How do I stop being paranoid that I'm going crazy?

Hi!

I'm 23 and I'm very paranoid. Recently, I've been fearing that I'm going crazy or that I'll go crazy in the future. I've had a very happy childhood and I'm surrounded by happy people, so I don't know how this can overwhelm me. The thought stays on my mind the whole day and goes on for weeks. I am often tense, especially when the thought seems to persist.

I try to tell myself I'm just imagining this and that I'm just creating my own problems, but that doesn't make it go away. I need to get my worry-free life back. I need convincing that I'm not going crazy.

Please help.

This question was submitted by 'Ana'

Mark says...

Hi Ana and thanks for your question.

So many people have this fear. Without talking with you, I can't know exactly why this preoccupying fear may have arisen, but I will focus on putting your mind at ease.

I used to work with severely psychotic or 'crazy' people, many of whom I grew very fond of. The general public do sometimes have a fear of people suffering in this way or fear they too might somehow 'catch' psychosis or accidentally go mad one day. But it's actually very hard to 'go crazy'.

First off, you need the genetic vulnerability - parents or siblings who have a psychotic illness. Then you need to have little to no insight that you are losing touch with reality. Part of having a psychotic delusion is believing you really are having thoughts beamed into your mind from aliens or that you are a member of the royal family (if you are not...actually a member of the royal family...ahem...you get my drift). Fear of going crazy is an anxiety, not a psychosis.

Then there is the fact that even people who experience psychotic delusions tend to have them as psychotic episodes, which means they don't stay 'crazy'. Typically, the first psychotic episode will occur during the early teenage years and actually occur less and less as time progresses. The person gets better at managing the episodes.

Many people who have a psychotic episode - in your words, 'go crazy' - only have one episode in their life. They have not 'gone crazy and stayed crazy' but 'visited crazy for a short while once'.

We need to be clear what 'crazy' actually means. We can all be irrational, have weird ideas, and misuse our imaginations to scare ourselves. If we don't sleep for a night or two, we may and eventually will experience wide-awake dreaming, as the brain still needs to dream even during your waking time. Everybody will have this 'crazy' experience if they stay up for a few nights. They have not 'gone crazy'; they just need to sleep. Sanity is a continuum. We are not 'sane' or 'mad'.

You are already 23 - way past the typical age for the onset of a first psychotic episode. Even if your parents have a history of psychosis, making you more genetically vulnerable, managing stress levels will help you remain healthy and strong. But I'm guessing no one in your family has a history of psychosis. It's still a great idea for you to relax often and lower stress levels, as a calm mind always sees reality more clearly.

All best wishes,

Mark