How stress, banditry contribute to mental health issues —Expert
Dr Taiwo Alatishe, a lecturer, honorary consultant psychiatrist and head of the Department of Psychiatry at LAUTECH and LAUTECH Teaching Hospital, Ogbomoso, in this report by Sade Oguntola, explains how to. . .
Dr Taiwo Alatishe, a lecturer, honorary consultant psychiatrist and head of the Department of Psychiatry at LAUTECH and LAUTECH Teaching Hospital, Ogbomoso, in this report by Sade Oguntola, explains how to distinguish healthy caution from clinical paranoia and why early treatment can save lives. Is there one myth about paranoia that you wish Nigerians would stop believing?Yes, the idea that paranoia is always purely spiritual. When someone develops severe suspiciousness, hears voices, becomes aggressive, or behaves abnormally, many people immediately assume it is a spiritual attack and take the person only for prayers. A safer approach is to seek medical evaluation while continuing to pray if that is part of the person’s faith. Some serious medical conditions can present with behavioural changes, and delaying treatment can be dangerous. Mental health professionals and faith communities can work together to help people recover, rather than seeing the two approaches as enemies. Can prayer and therapy or medication work together?Yes, they can. From a psychological point of view, prayer can provide hope, comfort, and motivation, which are very valuable during recovery. However, prayer should not be used as a reason to avoid medical treatment. We do not tell someone with diabetes or hypertension to stop their medication simply because they are praying. The best approach is for prayer and medical treatment to work together, not to replace one another. What exactly is paranoia from a psychiatric standpoint? Is it the same as being suspicious?The word paranoia is actually more of an English term than a strict psychiatric diagnosis, although psychiatrists use it to describe certain symptoms. In simple terms, paranoia means an excessive or unreasonable level of suspicion, especially the belief that other people want to harm you, are talking about you, or are plotting against you. It exists on a spectrum. Everyone has some degree of suspiciousness, it can even be useful for safety. One person may be only mildly cautious, while another may be much more suspicious. The problem begins when the suspicion becomes fixed and convincing despite a lack of evidence. For example, if someone thinks, “Those people may be talking about me, but I’m not sure,” that is still within normal limits. But if the person says with complete conviction, “They are definitely talking about me; they want to harm me,” and starts acting on that belief, then it becomes abnormal. In psychiatry, a strongly held false belief is called a delusion. Many psychotic disorders can involve delusions, including delusions of persecution (“people want to harm me”) and delusions of reference (“people are talking about me or sending me messages”). Is paranoia curable, and will treatment last forever?It depends on the cause. If the paranoia is due to a medical condition, treating that condition may make the symptoms disappear completely. For many psychiatric conditions, treatment is more about management and recovery than a permanent cure. Some people may need medication for one or two years, others for several years, and some may need long-term or lifelong treatment. The decision is made by the treating physician based on the person’s symptoms, recovery, and risk of relapse. Medication should never be stopped abruptly without medical advice. What are the early warning signs families should look out for?The earliest warning signs are often persistent difficulty sleeping, waking tired every morning, becoming unusually withdrawn, avoiding family and friends, as well as behaving in a way that is clearly different from the person’s usual character. If someone who was previously very social suddenly stops calling, stops interacting, and cuts off close relationships, it is worth checking on them and encouraging an evaluation. Early treatment is always better than waiting until the symptoms become severe. Do people with paranoia usually know that their beliefs are false?Most of the time, they do not. They hold the belief with strong conviction, and that is what makes the condition difficult. Family members may clearly see that something is wrong, but the person may insist that nothing is wrong with them. After treatment begins—especially with medication—the brain chemistry gradually changes, and the person may later gain insight into the beliefs they were having. In Nigeria, people may talk about witchcraft, enemies, or “village people. ” How do you distinguish cultural beliefs from clinical paranoia?Cultural context is very important. The same statement can mean different things depending on the culture. If someone says, “People are after me,” we do not immediately call it a delusion. We ask: “How do you know?”, “What evidence do you have?” “How strongly do you believe it?” “Is it affecting your life?”If the person says, “A spiritual leader told me this,” that is different from saying, “Nobody told me; I just know they want to kill me,” and then avoiding people, refusing to work, or isolating themselves. The key signs of clinical paranoia are a fixed belief without evidence, and a significant effect on functioning. For example, the person stops going to work, stops attending school, withdraws from family and friends, or becomes unable to carry out normal activities. Given the insecurity, kidnapping news, and fraud in Nigeria, is it normal for people to feel more paranoid?It is normal for people to become more anxious and more cautious during periods of insecurity. Someone living in an area where kidnappings have occurred may naturally become more alert and suspicious of unfamiliar people. In many cases, this heightened alertness reduces over time if the threat decreases and people begin to feel safer again. Government security measures, community reassurance, and public education can help reduce fear. However, in some individuals who already have a genetic or psychological vulnerability, severe stress can trigger a mental health disorder. What is the difference between healthy caution, social anxiety, and clinical paranoia?Healthy caution is simply being careful and security-conscious. It helps people avoid danger. A cautious person does not accuse others without evidence and does not act on the suspicion; they simply remain alert. Social anxiety is different. It is an anxiety disorder in which a person becomes very uncomfortable in situations where they may be judged or criticised. They may experience physical symptoms such as trembling hands, a racing heartbeat, sweating, and difficulty speaking or performing in front of others. READ ALSO:FG yet to implement mental health act despite rising treatment gap — PsychiatristThe person is not necessarily suspicious of others; they are mainly afraid of embarrassment or criticism. Clinical paranoia, on the other hand, involves a false or irrational belief that others want to harm the person. The belief is held strongly despite evidence to the contrary, and it often affects the person’s relationships, work, studies, and daily functioning. They may begin avoiding people, accusing others, becoming aggressive, or withdrawing from normal activities. Can a mentally healthy person experience paranoid thoughts sometimes? When does it become a disorder?Yes. A mentally healthy person can occasionally have suspicious thoughts. A thought may briefly come into the mind, and the person may wonder, “Could this be true?” but they still have doubt and do not act on it. It becomes a disorder when the person holds the belief with strong conviction, there is no evidence for it, and they begin acting on the belief. For example, avoiding a colleague, confronting someone, or changing their behaviour because they are convinced they are in danger. At that stage, we would consider it a delusion and evaluate what type of delusion it is. Is paranoia caused by biology, trauma, substance abuse, or all of the above?The first thing to understand is that paranoia is a symptom, not a diagnosis. It is similar to a headache or a fever—we then have to ask, “What is causing it?”Mental illnesses often do not have a single direct cause. Instead, we talk about risk factors, such as a family history of mental illness, childhood abuse or trauma, certain personality traits, and growing up in a highly suspicious or threatening environment. Others include substance use, especially cannabis, and some medical conditions, particularly in the elderly. A person may have several risk factors and still never develop a disorder. Usually, it is the combination of genetic vulnerability and environmental stressors that increases the likelihood. What mental conditions are commonly associated with paranoia?Paranoia can occur in several conditions, including paranoid personality disorder – longstanding suspiciousness that affects functioning. In schizophrenia, paranoia may occur alongside hearing voices, believing others can read one’s thoughts, and other psychotic symptoms. Severe depression can be accompanied by delusions. Also, paranoia can occur together with elevated mood and other manic symptoms. Similarly, delirium can be caused by infections, severe hypertension, or other medical illnesses. Dementia, a memory problem can lead to suspiciousness, such as accusing others of stealing or trying to cause harm. Likewise, postpartum psychosis, a severe mental illness, can occur after childbirth. To make a diagnosis, we look not only at the paranoid symptoms but also at the other symptoms that occur alongside them. In everyday language, people often talk about “weed-induced paranoia”. How do drugs trigger paranoid thinking?A simple way to understand it is through the brain chemical dopamine. People experiencing psychotic symptoms, including paranoia, often have increased dopamine activity. Substances such as cannabis, cocaine, and methamphetamine can also increase dopamine levels. In someone who is already vulnerable, this can push the brain toward substance-induced psychosis. Not everyone who uses cannabis will develop paranoia. Some people have a genetic vulnerability, which is why one person may use the drug without obvious symptoms while another develops severe paranoid thoughts. Different forms of cannabis also vary in potency, so the risk is not the same for every product. Can personality or genetics make someone more likely to become paranoid?Yes, absolutely. People can inherit a vulnerability, not the disorder itself. Having a parent or sibling with a psychotic illness increases the risk, but it does not mean the person will definitely develop it. We often describe it as “genes and environment working together. ” If the genetic vulnerability is present but there are few environmental stressors, the person may remain completely well. If significant stressors are added—such as trauma, substance use, chronic stress, or severe sleep problems—the condition may emerge. How do stress, lack of sleep, and social media increase the risk of paranoia?Stress leads to the release of stress hormones, which affect the brain and can worsen mental health symptoms. Sleep is especially important. Sleep allows the brain to rest, recover, and regulate itself. When someone is not sleeping well, the brain is under strain. One important point is that poor sleep is often an early symptom of a developing mental illness. Many people think the lack of sleep caused the paranoia, but sometimes the disorder begins with sleep disturbance and the paranoid symptoms appear later. We use the term poor sleep broadly. It can mean sleeping far fewer hours than expected, waking repeatedly during the night, waking very early and being unable to return to sleep, or sleeping for many hours but waking unrefreshed. If poor sleep becomes persistent for days or weeks, it may be a sign that something is wrong and should be assessed. Social media can contribute in several ways: it can create pressure to compete with others, it can expose people to frightening or suspicious content, and it can keep people awake for long hours, worsening sleep deprivation. Some people think you can simply reason with a paranoid person. Does that work?If the suspicion is still mild and not yet a true delusion, calm discussion may help. But once it becomes a fixed delusional belief, reasoning alone is usually not effective. In fact, the person may begin to see the person trying to help as part of the conspiracy. At that stage, medical treatment becomes the most important step. Medication helps reduce the abnormal brain activity, and supportive conversations become much more effective once treatment has started. WATCH TOP VIDEOS FROM NIGERIAN TRIBUNE TVBack to School, Back to Business A Fresh StartRelationship Hangout: Public vs Private Proposals – Which Truly Wins in Love?“No” Is a Complete Sentence: Why You Should Stop Feeling GuiltyRelationship Hangout: Friendship Talk 2025 – How to Be a Good Friend & Big Questions on FriendshipPolice Overpower Armed Robbers in Ibadan After Fierce StruggleGet real-time news updates from Tribune Online! Follow us on WhatsApp for breaking news, exclusive stories and interviews, and much more. Join our WhatsApp Channel now