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What's the difference between paranoia in schizophrenia and social anxiety?

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Posted · Report post

I hate going outside. Im ok if i go for a short walk around the block, and most days im ok going somewhere if my husband is with me (although sometimes even with him there i still panic), but if i have to go somewhere and have to interact with people, i fall apart. I get so embarrassed, i cant stop thinking that they're laughing at me or judging me. Or that they're going to yell at me/ hurt me. It is so bad that i often dont even want to leave the house, i just stay indoors all the time. I always assumed this was just paranoia from the whole schizo thing, but recently i had it brought to my attention that i might be suffering from social anxiety/ social phobia.

What's the difference?

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Posted · Report post

I don't have schizo-affective disorder. I am not sure that it makes a difference whether the schizo-affective is causing the paranoia, or social anxiety. I haven't had social anxiety (well, almost none) for awhile, and it was never severe. But *in my opinion only,* those symptoms sound a little intense to be Social Phobia.

*Cue all the CBs members with social phobia who have the exact same symptoms as you do*

So take what I say with a grain of salt.

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Posted · Report post

I suffer from social phobia and yes I share your symptoms. I dread leaving the house and interacting with anyone, even going to the store and using the self-service checkout (so I don't have to talk to or make eye contact with a single person) I'm internally freaking out because I'm sure everyone is judging me, laughing at me, talking about me, etc. I almost had a fight today with my (one and only) friend because he wanted me to go through the drive through and I was driving. Place an order, hand over money, get food. Simple right. What could possibly happen, he said. Oh, I said, you don't even want to know the thousands of possibilities I conjure in my head.

I can't comment on the schizo question. But your description sounds like my experience with social phobia.

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Posted · Report post

There is paranoia with schizoaffective, but with meds it IMO isn't as pronounced as you write (to the OP). Actually now that I think about this, I have SZA, and also agoraphobia; and it is the agoraphobia that keeps me in, not the SZA. So I think with me, what keeps me inside/hard to go out, is not the SZA (or at least most of it), but something else with other symptoms that are controlled by meds. I dont have social phobia, but it sounds to me like what you are describing is something running parallel to the SZA. (I hope this makes sense ... I'm having a hard time wording things).

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Posted (edited) · Report post

In social anxiety, the paranoia is focused on interactions and the anxiety that interactions with others cause.

In schizophreniform (how's that for a fancy word!) disorders, the paranoia is not necessarily limited in this way. That is to say, the paranoia can be more broadly focused and include delusions of persecution as well as other foci.

Think of social anxiety akin to a simple phobia, but instead of being afraid of spiders or snakes, you're afraid of interactions with others.

In schizophrenia, there isn't this same kind of fear necessarily. The paranoia has a different quality or flavor and is usually based on a delusion.

Edited by Wooster

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Posted · Report post

I do not have SZA but I have had a psychotic break related to my depression -- I also have extreme social phobia now (which I am working very hard to get over). The difference between the two I experienced first hand. When I was psychotic I beleived I could hear the thoughts of the people around me and the thoughts were very mean, negative and hateful towards me. This made me very afraid to be around people and I quit going out.

More recently, with the psychosis managed by medication and lessened over time - I still have social phobia and the same fear of going outside around people. But the experience is much more related to my own thoughts about myself/self talk. In public those thoughts are are mean, judgemental and self-loathing thus perpetuating the social phobia.

Like Wooster said - one was based on the delusion that I could hear people's thoughts and the other is based in a neurosis of my own negative thoughts directed at myself.

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