Persecution Mania: Symptoms, Causes, Diagnosis and Treatment

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The term "persecution mania" is incorrect from the point of view of clinical psychiatry and is used in everyday life as a synonym for increased anxiety, suspiciousness and vigilance. In medicine, the term "persecution delirium" is used, denoting a serious pathology of thinking, characteristic only of psychoses (psychotic disorders).
Persecution delusion is the most widespread and dangerous type of delusion, since its pathogenic development poses a serious threat not only to the patient himself (like most other delusional ideas), but also to his loved ones, as well as to society as a whole.
In this article, you will learn what constitutes persecution mania scientifically, the symptoms and signs by which it can be recognized, the reasons for its occurrence, and methods of treatment and prevention.
If you care about your mental health, be sure to sign up for our Mental Self-Regulation online program, which teaches you effective techniques for managing your emotions, dealing with stress and relaxation, with which you can avoid psychological problems and minimize the risk of serious mental health problems. diseases.

"Persecution mania"​

Persecutory delusions (paranoid or persecutory delusions are a person's persistent belief that they have ill-wishers who follow them in various ways to harm them.
The role of ill-wishers can be both real people (relatives, neighbors, colleagues, friends, acquaintances, etc.) and fictional characters (secret organizations and agents, aliens and other unreal subjects).
To better understand what delusional ideas of persecution are, consider their types.

Types of delusional ideas of persecution​

Delusional ideas of persecution can have absolutely any content, but scientists still identify several main types of them. The most common particular cases of manifestations of delusional ideas in medical practice are:

• Persecution delirium (in the narrow sense). It seems to the patient that he is being closely followed. He thinks that someone is watching his every step, wherever he is: at home, on the street, at work, at a party, in public places, etc. He is sure that ill-wishers penetrate and install tracking devices everywhere: in his apartment, entrance, office, elevator, telephone, computer, etc. This type of delusional ideas is especially relevant in our time, when information technologies are used everywhere and there is a real threat to the security of personal data.
• Delusional relationship. The patient feels heightened attention to his person and is sure that everything that happens around is directly related to his personality. It seems to him that all people want to cause him physical or psychological harm: even in the case when the words and actions of people are neutral in color or directed at others. For example, when a person walks into a store, it seems to him that everyone starts to look at him and discuss his appearance.
• Delusions of impact. The patient is seized by the thought that he is undergoing mental or physical influence. With a delusion of physical influence, the patient is sure that someone is influencing him through various devices or devices (for example, chips, beams, lasers, etc.) with the help of various kinds of suggestion (hypnosis, telepathy, witchcraft, etc.). Some patients even believe that they are controlled by God or the devil.
• Delirium of poisoning. A person is convinced that someone is trying to poison him by adding toxic substances to food, water, running them into ventilation or laying them around the apartment, etc.
• Nonsense of material damage. The patient thinks that his ill-wishers constantly spoil or steal his personal belongings: from socks to real estate.
• Staging delirium. The opinion that everything that happens around is nothing more than a kind of "conspiracy" against the patient. All the people around them participate in the dramatization, specially adjusting reality in such a way as to somehow ruin a person's life, kill him, etc.
• Delirium of jealousy. The patient is convinced that his partner is cheating on him: he begins to follow him and collect evidence of his infidelity.
• Delirium of litigation. The patient is sure that his rights have been violated, and constantly appeals to all kinds of authorities with various kinds of complaints. For example, it seems to him that he was unlawfully fined or detained, deprived of parental rights, forced to make any payments, etc. (although this may not have happened at all in reality).
• Erotic delirium. A person considers himself a victim of erotic claims from others: starting with unobtrusive flirting and ending with accusations of rape.

It is important to note that absolutely all ideas of persecution are devoid of any positive connotation and are strictly negative in nature: the patient does not think that he is being watched because he is interesting or sympathetic to someone, but is sure that the persecution is always directed against him.
But why do such absurd and illogical ideas arise and develop ? Let's figure it out.

The reasons for the emergence and development of "persecution mania"​

All delusional ideas are inherent only in psychoses (psychotic disorders) of various origins, which are the most striking manifestations of mental illnesses, in which mental activity is so modified that the perception of reality by a person is greatly distorted.
The main difference between psychoses and other types of mental disorders is the presence of positive symptoms - qualitatively new signs that are not inherent in the psyche of healthy people. The main positive symptoms of psychosis include hallucinations, movement disorders, mood disorders (affective disorders), and delusions (delusions).
Delusional ideas are erroneous judgments that clearly contradict reality, but so capture a person's consciousness that he absolutely defies dissuasion. One of the main delusional ideas is the delusion of persecution, which in everyday terminology is called "persecution mania."

So, the main reason for the emergence of delusional ideas of persecution is the development of psychosis, which can have a different character:

• somatogenic (for example, occur due to myocardial infarction);
• neurological (psychosis can appear as a result of stroke, Alzheimer's disease, cerebral atherosclerosis, Parkinson's disease, etc.);
• endogenous (psychosis is inherent in paranoid schizophrenia, bipolar-affective disorder, etc.);
• intoxication (psychosis can occur as a result of toxic poisoning of the body with psychoactive substances - alcohol, drugs, drugs);
• traumatic (severe traumatic brain injury can also lead to the development of psychosis).

Delusional ideas can arise from psychosis both by themselves and under the influence of various factors. However, psychological trauma and objective prerequisites can only serve as a catalyst for the emergence or development of psychosis, but they are never the main reason for the emergence of the delusional ideas themselves as such. Neither difficult life situations, nor the presence of real facts of any kind of surveillance can cause delusional ideas of persecution in a person with a healthy psyche. If a person does not have the aforementioned mental abnormalities, they can only lead to the emergence of various psychological problems: phobias, anxiety, suspiciousness, vigilance, etc.
So, we examined the main types and causes of the onset and development of persecution delusions. Now we will tell you how to recognize the "persecution mania", and what is its danger.

Signs of "persecution mania"​

Any delusional idea of persecution meets the characteristics common to delusion that help in its diagnosis:

• "Pathological soil". Delirium always arises as a consequence of a serious illness, therefore, delusional ideas are qualitatively different from the delusions of mentally healthy people.
• Distorted perception of reality. Delusional ideas always arise from mistaken reflections of reality. Despite the fact that certain prerequisites for the emergence of delusional ideas can be objective, the logic of judgments is always violated: a picture is built in the patient's worldview that has nothing to do with reality.
• Steadfastness. The patient cannot be dissuaded from the correctness of his judgments by absolutely no means. Moreover, attempts to do so lead to a worsening of the situation. The patient is absolutely sure that everything that happens to him is real and 100% reliable, he does not even admit the possibility of the existence of alternative options.
• Erroneous logical reasons. The logic of delusional ideas is distorted and takes the form of a "logic curve" or "paralogics".
• A radical change in personality. Delusional ideas completely take possession of a person's consciousness and change his attitude towards himself, his environment and the world as a whole.
• Self-awareness problems. Patients with delusional ideas are clearly aware of reality, but they completely lose touch with their real "I" .
• Preservation of intelligence. Despite the decrease in mental activity, intellectual abilities remain at the same level or decrease only slightly. Moreover, the stronger the dementia, the less pronounced are delusional ideas.

It is important to answer that in order to classify an idea as delusional, it must necessarily have all of the above characteristics, and not at least some of them.
What is the difference from other delusional ideas specifically "persecution mania"? Symptoms and signs of particular cases of persecution delusion vary considerably depending on its content and stage of development.

However, in general terms, the signs of "persecution mania" can be reduced to four main changes or violations:

• Impaired thinking. The main sign of delusional ideas of persecution is the emergence of thoughts that someone is watching the person in order to harm him. However, in most cases, patients do not speak openly about this, but carefully hide it, therefore, delusional ideas can be recognized only by changing the emotional state, behavior and attitude of a person to other people.
• Change in emotional state. The patient has increased anxiety, fear, panic, problems with eating and insomnia.
• Behavior change. It manifests itself in attempts to avoid persecution through the commission of a defensive response. This can be like trying to avoid persecution (for example, a person constantly looks around, installs additional locks on the door, clogs all the windows, gets rid of all objects in the room, refuses to eat, does not leave the room, wants to urgently move to another city, etc.) etc.), and attempts to deal with the persecutors with the help of their own active actions (the patient may begin to follow his ill-wishers in response, show verbal and physical aggression towards them, complain to various authorities, set traps, etc.)
• Changing attitudes towards people. The former benevolence and openness are replaced by unreasonable hostility, aggressiveness, suspicion, distrust and secrecy.

The severity of these symptoms directly depends on the stage of development of delusional ideas:

1. At the first stage, signs of violations only appear and are not too obvious (increased anxiety, irritability, suspicion, isolation are observed).
2. At the second stage, the patient is increasingly absorbed by his ideas, so the signs of violations are becoming more and more noticeable (asociality, a desire for self-isolation, an increase in distrust, problems with sleep are noticeable ).
3. At the peak of the development of the disease, the symptoms are expressed as much as possible, since the patient is completely absorbed by his ideas (there is a deterioration in the general condition, depression, acute aggression, a strong feeling of fear, complete distrust of the world around him, insomnia, suicidal tendencies). At this stage, the "persecution mania" is simply impossible not to notice.

As we can see, the development of delusional ideas of persecution can lead to two very serious negative consequences: suicide and causing serious harm to other people as a result of self-defense against an imaginary threat.

In order not to aggravate the situation, when communicating with a person in whom you have noticed these symptoms, adhere to the following recommendations:

• do not ask him to tell you about his crazy ideas in detail;
• do not treat his statements with disdain, do not ignore them and in no case make fun of them;
• do not try to convince him of the correctness of his judgments;
• do not prevent him from “hiding” from his pursuers (no matter how absurd the ways of his isolation and protection may be);
• monitor the patient's condition to prevent the risk of suicide (pay attention to what he says and does, and treat it with understanding);
• hide all dangerous objects in the house (tablets, weapons, sharp objects, etc.), close windows and doors.

If you notice these symptoms in yourself or in someone close to you, be sure to visit a psychiatrist so that he can identify the underlying disease that led to the emergence of delusional ideas. This can be done by seeking free consultation at a neuropsychiatric dispensary at your place of residence, psychiatric research institutions and private clinics.

Diagnosis of "persecution mania"​

The diagnosis of delusional ideas themselves takes place in different ways. If they are at an early stage of development, patients usually agree to see a doctor. If the patient is in an average and serious condition, when delusional ideas already seriously affect his consciousness, he is no longer able to realize the true state of affairs and does not trust anyone, the only sure step is to seek qualified help without his consent. This is the only way to protect everyone: him, himself, and other people.
But, as we said earlier, the delusion of persecution is one of the symptoms of psychosis of various genesis, therefore it is much more important to diagnose not the delusional ideas themselves, but the disease that underlies them.
Comprehensive diagnostics of the underlying mental illness includes instrumental studies of the brain, a clinical conversation with a psychiatrist, and pathopsychological testing:

• Instrumental studies (electroencephalography, MRI and X-ray of the brain) can reveal the severity of the foci of excitation in the cerebral cortex, which lead to the emergence of delusional ideas, as well as identify other damage and lesions that will help determine the disease that causes delusion.
• A clinical conversation with a psychiatrist involves the collection of anamnesis (information about pathological symptoms, heredity, past diseases, craniocerebral trauma, etc.). During the conversation, the psychiatrist will also observe the patient's emotional and behavioral reactions in order to make an accurate diagnosis. In addition, in case of psychosis, it is strongly recommended that not only the patient himself, but also his relatives talk to the doctor, because only in this way the psychiatrist can see the real picture of what is happening.
• Pathopsychological testing is carried out using standard techniques. First, it is necessary to conduct a study of the basic mental processes, since in psychoses, there is a decrease in mental activity in general. Second, confirm the initial diagnosis (eg, bipolar disorder, schizophrenia, etc.), if possible, with specialized tests. Third, determine the real level of fear, anxiety, aggressiveness, secrecy, etc.

Based on the results obtained in the above three studies, the psychiatrist will be able to make an accurate diagnosis and prescribe the appropriate treatment.

Treatment of "persecution mania"​

Delusional ideas of persecution do not lend themselves to specific correction, therefore, to eliminate this symptom, it is necessary to treat the underlying disease.
Since delirium arises as a result of psychosis, the underlying disease is primarily treated with drug therapy: typically, typical and atypical antipsychotics, tranquilizers and sedatives are used. Patients with psychosis are also advised to undergo cognitive-behavioral and family psychotherapy, which will help them return to normal life in society as soon as possible.
If crazy ideas have arisen after a strong emotional shock, you need to devote more time to psychotherapy. If the delusion of persecution is due to toxic poisoning of the body with alcohol, drugs or drugs, the patient must stop using psychoactive substances and undergo rehabilitation in an appropriate institution.
The prognosis of psychotic disorders is influenced by the type of underlying disease, the degree of its severity, as well as the timeliness of initiation of therapy and its intensity.

Treatment prognosis for "persecution mania"​

After proper treatment, delusional ideas of persecution almost always disappear, however, as a rule, relapse soon occurs, especially in endogenous diseases. In most cases, psychoses occur with periodic exacerbations, which are provoked by physical or psychological factors. Sometimes psychosis becomes chronic and proceeds with pronounced symptoms until the end of a person's life. However, there are also individual episodes of psychosis, which after a single treatment never occur again, and the human psyche is almost completely restored. As a rule, such cases are observed mainly in adolescence.
The format of treatment and its timing also vary depending on the underlying disease and its severity. If there are no serious complications and it is quickly possible to find the right pharmacological drugs, the treatment is carried out on an outpatient basis and lasts on average up to two months. If the symptoms of the disease are difficult to respond to drug therapy, it is recommended to visit a day hospital. However, in most cases, hospitalization is required for treatment in order to protect both the patient and his environment from the negative consequences of delusional ideas.
Nevertheless, the effectiveness of treatment and further prognosis directly depend on the specific pathology, the consequence of which is psychosis, as well as on the lifestyle that a person will adhere to after treatment.

Prevention of "persecution mania"​

At the heart of the emergence of delusional ideas of persecution are psychoses of various genesis, it is impossible to insure your health against the appearance of which. Nevertheless, the likelihood of psychosis and how it will proceed directly depends on the lifestyle that a person leads.

To minimize the risk of onset and exacerbation of psychosis, the following guidelines must be followed:

• adhere to a healthy lifestyle (fully rest, eat right, stop using psychoactive substances, play sports, etc.);
• periodically undergo a general and psychiatric examination;
• consult a doctor in a timely manner if the slightest signs of the development of the disease occur;
• monitor your psychological state (learn to manage your emotions and cope with stress, avoid stressful situations).

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