Topic: anxiety

Question: How do I handle my extreme paranoia?
I'm just an extremely paranoid person. I constantly feel as though I am in some sort of danger, like as though I live in a horror movie with no resolution. It worsens at night. It gets to the point I'm scared in my own home more so than anything. I have no access to the help I need so I'm desperate.

Answer (from Kaileen McMickle, MS, LPCLicensed Professional Counselor):
That really sucks and I'm sorry that's happening to you.I'm curious what kind of paranoia you are experiencing--like someone will hurt you?  That something bad in general will happen?  Sometimes intrusive thoughts, like paranoid thoughts, are just thoughts.  They don't mean you are actually in danger or that something bad will happen, so pay attention to the meaning you apply to those thoughts.  If you've been through something traumatic such as rape, domestic violence, or any situation like that, it could provoke paranoia bigtime.  Your brain feels as if it has to be "hypervigilant", meaning it has to be extra attuned to everything around you to keep you safe.  That's exhausting.  If it's worse at night that probably means you aren't getting much sleep--also exhausting and contributes to heightened paranoia, so it becomes a pretty vicious cycle.It's not shocking that it's worse at night because night is generally a scarier time and sleeping is, physically, when we are in our most vulnerable state.  It can help to take a look at how much of that paranoia is actually helping you to protect yourself vs. how much is additional stress.  A way to figure that out is to ask the question, what behaviors are necessary to keep you safe?  So if you lock your doors, lock the windows, shut the curtains, have an escape plan (if needed--I'm not sure what your situation is), is that the most you can do?  Beyond that, are you performing other behaviors that may not be keeping you safe but exist to cope with the paranoia?  For example, if you are checking over and over to make sure the doors and windows are locked, those behaviors are more like compulsions/rituals that help you feel safe by reducing anxiety even though they use a ton of energy to perform.  Response prevention can be helpful here--this method involves avoiding your usual response so that you can sit with the anxiety rather than escaping it through the behaviors.  Let's say your anxiety rises and you feel the need to check the door lock.  You check the lock, it's for sure locked, and your anxiety is reduced.  At the same time, the behavior of checking the lock is reinforced by feeling better, so your brain decides if you want to feel better, you need to check the lock.  It becomes an exhausting habit that only temporarily makes you feel safe.  However, if you feel a bout of anxiety and sit through it without checking the lock, your anxiety will go back down and your brain learns that you don't need to perform that behavior over and over.  I'm so sad to hear you don't have access to help.  There may be some counselors right now offering reduced-rate or probono (free) sessions via telehealth due to COVID-19, so if you search around on google for your specific state, you may find someone that can help you from your home.  Counselors usually reserve space on their schedules for people that cannot afford therapy or need a lesser rate.You are always welcome to come back to this forum and ask additional questions!

Answer (from Sherry Katz, LCSWCouples and Family Therapist, LCSW):
One approach is to be more accepting of yourself as someone who has fears.It is much easier to manage a problem when you're not fighting yourself for having a problem.Once you are willing to accept this quality within yourself you may start to feel a little more relaxed about handling the fears when they arise.One answer is to examine the facts about the fears.   Ask yourself fact based questions as to how you would handle the worse case scenario of your fears.Feeling prepared, whether or not the circumstance is highly unlikely to happen, may increase your peace of mind with living the great fears within your mind.