indeed, almost all of the world’s serious violence is caused by extroverts. If all or nearly all of your energy is going inwards instead of outwards, you simply are not directing enough energy to the outside world to get violent, or even very aggressive. In order for substantial external aggression to occur, quite a bit of energy must be directed outwards towards the object(s) of the aggression. With the introvert, so much energy has been exhausted going inwards that there is simply not enough reserve left over to put enough outwards to do anything violent. Combined with the introverts fears and worries, basic conservatism and do-gooderism and extremely high morals, and you just don’t see a lot of serious violence in these folks. Not to say some won’t fight back though. Some will, and people are always stunned at a counterattacking introvert. They are ready to call the police, because they are sure that he must be insane or homicidal. This is because his behavior is so contrary to his nature. But even counterattacking, the introvert’s violence will be measured. He will throw food, dishes, water or books. If a serious object is flung, he will deliberately miss you. He will scream and yell and call you horrible names. If you really deserve it, he will punch you, but not very hard. Everyone has a breaking point. Extroverts’ violence is much more likely to be the initial violent blow, to use fists or kicks or other weapons, or to have serious consequences. This is because the extrovert, by his nature, does not think of consequences of acts so much as the introvert does. He’s more likely to get caught up in things. One of the things that is annoying about having OCD (other than having it) is dealing with all the dipshits who don’t understand it and insist that I must be crazy, a criminal, a killer, a rapist, a schizophrenic, a psychotic, a manic depressive, or some other bullshit. Some idiots keep on with these delusions after I have known them for years and they really ought to know better. It’s very frustrating! Paranoia is totally misunderstood by your average dipshit. One of the prime splits in paranoia is between social anxiety and paranoia. It’s true that it’s a bit hard to tell the difference sometimes, but I am convinced that these are two completely different ways of looking at the world. They might as well be on two different planets. The person with social anxiety may or may not be falsely evaluating situations. I have known folks who were afraid to go out because they thought that people thought that they were weird. Guess what? I knew these folks, and definitely, people did think they were weird! So that wasn’t a false analysis at all. But many social anxiety types take this way too far. They assume that everyone that they know or meet hates them, usually because of some inadequacy that they may have. People are always talking about them behind their back. Whenever anyone laughs, they are laughing about them. I’m convinced that this is probably a false analysis. The news is that most people are not looking at you all the time. If they are laughing, most of the time, they are not laughing at you. Sometimes they are looking at you, but you often can’t tell what the looks mean. Once in a while they might be laughing at you, but what of it? Let them laugh. The problem here is that this person thinks that the world is focused on them. Not so. Most people are just thinking about their own stuff all the time and are not thinking about you at all. If you are acting very strange, a lot of people will be more likely to pay attention to you. The more normal you act, the less people will care. I don’t generally think that everyone is looking at me. Most people seem to be ignoring me most of the time, which is the way it ought to be. When people are talking, most of the time, they surely are not talking about me. Every  now and then people seem to be talking about me. I try to figure out why, then adjust my behavior. Sometimes it’s something like, “Look at this guy staring at us.” In which case, I quit looking at them. When people are laughing, I assume they are not laughing at me. A few times, I have caught some idiots laughing at me, and it pissed me off. I don’t know why they did it. Why doesn’t someone go interview them and ask them why? If I catch you doing that, I will hold it against you for a very long time, which is proper. The truth that we are just not that important. We are grains of sand on the beach, blades of grass on the football field. Most people are not paying attention to you very much. The paranoid takes this a lot further. The paranoid thinks people are watching them, following them, commenting about them in menacing ways, trying to kill them, trying to break into their homes, hatching conspiratorial plots against them, etc. In the vast majority of cases, this is simply not the case. Not only are folks too self-involved to notice you very much, but they surely have better things to do than hatch idiotic conspiracies against you. Nevertheless, paranoids carry on with their paranoia. Why? For many, there is probably something wrong with their brains. They probably need to take a drug to make it go away. For others, they may have adopted an erroneous thinking style for some reason. For yet others, it seems to serve some sort of defensive purpose. I don’t have much issues with paranoia. In fact, I’m the anti-paranoid. I tend to think that everyone likes me more or less and that no one or almost no one hates me. Sadly, this is just not true. I’ve definitely got some enemies out there. There are some others who just don’t like me. Where one ends and the other begins, I’m not sure. This is painful for me to acknowledge, so I keep falsely assuming that these folks are my friends. But they are not! And this causes me all sorts of trouble. Where people may indeed by laughing at me, I am inclined to assume that they are not until proven otherwise. I assume that hostile persons actually are my friends, seeking out little bits of niceness amidst the emotional glaciers. Where people are talking about me, I assume they are not, or at best, it takes me a while to figure out that they are. This anti-paranoia is probably better than being a paranoid, but it causes a lot of issues in that I am too friendly towards folks that just flat out don’t like me for whatever reason. I try to talk to them, and that’s typically a bad idea. I’m overcorrecting in the direction of mental health, but the best social actor is a very cautious person. Here are some cases below, some of social anxiety, and some of paranoia. Social anxiety first: SA Case 1:

Well, what can I say? I am starting to believe that I genuinely suffer from one form of paranoia or the other. I started university last year and it has not been entirely easy, academically and socially. Although I have encountered feelings of anxiety and paranoia before in my life.If I am with a friend, who maybe has a closer friend with them who does not talk to me as much in the conversation, I always get the feeling that that other person does not want me around, or is slightly resentful of my presence. If someone I text does not text back, I assume it is because they do not want to talk to me, and just ignore or delete my text. I also feel they must be annoyed with me for bothering them, and wish I would leave them alone. Also that they are only being polite with me in a conversation and eagerly want to talk to someone else who shows up. When I am in shops or on the street, I presume they are watching me to see if I do something strange, so they can secretly laugh to themselves. Or if I have been in a group meeting, as soon as I walk away, they start making comments about how I acted. I also think people are going to make “look at loner/saddo” expressions when they see me on my own. I also panic and look to see if everyone else is with their friends. I really want to be happy and stop looking behind my back for threats. I also don’t want to quit studying, and would like a job as an auxiliary nurse, as I do enjoy working with people on a professional level. I have one best friend and two or three other close friends, and people I talk to. However, I wonder if people pity me or think I am a loner because I do not go out clubbing or anything, and don’t have more buddies. So do I suffer from paranoia, and/or low self-esteem? I really want to do something about this, and talk to someone professional who I can trust. But I am even afraid of a professional getting it wrong and putting me on a cocktail of drugs- which I don’t want! I would rather talk. I’m scared that I am just selfish, and want everyone to like me or at least think I am alright.

SA Case 2:

I have suffered with paranoia for most of my life and I’m now heading for 40. The worse time i have with it at work. I had a manager a few years back who bullied me and got me thrown out of my job and made it clear that it was because I was a threat to her position. Ever since then I fear that in any job I do that people are talking about me behind my back, unfortunately in my last long term job I had this did turn out to be true.

I am now in a job that is temp to perm and there has been issues in getting me perm and I cannot stop the thought that they never will and that they will get someone else in and they will take my place because of my paranoia as I am not fit to keep down a job.

The fear of being made unemployed and thus losing my place I live is tearing me to pieces. It hasn’t been helped by my parents pointedly telling me that if I ever need somewhere to live I could not live with them as the only spare space they have is reserved for my niece and nephew whenever they stay over.

I suffer badly with self esteem and I know that a lot of this stems back to my childhood as my mother was always telling me that I was an accident and that my younger siblings were planned and wanted. My mother also is still to this day very happy to tell anyone who wants that she has never been able to love me and only tolerated me because she gave birth to me. I am doing my best to fight my paranoias but it is hard to keep going on your own. My doctors refuse to listen to me and just want to prescribe drugs all the time, but they just make me very ill and the only option open me they state is lithium and i refuse to take that or any other antidepressants as they don’t solve the issues or actually help me.

SA Case 3:

I always think my friends don’t like me and people are out to get me and I don’t have any confidence in my self I think I am ugly and fat even though people tell me I am not I still think I am I also get depressed and angry very easily what can I do lol I’m glad I’m not the only one that feels like this though 🙂

SA Case 4:

I’ve always felt that, when I go down hallways with people in them, they’re looking at me, making fun of me, ridiculing what I’m wearing, my hair, no matter if they are or not. It’s even worse if I hear them talking about someone else, because then I just assume it’s me. No matter who I talk to, I feel like I’m annoying them, like no one wants to talk to me. Because of this, I don’t start conversations very often and only talk to a tight-knit group of friends.

I reminisce on old fights with my family and friends, thinking they still hate me over things that happened a long time ago. In essence, I guess it feels like everyone’s always out to get me, and that in reality, I’m a nuisance to everyone.

SA Case 5:

On a really bad day I hate people even looking at me – I image that they are thinking that I’m so ugly they really pity me. I hate it when people are walking behind me for the same reason. I’m sure that people hate being near or around me – and I agree with Ian that if I’m near a group of people and they start laughing I’m convinced they are laughing about me.

That ought to give you a basic flavor. The principle issue here is one of insecurity. Now onto some real paranoia: Paranoia Case 1:

I thought there was a camera in the lamp-post and a microphone in my button. I thought the cars behind were following me. People at work always seemed to use certain “phrases” – or I noticed them. Helicopters flew over our house and I was convinced they were spying on us and checking we were at home. I thought the phone was bugged.

I really noticed policemen – they seemed to be everywhere and police cars and vans were there because of me. I did not think there was something wrong with my thinking, I thought there was something wrong with society. Why didn’t society trust me’ I learnt in the end that maybe it was me not trusting myself and maybe I needed to do stuff that I “approved” of and felt good about.

Paranoia Case 2:

Like Alex I always think someone has come into my home and stolen the thing I can’t find. My son always says ‘who would want that’!’ it is a family joke now but I still think it immediately something is not where I thought it would be!

When very paranoid I think my phone is being tapped/I am being secretly filmed/being followed. I know it’s not real but at the same time it is real: ignoring these thoughts just help them to grow. I have nightmares about someone being in my flat when I am asleep.

I have started reading the book and am finding such reassurance from other’s personal accounts – such incredible relief to know I am fairly ‘normal’ for a paranoiac :o) I know why I feel the way I do but, before now, I didn’t have any solution to stop these thoughts.

Paranoia Case 3:

I always seem paranoid. I think when i hear people laughing, that they are laughing about me and slagging me off. The television, radio, books, mags all are disclosing personal information about me, like reading my mind. When i cant find something in my home i always think my friends or mother have stolen from me. I hate talking in groups because i think i am being judged by everyone.

Paranoia Case 4:

I hate my paranoia, i think people are going to attack me for no reason. I can’t get on public transport, i often think i hear the doorbell and there’s no one there. I hear people saying my name out in the street when I’m sitting in my room and there’s no one there. I think i hear the phone ringing as well. The doctor has put me on Seroquel (300mg) every day.

It’s taken over my life, I’m absolutely sick of it, I sometimes start to get really angry. I’m getting angry speaking about it now, it makes me feel stupid. Not right in the head. None of the doctors seem to want to help.

Paranoia Case 5:

I have had a lot of problems with anxiety in the past but recently I have been so scared all of the time. I often think people are following me, especially when I’m driving. Often I think that someone in front of me is slowing down and waiting to see which way I’m indicating then going the same way. I think people are watching me.

Tonight there was a car in the street outside and when he saw me looking out of the window he sped away. I cant stay at home on my own at night. I am just scared all the time that someone is going to harm me, try and break into my house or kill me 🙁

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0 thoughts on “Paranoia Versus Social Anxiety”

  1. Lindsay, do you think someone with a neurological illness that has no impact on their sanity (depression, anxiety disorders, eating disorders, social disorders) should be allowed to purchase arms? (Not taking into account your position on gun control.)

  2. I can identify with quotes from both anxiety and paranoia. I have anxiety dissorder and OCD but I also have paranoia about things for example i have been concerned that my food is contaminated at a resteraunt or that someone is following me. It can get confusing which is which for both sufferers and even therapist and pscychiatrist.

  3. my paranoia started when i was a paratrooper in viet nam and i thought that the commies were trying to kill me.oh,wait they were trying to kill me.when i came home i went through oakland and two urban maggots though my money was theirs’ and i shot both of them.i spent every dime i had saved on i always sit where i can see everything because i am still paranoid.

  4. A few patients have a hernia condition that can induce the symptoms of acid reflux Gerd.
    Cholecystokinin (CCK) has long been known as a central nervous
    system neurotransmitter involved in anxiety. Or you
    turn over to hug your loved one and forget you’re on the reflux pillow and slip off.

  5. Even I this is old as fuck I wanted to say thanks. I’ve been diagnosed as paranoid schizoid and my family tried to force me into risperidone, and since I read on the internet how shitty it is and decided not to take it I was kicked out.
    But the thing is, I’m not schizoid since I do want friends, and after reading this, I’m positive I’m not paranoid either, just a social wreck.
    Fukken doctors ruined my life, ha

  6. Hello, this is a great article and I can really relate to all of the comments about SA. I am a recovering schizoaffective, I have been on meds for about 2 1/2 years and am doing ok, after a paranoid episode. I still however think people are always laughing about me even if they cant see me or i them. It’s so tiring that I often think about giving up, I just hope this will one day go away. To read this Paranoia Case 3:
    I always seem paranoid. I think when i hear people laughing, that they are laughing about me and slagging me off
    is very confusing for me, My psychiatrist and psychologist assure me I’m no longer having any psychosis, I just cant tell anymore. Thanks

  7. OCD is certainly a puzzle. I know a quite clever guy who could not stop washing his hands. But he is ok now. I never asked him how he overcame it but he is fine. I think for some people it must be just a phase. And for others a life long thing. Still these people are not dangerous. He is one of the nicest white guys ever.

  8. I have depression, Tourette’s, Autism, and OCD (diagnosed and medicated) and suspected social anxiety (not diagnosed). Your introverted anxiety description fits me to a T except when I’m severely sleep deprived.
    I just lashed out at someone because I thought he was judging me for my foul stench. I perceived a disgusted look on his face and I immediately challenged him on it in an angry voice. Normally I’d have that thought and know rationally he’s probably not paying attention so I’d filter that out but I think increased impulsivity and impaired judgement came into play.
    It’s not paranoia. As soon as he acted confused I thought oh crap I just made a scene when he wasn’t judging me at all. When I explained that I thought I saw him sniffle when he caught a whiff of my stench I thought oh shit now I seem paranoid to the outside observer. I knew I wasn’t but the point is that the way I handled my fear of judgement was a lot different from the friendly do-gooder introvert you describe and the difference was because I hadn’t slept in 2 days.
    This also goes into the blanket statement you made about extroverts not caring about the consequences of their actions. You should have specified consequences to others. I hadn’t slept in 2 days because I often don’t care about the consequences of my actions to myself but it’s specifically myself. I’d never dare harm someone else. An introvert (especially a depressed introvert) can be extremely reckless and impulsive due to a lack of concern for themselves. That’s me. Plus subjective experience is the only thing that matters so I’ll sacrifice well-being just to experience something (which sounds kind of extroverted doesn’t it) but that’s a whole different issue altogether.

  9. Not entirely sure how I stumbled upon this post but found it very informative. I’ve battled anxiety for years and, although rather painful to admit , the SA cases really resonated with me. The thing about anxiety is that it’s a constant sort of grind on your sense of well-being. Thanks for this post, Robert. Enjoy this blog immensely

  10. Great post, Mr. Lindsay. Very informative. I’ve battled social anxiety my whole life and, though painful to admit, the SA case studies match my own experience. The thing about SA disorders is that they tend to act as a constant grind on your sense of well-being. You want to participate in the social interaction that others find seemingly effortless. Unfortunately, more often than not, one comes away from interactions feeling completely depleted of energy and spirit. To other sufferers FWIW I have found cognitive therapy to be somewhat helpful in combating this sort of thing. Best wishes to you

  11. I was recently diagnosed with four different anxiety disorders, so I started doing some research on each of them and comparing them to my own experiences. This article came up, and at first, I thought paranoia to be too extreme for my situation, but then I read the case studies you listed and my mind went “Oh yeah, I remember thinking stuff like that.”
    Every time I go downstairs at night to grab a snack, if I hear a noise outside, I start thinking someone’s watching me with a knife or gun. I know it’s never the case, but reason doesn’t kick in soon enough before I start having some scary thoughts.
    Every time I wake up at 4 or 5 AM, the milkman comes to deliver bottles of milk and other things to our house. When I see the light from his car flicker on and off, I freeze almost completely. I feel like there’s either a policeman or armed robber about to break into my house.
    Even bugs give me problems. I’ve knocked things over from the split-second reflex upon seeing them. My body feels like it’s getting an electric shock, I jump so hard. It takes me several seconds to exit panic mode and regain myself. Even after the bugger disappears, I’m watching the room all the time, checking to see if it’s either come back or has friends.
    I had a terrifying experience during childhood that may have contributed to these unnatural thoughts. Once with an angry fire ant colony at age 9, and another from when my parents were on the phone to an asylum with the intent to put me in there at age 12. I was crying harder than a Screaming Mandrake from Harry Potter because I also grew up with clinical separation anxiety. Being put in a little cell with a bunch of “inmates” was a terrible thing to imagine at that age.
    I’m so scared of getting into trouble with the law, and yet I’ve never done anything. It could be because I was subject to heavy psychological and physical abuse at school (not just by the kids, but the teachers as well). Having been diagnosed with Asperger’s at age 8, it was during a time when autism was just beginning to gain recognition, so there wasn’t much support for autistic children.
    I never did anything wrong, but there’s a voice in my head that is absolutely convinced I’m guilty as fuck. And it annoys me so much because I know it’s not true and based on prior subconscious conditioning. But it enters my conscience so quickly, it takes effort to get the lying bastard in my head out of my hair.
    I’m glad I read the article because I learned some things I was only mildly aware of until now.

  12. Maybe people mistake paranoia for social anxiety and vice versa because they often occur together in the same people and both stem from fear, paranoia comes from the fear of being harmed and brings extreme mistrust, social anxiety comes from the fear of being rejected and bring extreme shame. There is nothing stopping a person from being both and paranoid and socially anxious.

    1. Actually they don’t.
      Social anxiety people are almost never true paranoids. And paranoids usually do not have social anxiety. Paranoids are angry and hostile. People like that don’t have social anxiety. Social anxiety people are usually very nice.
      They are both frightened of other people, and prescribe harmful motives to others, so I guess that is the confusion.
      A lot of dumb people think frightened = paranoid. Actually, I even know some very smart (genius IQ) people who believe that. Very common misconception.

      1. It depends on what you mean by paranoid, if you mean somebody who is hostile out of mistrust, then they are usually not anxious, if you mean somebody who is simply too much afraid of people harming them in any way, like killing, robbing or kidnapping them, then they can be socially anxious too.

        1. if you mean somebody who is simply too much afraid of people harming them in any way, like killing, robbing or kidnapping them, then they can be socially anxious too.
          This sort of person is often psychotic or psychotic-like. And yes if they are psychotic or similar, they can also be socially anxious.
          Paranoid people usually think that others are actively plotting or conspiring to harm them. It often goes along with a lot of hostility.

  13. Hello Robert. Ok, so I read this comment, and I am really confused now. Do I sound paranoid or like someone with extreme SA? Literally every day when I go in public, I’m always on the defense. I always assume that people are looking at me strange, talking about me, whispering about me, giggling and laughing about me, etc.
    Here are some differences though. I don’t really value human connection. I’m not always trying to make friends. In fact, most people really annoy me, and I feel happy when I’m alone at home playing computer games. Another thing about me is although I don’t think the TV or magazines are talking to me, I do sometimes become hostile and confrontational with strangers in public.
    For example, just tonight there were these people that kept looking at me and kind of giggling a lot, and it really pissed me off. I ended up getting in their faces, and I told them to cut the shit, and I called them cowards and flipped them the bird. I didn’t violently assault them or anything, but each day I feel like I’m slowly getting closer and closer to the edge, and one day I’m going to end up hurting or killing someone or some people and end up in a lot of trouble. I know this post is super old, but I really hope you read this and give me some clarification.

    1. No you seem to be getting paranoid. But maybe people ARE making fun of you, etc. For a client like you, I would like to go out in public with them and see if people really ARE laughing at them, etc.

  14. So, here’s my issue, and maybe you can help me with it. I have been diagnosed with social anxiety, OCD, and bipolar disorder. Up until today, I didn’t realize that there was a difference between paranoia and anxiety. I thought my anxiety made me paranoid. The problem is that while I recognize that I totally fit the profile of someone who is socially anxious, longing for interpersonal connections while simultaneously believing that everyone has negative feelings about me, I also really relate to a lot of what the paranoid cases are saying.
    I don’t often share this, but I am particularly distrustful of reflective surfaces. Although I know it’s ridiculous, but I think there is a camera on the other side, and someone is recording me. Also, when ever I see a police officer or military personnel, I get really freaked out that they are going to shoot or arrest me, even though I’ve done nothing wrong. I don’t drive anymore since I’m off my meds, and am a danger to myself and others behind the wheel, but when I did, I felt that people were following me to find out where I lived and come back to rob or hurt me.
    Is this anxiety, or am I paranoid? I’m really confused.

    1. General mistrust of almost everything is mostly anxiety, imho.
      A very specific and intense fear is paranoia, imho.
      I find high altitudes to be a bit unnerving, and, I take sometime before trusting people.

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