How do you help someone with paranoid thoughts?

[Just13moreyearstogo]

Hello - I visited an old friend yesterday. She's 44, single and childess, lives with her parents, hasn't worked for many years, doesn't seem to have local friends and is scared to even walk around her neighbourhood because she believes everyone is talking about her. She also believes this happens when she goes to places where she is unknown. She tries to work out how and scans the internet to see how people could possibly know about her. She's very depressed and ashamed. She was given a diagnosis of BPD about 15 years ago and was an in-patient for a few months. These days she just seems to be depressed and paranoid, without manic episodes. She did once overdose a few years ago, but states that she wouldn't do it again for the sake of her parents. Her parents are in their seventies and, obviously, she's terrified about what will happen when they die as she is completely emotionally dependent on them - she only feels safe when they're around. I caught her at a particularly bad time yesterday as her parents had gone away to a funeral for a couple of days, but are in phone contact. She also has a local brother and sister who look out for her. She drives and feels safe in the car so will drive somewhere away from home to walk her dog. She loves animals and I would hope that if there is any improvement in her mental state she might be able to do some voluntary work with animals - anything to get her out and about. There was absolutely no convincing her that her paranoid thoughts were not based in reality and I think that maybe if she could live with them and be able to say 'so what?' to the thoughts that people are talking about her she might be able to make some headway. She sees a psychiatrist every few weeks and a mental health nurse but feels they're losing patience with her. I think a course of CBT might help - I'm sure her family would pay privately as they must be at the end of their tether. She's in the Northamptonshire area. Does anyone know anything about services there/support groups or does anyone have experience of dealing with paranoid thoughts? I don't live near her so can only offer support by phone or email. I'd be really grateful for any advice or experience.

It sounds like she's getting quite intensive input. The fact that she feels her team are getting fed up with her fits neatly into the paranoid picture to be honest and may have little to do with the reality.

May Mind can give you some advice how to help her? Or can you see her mental health nurse together with her to get a better idea?

AFAIK she will not easily be able to say 'So what' to the idea of people talking about her, that's part of the problem. Saying 'so what' requires reality rather than paranoia to talk.

Bump

Feeling a bit paranoid that everyone's ignoring me

Whoops - sorry madmouse I missed your post!

Thanks for your reply, madmouse. I don't live near her so it will be hard for me to see her mental health worker but I'm trying to gather information so I can talk to her and her parents about it. I have no experience with this sort of problem though so feel at a bit of a loss and also feel quite emotional about it as she's my oldest friend - I've known her since she was 4 and it's so sad to see her like this.

Is she telling her mental health team everything? Sometimes people with paranoid thoughts don't disclose them to the people they should tell, and if her thoughts are stopping her going out to that extent it is important that her psychiatrist/CPN knows what it going on. You could contact them - they can't give out any details to you but your input might be useful in firming up her diagnosis.

I have experience of this (as a patient!) and if she is having paranoid thoughts which affect her behaviour to this extent she may well need medication to stop them - that's why I asked if she is being truthful with her medical team.

Can you clarify - when you say BPD do you mean Bipolar or Borderline Personality?

I've found the names of some CBT therapists in her area and I've found details of a book about dealing with suspicious and paranoid thoughts. I've emailed the information to her. I suppose I would just like to hear from anyone who's dealt with this problem in themselves or someone they know and who might have some ideas about what can help.

You have my sympathies as a dear friend of mine has been having similar problems. She seems to be on the mend now - a lot of her difficulties seem to have stemmed from where she was living and now she has moved she is better, but also she has a history of thyroid trouble and her GP has altered her meds accordingly as it seems to be playing up again - don't know if it;s worth checking that your friend's doctors have tested her thyroid function? It does seem to be associated with anxiety and depression sometimes.
It;s very unlikely that her mental health team are 'fed up with her' - it's their job not to be, and they will be continuing to look after her unless she becomes so ill that she starts beating them up or something - and if that were to happen she would probably be taken in somewhere as an inpatient for a while. BUt don't fret that she will be left without care.

Thanks itsonlyajob - I will call her local Mind office. Weegiemum - bipolar disorder. I don't know the full details of her medication but she said she's on an antipsychotic, an antidepressant and valium when she needs it for anxiety. It doesn't seem to me that the medication is really helping but it could be that it needs to be increased, I suppose.

weegiemum - thanks for the idea that she might not be telling her team everything - I hadn't thought of that and it might be worth talking to her about.

Thanks SolidGoldBrass - I don't know about her thyroid function so again, that's something I can explore with her.