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How to Help Someone With Paranoid Delusions in the Workplace

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People have described me as icy when I am symptomatic. This usual bubbly happy person suddenly becomes cold, icy, and aggressive. This has been a monumental struggle in the workplace for some of my coworkers differentiating between the “real” me or my core personality and the delusional, protective self that is cold or icy. People crave to be understood and this is my craving.

Just because I am symptomatic in the moment and seemingly a different person, doesn’t mean that my core personality is different. It just means that I am in need of protection and understanding. Soon, I will return to the person that is capable and a strong leader.

One of my symptoms is delusions and paranoid delusions. I work in retail and this makes it especially hard interacting with customers and coworkers. Strangers are especially dangerous. In addition to that, I have developed mild agoraphobia according to my psychiatrist. But what I really want to hone on is the ways you can help someone with paranoid delusions, specifically in the workplace. As a reminder, you have the ability to request reasonable accommodations and if I am symptomatic, I am allowed up to an hour additional break. This is crucial to my mental health and well-being and I encourage every person to request accommodations as needed. It has given me opportunities and safety that I otherwise wouldn’t have.

With paranoid delusions or persecutory delusions, which are mainly when the individual thinks harm is occurring or going to occur, I primarily think people are trying to kill me — nothing specific, but general fear. I know these instances occur because people have told me that I say these things, but I have few or blurred memories of these events. This has occurred since I was 5 years old, when my mom would leave me alone with my biological father. Childhood trauma is often linked to psychosis. According to Ingo Shafer M.D. and Helen L. Fisher Ph.D., this is possibly linked to the “negative perceptions of the self, negative affect, and psychotic symptoms, as well as biological mechanisms such as dysregulated cortisol and increased sensitivity to stress.”

Other examples of persecutory delusions include:

1. Neighbors are spying on me.
2. Police are following me around.
3. Government is setting up cameras and watching me.
4. People are stealing my stuff.

Some of these delusions can be very specific but they can also be quite vague, which is what I experience. Most people find delusions to be a very scary, real and confusing thing to encounter for the person inflicted and the person observing. For instance, someone is out to get me, but I can’t quite articulate “who” this person is. The specific delusions I have experienced within the workplace include:

1. My boss is trying to kill me.
2. My coworker is sexually harassing me and is very aggressive.
3. My relative is coming to my work to harm me.

One of my favorite articles published by the National Alliance on Mental Illness by Kim Runkle talks about the different ways you can help a loved one who is experiencing delusions. I am including some of these tips but with a more workforce spin on it. Most of my coworkers and loved ones feel like they cannot help me when I am gripped with psychosis and in this article, my hope is to shed light on understanding delusions but also in ways you can help. Runkle talks about how delusions should not be disputed or reinforced, and I think this is one of the biggest helpers in my situation at work. It is not helpful to argue with me or tell me that I am wrong that my boss is not trying to kill me because no matter what you say to me, my belief will not be shaken. It is embodied in this false belief and will not be swayed.

It is common for delusions to change based on new information. For instance, I have an old family friend struggling with paranoia who believes that there is trouble at the borders in Texas. When someone declared to him that it was not a concern to him, this delusion shifted into believing that he was an FBI agent sent on a mission to rescue people from ICE and the government was hiding things from him to make his mission harder.

Another thing that is incredibly helpful is to be validated in my concerns. For instance, I am scared someone is trying to harm me. A good and healthy response to this would be redirection and acknowledgment, such as: “Oh, that must be really scary. What have you been reading recently?” Or another example that is incredibly soothing is talking about a significant other or loved one. This redirects their delusions to something that they can grasp with equally high emotions. Asking me about my husband Sam is the easiest way to ease my mind and allows me to contact him.

One last thing that must be understood is that we cannot express what we need in these moments of delusions. It is important to educate yourself to better understand in helping someone with a mental illness or delusions. However, I will say that I am grateful for every moment a coworker has tried to help me during these moments. Even though some of them have done more harm than good, the support and love that has been expressed makes all the difference in my road to recovery. In order to better manage my delusions, I have taken a second leave of absence from my work. Wish me all the best in my endeavors to become a healthier, whole version of myself as I struggle to navigate my mental health. My main concern in writing these articles is to articulate my experiences and help my coworkers and loved ones better understand the challenges I face. Currently, I am working on a kit I can bring to work with me to help manage my symptoms without the aid of other people.

Photo by Slava on Unsplash

Originally published: January 25, 2021
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