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Coping with Paranoid Thoughts, Delusions, and Hallucinations

"Delusions are strong beliefs that are not consistent with the person’s culture, are unlikely to be true and may seem irrational to others" (NAMI). I struggle with delusions consistently and have for years. In my pre-teen and teenage years, I sat in bed bartering with a complex society of monsters each night to let me live through the night, and I covered my neck so that one monster in particular could not turn me into one of his minions. Today, I struggle with thinking that people I see are vampires, werewolves, or goblins using illusion magic to pass as human. I also struggle with thinking I'm being watched and followed or recorded. Other common delusions include believing that outside forces are controlling your thoughts or actions, believing little remarks or objects have special significance, and believing that you have special powers (NAMI).
"Hallucinations are seeing, hearing or feeling things that aren’t there"  (NAMI). I didn't start dealing with hallucinations until I was 19 or so. I experience simple hallucinations, such as seeing smoke, shadows, sparkles, flashes of light, or other small and brief phenomena and hearing things like knocks, creaks, and beeps. I also sometimes experience more complex hallucinations, such as seeing beings that aren't there or hearing voices, but for me, this is usually a sign that my medication needs adjusted.
In paranoia, an individual mistakenly interprets “others” actions and motives as being of a threatening nature (NAMI South Bay). I experience paranoia as a result of my delusions; I think people around me have been replaced by replicas or fantasy creatures or are colluding with aliens at times. I also experience paranoia as a result of my inability to read social cues, a facet of my autism. I tend to assume that people are upset with me or trying to communicate some hidden message. This is worsened by the fact that I grew up with emotional abuse, where there often was a hidden message in the other party's behavior. However, paranoia is the symptom I experience the least out of the trifecta, and it's the one I'm most often able to look at rationally.
 As you can see, paranoia, delusions, and hallucinations can play into each other. A delusion can be reinforced by the sounds that someone is hallucinating, or paranoid thoughts can be brought on by delusions. Therefore, the coping methods for these things are not discrete, but blended together, with each method being at least somewhat useful for all 3 symptoms. Here are some ways to cope with delusions, paranoia, and hallucinations:
Method 1: Challenge the Thought or Hallucination
Make a list of reasons why the thought or hallucination might be real and reasons why it could be unreal. It's okay if you don't make a decision about whether it's true or not, but if you do decide that it's a untrue, you can come back to this list when you start to doubt and remind yourself why you don't think the hallucination, delusion, or paranoid thought is reality-based.
Method 2: Reality Check with a Friend
Establish with a friend ahead-of-time that they are willing to help when you are experiencing psychosis (delusions and hallucinations). Talk to them about how you want them to respond. Then, when you have a thought or experience you think might be unreal, contact them and have them help you test the thought or experience by coming up with evidence that it might be real and evidence that it might be unreal, including whether they are sharing the experience.
Method 3: Respond Differently
Identify what you are thinking or experiencing, what emotions it causes, and how you usually respond. For instance, if I hear roaring outside, and I feel afraid, I might stay away from the doors and windows. Then, try responding differently, and see if the delusion, hallucination, or paranoid thought changes. For instance, in the example above, I might try going outside or looking out the window to see what happens. Use a notebook to keep track of your experiences, how you felt, how you responded, and what the result was. Review it with your mental health professional, if possible.
Method 4: Be Distracted
Sometimes, the best thing you can do with persistent psychosis is ignore it. Don't be afraid to take a bath, watch a show, call a friend, take a walk, or do something else that will take your mind off of the unsettling things you might be experiencing.
Method 5: Get Professional Help
If you need to talk through what you're experiencing with someone, a text-based crisis line can be reached by texting 741741 from anywhere in the USA, and the suicide hotline can be reached by phone at 1-800-273-8255.
If your symptoms are new or worsening, you should also consider making an appointment with your mental health professional, if you have one. Finally, if you think you are a danger to yourself or others, go to an emergency room. They have to help you, even if you can't afford to pay. Emergency services can be reached in the US by phone at 911.

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