And (I always feel like)

(Somebody's watching me)

And I have no privacy

Whooooa-oh-oh (I always feel like)

(Somebody's watching me)

Tell me, is it just a dream

When I come home at night

I bolt the door real tight

People call me on the phone

I'm trying to avoid

But can the people on TV see me

Or am I just paranoid?

Lyrics to Rockwell’s “Somebody’s Watching Me”

Many of you have probably heard this song before, Rockwell’s one hit wonder of the 80s, Somebody’s Watching Me. Every time I hear it I think of how difficult it must be to have paranoia. Although this song was meant to be entertaining, for the person who suffers from paranoia, intrusive thoughts of persecution and fear are anything but entertaining. They can be downright disabling.

I have some experience as a witness to the horrific effects of full blown paranoia. I grew up with a mother who has paranoid schizophrenia.  I can tell you from my experience that stress and anxiety always fueled my mother’s paranoid episodes and subsequent breaks from reality. During these times logic flew out the window. Reasoning and rationality on my part only served to make my mother cling onto her delusions with a heightened ferocity. If I did not “believe” that there were aliens on our roof or that my dead grandmother had faked her own death and was trying to poison us, I was considered the enemy. My own identity was often questioned when my mother would accuse me of being an imposter. Just try to prove that you are really you to someone who thinks you are tricking them. It would be a difficult feat for anyone let alone a child.

The one thing I learned about paranoia growing up is that it is hell for the person experiencing it and for the individual’s family. If paranoia was a beast it is an animal born from raw fear and terror. It jacks up that flight or fight instinct to unimaginable levels. Anxiety fuels, feeds, and sustains paranoia. Likewise, paranoia can cause anxiety and panic. It raises the question of which is the cause and which is the effect?

Is paranoia a symptom or a co-existing condition of anxiety? Can paranoia be associated with other psychiatric conditions?

In reviewing the literature there is no clear-cut consensus on how to answer this first question. Certainly not everyone who suffers from anxiety will experience paranoia. But it is true that those who have a paranoid episode will experience stress, fear, and anxiety.

Mainly we think of schizophrenia when we speak of paranoia but paranoia can co-occur or be a symptom of a wide variety of mental and medical illnesses.

Here are just some of the disorders which can be associated with symptoms of paranoia:

• According to authors Freeman and Garety (2006) precursory paranoid delusions can occur in patients having depression, mania, post-traumatic stress disorder, dementia, and epilepsy.