#Diagnosis: Paranoid

[arkham-dossiers]

Patient File: Lysandre

It's the 4th of July.....so naturally I'm analyzing a Frenchman.

In public, Lysandre is the head of Lysandre Labs, a charitable philanthropist responsible for the Holocaster technology used across the Kalos region. In secret, Lysandre is the boss of Team Flare, a criminal group that wants to wipe out all life in Kalos, and then the world, save for a chosen few that will restore the environment to its original natural beauty and purge all perceived ugliness from life.

The difference between Lysandre's public perception and his true self is quite stark. What led a man of privilege like him to such extreme, misanthropic beliefs? And is there anything that can remedy it?

To start with, it must be noted that Lysandre is descended from ancient Kalosian royalty, being the brother of the infamous King who built and activated the Ultimate Weapon of legend. This status warped Lysandre's view of people early in his life. It made him believe that certain people are inherently better than others, that they are "chosen" for greatness. This belief also placed a great sense of burden upon him, as he made it his life's mission to live up to that greatness. He saw it as his duty to provide for his region, to give to those less fortunate, to help shape a brighter future for everyone.

But Lysandre's ideals ended up clashing with reality. For everything he provided, there were people who misused or squandered it. For all he gave to the poor, he couldn't single-handedly solve income inequality meaning there were always more poor people in need. And for as much as he tried to create a better future, he ended up seeing signs everywhere of a worse on. Some signs may have been legitimate, many likely just in his own paranoid mind, but whatever the case it left him devoid of satisfaction and fulfillment. Being a man whose emotions burn fiercely, Lysandre began to feel deep hatred. Hatred for people who didn't notice or care about how they were affecting society. Hatred for the poor whom he saw as "parasites" who didn't fight hard enough to advance themselves in favor of taking from those who worked for their fortune. And hatred for things like deforestation, pollution, crime, war, and general lack of decorum. Lysandre became a misanthrope, seeing fault in everyone but himself and "chosen ones" that he deemed respectable like himself.

While Lysandre does feel remorse for the lengths he is willing to go to in order to cleanse the world of all that he perceives to be ugly, knowing it to be morally wrong, he keeps himself on this path anyway because he feels it's the only solution and that as a chosen one it is his burden to bear - that he has come too far to turn back now. Despite this, Lysandre is pathologically hypocritical. He wishes to be someone who gives, and yet his ultimate plan is to take the lives of many. He hates selfish, greedy and frivolous people and yet many such people make up the ranks of Team Flare all because they had a lot of money which Lysandre automatically thinks makes them self-sufficient workers who benefit society. And he considers himself to be an idealist even though his view of everything and what must be done about it is so deeply cynical. It's to the point where he can manipulate and threaten and do unimaginably cruel things while still insisting it's other humans, including his victims, that are the problem. In one famous instance, he wept for the Pokémon of the world that he felt he had no choice but to kill, saying as long as they exist humans will be tempted to abuse them as tools, making them and others suffer. He says this while he is enacting a plan that is abusing Pokémon as tools, making them and others suffer! The depth of his delusion and utter lack of self-awareness is stunning to behold.

Diagnosis: Lysandre suffers from a triple whammy of Paranoid Personality Disorder, Obsessive-Compulsive Personality Disorder, and Narcissistic Personality Disorder, with sociopathic tendencies as well even if he lacks the criteria to be a full sociopath. Treatment will be exceedingly difficult, but one aspect of his warped psyche can be used to the advantage of this end: his respect for fellow "chosen ones". Lysandre is not narcissistic enough to believe that only he has value, as he takes the views of other chosen ones seriously even if he disagrees with them - a prime example being his friend Professor Sycamore. If such people keep working with Lysandre to show him better alternatives to the problems he sees than his genocidal aims, it is possible that he will calm down and adjust to a safer way. It will take a lot of time and effort, but it is recommended as the only way to save him. For if he isn't saved, then the likelihood of self-destruction is great, and unfortunately Lysandre is a man with the will and power to take many others down with him.

This patient is sometimes dangerous. It depends on whether or not he views you as among the "chosen" or not. If he does, you may engage with him intellectually. If he does not, avoid at all costs.

[valtsv]

okay idk about you but i always thought my paranoia was, like, normal, because every time i say "yeah im paranoid almost contantly" people are like "lol yeah me too." but recently i actually went on about it in more detail (someone installed cameras in my house, someone is in the backseat of my car, someone hacked my phone and is looking at everything i do, etc.) and only THEN am i told that they dont have specific worries like that?? what even is paranoia anymore. how much is normal

i'm not any kind of licensed professional but i guess it really depends on how much it affects your life? i mean, we do live in a world where surveillance is increasingly normalized and encouraged both in real life and online, so it's "normal" in the sense that most people would reasonably be affected by that. but if it interferes with your life to the point of causing major obstructions in your day to day behavior, then i'd say that isn't "normal" in the sense that your quality of life is being significantly impaired by it. it's not right regardless that paranoia is simultaneously stigmatized (through mentalities like "if you have nothing to hide then you have nothing to fear") and encouraged (through surveillance and lack of privacy), but you might be more acutely affected than most people. what you described about the cameras and your phone sounds like paranoia to me, HOWEVER i really can't "diagnose" you as such, especially based on an anon ask and nothing else. you're not alone, though, and it is possible to feel more comfortable and secure by recognizing the issue and discussing it with people you trust, if you have any, and learning more about how to cope with your thoughts and feelings. paranoia is a very isolating condition, but speaking from experience talking to people and building strong relationships helps immensely. it's hard work, but very rewarding. i hope whatever happens you are able to find support and understanding.

[schizotypaldisciple]

The WWWWW&H? of Schizotypal Personality Diorder -or- S✝PD

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What is S✝PD?

S✝PD is a classified schizophrenia-spectrum disorder, as well as a classified personality disorder.

The 2025 ICD-10-CM describes Schizotypal Personality Disorder as:

Diagnostic Code F21:

"A disorder characterized by eccentric behaviour and anomalies of thinking and affect which resemble those seen in schizophrenia, though no definite and characteristic schizophrenic anomalies occur at any stage. The symptoms may include a cold or inappropriate affect; anhedonia; odd or eccentric behaviour; a tendency to social withdrawal; paranoid or bizarre ideas not amounting to true delusions; obsessive ruminations; thought disorder and perceptual disturbances; occasional transient quasi-psychotic episodes with intense illusions, auditory or other hallucinations, and delusion-like ideas, usually occurring without external provocation. There is no definite onset and evolution and course are usually those of a personality disorder."

The 2022 DSM-V-TR describes Schizotypal Personality Disorder as a Cluster A ("unusual & eccentric") personality disorder, and states:

Diagnostic Code 301.22:

"(S✝PD..) is characterized by a pervasive pattern of social and interpersonal deficits, marked by extreme discomfort with close relationships, cognitive and/or perceptual distortions, and eccentric behaviors; often including odd beliefs, magical thinking, and unusual perceptual experiences, all beginning by early adulthood."

Personality disorders are a specific class of mental health conditions - characterized by long-lasting maladaptive patterns of behavior, thinking, and internal experience, which are present across many contexts, and which deviate from what is usually deemed acceptable by the individual's culture.

According to the DSM-V-TR, to receive a Diagnosis of S✝PD, patients must present with:

A persistent pattern of intense discomfort with, and decreased capacity for, close relationships.

Cognitive or perceptual distortions and eccentricities of behavior.

This pattern is shown by the presence of ≥ 5 of the following:

Ideas of reference (notions that everyday occurrences have special meaning or significance personally intended for or directed to themselves) but not necessarily delusions of reference (which are similar but held with greater conviction).

Odd beliefs and/or magical thinking (ex: believing in clairvoyance, telepathy, or a sixth sense; being preoccupied with paranormal phenomena).

Unusual perceptional experiences (ex: hearing a voice whispering their name).

Odd thought and speech (ex: that is vague, metaphorical, excessively elaborate, or stereotyped).

Suspicions or paranoid thoughts.

Incongruous and/or limited affect.

Odd, eccentric, or peculiar behavior and/or appearance.

Lack of close friends or confidants, except for 1st-degree relations.

Excessive social anxiety that does not lessen with familiarity, and is related primarily to paranoid fears.

(Also, to recieve a Dx, these symptoms are required to have begun by early adulthood.)

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Who experiences S✝PD?

The lifetime prevalence of S✝PD in the United States (US) has recently been estimated to be just under 4%, with slightly higher rates among men (4.2%) than women (3.7%)

Likelihood of S✝PD is greater among black woman, among those with a low income, and among those who have experienced separation, divorce, or have been widowed.

The odds of being Dx with S✝PD are lowest in Asian men.

After adjusting for sociodemographic parameters and comorbidities, S✝PD remained significantly associated with:

Bipolar I & II Disorders

Post Traumatic Stress Disorder

Borderline Personality Disorder

Narcissistic Personality Disorder

Additionally, even after adjusting for sociodemographic parameters and Axis I and II comorbidities:

Patients with S✝PD had significantly greater disability than those without S✝PD.

Patients with S✝PD have been shown to be less likely to live independently or have obtained a Bachelor's degree, than even patients with Avoidant Personality Disorder (AvPD), as well as healthy control participants. (both patients with S✝PD and AvPD earn a lower hourly wage compared to healthy control participants, however)

S✝PD patients demonstrated lower functional capacity than patients with AvPD, as well as healthy control participants.

Similar to the role of cognitive dysfunction (working memory, processing speed, executive function) as a major determinant of functional outcomes in schizophrenia, functional capacity in patients with S✝PD is shown to be significantly correlated to a composite measure of cognitive function.

Cognitive function among S✝PD patients is shown to be poorer than among healthy control participants, and even patients with AvPD.

While a diagnosis of S✝PD is associated with less likelihood of employment than in patients without, this difference is found to be primarily determined by cognitive impairment.

Even after adjusting for cognitive function, however, a diagnosis of S✝PD was associated with employment at jobs involving less social contact.

Identifying S✝PD and associated traits in the clinical setting can be challenging, as manifestations overlap with many other more well-known psychiatric conditions, or may simply be qualified in colloquial terms (ex: "loner") without further diagnostic attribution.

Common complaints of patients with S✝PD or schizotypal traits are related to attentional/cognitive difficulties, social anxiety, difficulty “connecting” to others, and longstanding interpersonal complications related to suspiciousness/paranoia.

Superficially healthier S✝PD patients may present with characteristic anxieties or ‘neurotic conflicts’ that are, in a more latent manner, determined or exacerbated by underlying magical ideation, odd beliefs, or overvalued ideas.

S✝PD patients are not uncommonly first diagnosed with ADHD (inattentive type); Social Anxiety Disorder; Autism-Spectrum Diorder; Dysthymia.

Additionally, the role of an underlying odd/magical belief as an aggravating factor of a concurrent symptom disorder (ex: Anorexia, OCD..) may be overlooked, as well as what appears to be anxiety-related complaints or other symptom-related disorder complaints, may be overlooked.

Many of the cognitive/perceptual disturbances that schizotypal patients can bring to a clinician's attention can be quite dramatic or alarming, and even though these phenomena are not associated with a patient that has a fair degree of intact reality testing, these patients may nevertheless receive a diagnosis of a formal psychotic illness.

Clinically significant schizotypy can exacerbate the treatment of other clinical syndromes that may be the primary area of focus.

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When & Where was S✝PD first recognized/recorded as a disorder?

"Schizotypy" wasn't officially recognized until the latter half of the 20th century, however it's associated symptomology was first observed in the early 1900's, where common behavioural characteristics in relatives of schizophrenics were observed.

S✝PD is a recent psychiatric nosological concept developed by Spitzer at the end of the 1970s, based on the analysis of the characteristics of relatives of schizophrenic subjects included in the adoption studies carried out in the same decade (by Kety, Wender and Rosenthal). However, this entity is based on older observations at the beginning of the past century.

The status of S✝PD within our current nosography remains dubious, sometimes classified among personality disorders, sometimes in the schizophrenia spectrum disorders.

It is interesting to present the origins of this concept that stem from two complementary approaches: a family approach, and a clinical approach of sporadic cases; then to redefine the framework within, which the diagnostic approach was based, and its continuity, up until our current classifications.

Basically, the historical origins cannot summarize S✝PD, and it is apparently important to more precisely redefine the multidimensional characteristics of this disorder.

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Why & How do humans develop S✝PD?

Etiology: the cause, set of causes, or manner of causation of a disease or condition.

Etiology of S✝PD is thought to be primarily biological, because it shares many of the brain-based abnormalities which are characteristic of schizophrenia. However, studies have provided evidence that S✝PD is determined by both familial-genetic and unique environmental factors.

The COMT Val158Met polymorphism is one of the best studied candidate schizotypy genes.

S✝PD is more common among 1st-degree relatives of people who experience schizophrenia or another primary-psychotic disorder.

Unique environmental factors (i.e., those not shared among all siblings) are strongly suggested to be involved in the development of S✝PD, schizotypy, and specific schizotypal dimensions.

Similar to findings in schizophrenia, prenatal insults, such as influenza exposure during the 6th month of gestation (specifically, week 23) have been associated with higher scores of schizotypal traits in an adult male population.

A number of forms of psychological trauma and chronic stress have been associated with S✝PD. The effect of trauma on the development of schizotypal symptoms, however, appears to be dependent on genetic background.

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I will continue to update this post with relevant information as it is made known to me. I welcome submissions, suggestions, and information from both personal and professional sources.

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S✝PD

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(Sources: google.com - https://icd.who.int/browse10/2016/en#F21 - https://www.merckmanuals.com/professional/psychiatric-disorders/personality-disorders/schizotypal-personality-disorder-stpd - https://www.icd10data.com/ICD10CM/Codes/F01-F99/F20-F29/F21-/F21#:~:text=F21%20is%20a%20billable%2Fspecific,ICD%2D10%20F21%20may%20differ. - https://pmc.ncbi.nlm.nih.gov/articles/PMC4182925/ - https://www.researchgate.net/publication/5337114_The_schizotypal_personality_disorder_Historical_origins_and_current_status)

[vampireknitting]

[thelastsaiyanprincess]

i think the tumblr men who fuck w mentally ill women on this site do so intentionally as some kind of ego boost. and i'm starting to believe y'all get this weird gratification out of seeing a girl publicly spiral over you. its sickening

[ppd-culture-is]

Self-diagnosed PPD culture is being sick of your constant paranoia, but being scared to tell anyone so you can get diagnosed and get help because you’re scared they’ll use it to hurt you.

.

[iwowzumi]

powerful, clever, and good-hearted characters that are seen as untrustworthy or unstable due to paranoia and/or destructive behavior patterns forced by external circumstances my beloved

[jackdawandicarus]

I hate that I’m so self-destructive. I wish I could just let the paranoid thoughts stay as thoughts and not destroy my relationships constantly seeking out affirmations. I wish I didn’t take every little thing as some sort of conspiracy against me. I wish I didn’t constantly think people were going to abandon me. I wish my actions because of these thoughts didn’t cause me to lose my friends.

I wish I wasn’t such a self-fulfilling prophecy.

[oysterie]

should i just spend the 40 bucks and speak to a psychologist or councelor or whatever and get over myself -_-

[moodr1ng]

recently been seeing (and seeking) more info on moral ocd and its like wellll it does seem like i definitely have that but talking about the stuff i obsess over w my psychiatrist feels impossible bc i cant admit to thinking about it without feeling like a horrible person, so im just gonna keep sweeping it under the rug lol....

[hemanthsworld]

Psychotic Disorders: Differential Diagnosis and Key Symptoms Overview

Psychosis is a mental health condition marked by a break from reality, which can include hallucinations, delusions, disorganized thinking, and impaired insight. It can be seen in psychiatric disorders like schizophrenia, bipolar disorder, and severe depression, as well as in neurological conditions, substance use disorders, and various medical conditions. Etiology (Neuropharmacology) Dopamine…

[a-hollow-forest]

i'll admit it always feels a little insulting when a psych i went to for something else entirely goes out of their way to write 'does not have delusions' in my file because it's not like any of them fucking asked what weird bullshit i believe and it's not like believing i was literally put on this earth to Fucking Kill God is something i'm inclined to bring up during an assessment for ADHD?

[tuesdaygray]

.

[starrbar]

Dude, asp3rgers is literally named after Hans Apserger, a Nazi. Just use Google my guy, you're using Nazi terminology, dickhead.

Imagine blaming someone for the name of their PROFESSIONAL DIAGNOSIS, my guy.

Like, does it occur to you that this is the most far removed you could ever get from "activism".

What made you wake up in the morning and come to me specifically, by the way? Have you been sending this to everyone else in the world who was told by a fucking doctor that they have a mental disorder called Asperger's that has done been a thing probably their whole lives, and telling them THEY are perpetuating bigotry by going on with their damn life and accepting the word they've been given for their condition?

Whaddaya want? Ya want me to frantically scurry to my Carrd to change the label? Would that make me less of a direct contributor to anti-Semitism?

Ehehehehehehe, here I was bitching about anti-kink fuckers when the internet has people like you misfiring their righteous anger so hard that you're mad at random mentally ill people for being oh... so, so ignorant to the catastrophic harm they're causing for not suspecting that the label they were given might be a Nazi term~!

You are the most self-important asshole I have ever seen, and that's saying a lot considering the shit I've witnessed online. I hope you're as miserable a person as this makes you sound, because my god, this is pathetic.

I did look it up btw, for anyone who is curious. It looks like anon is indeed correct about the origins of the name.

I still don't give a single pebble of my oddly blue shit because I am not fucking responsible for any of this.

Yes, my shit is blue right now because I ate some heavily-dyed cake yesterday. Yes, I loved adding that to my response to this person and their worthless take. Enjoy reading about my bowel status before I cast you into obscurity, as your next messages will be ignored unless you have the balls to come off anon about it.

Go fuck yourself. 💖

For everyone else:

Do I need to explain btw that if someone came to me in GOOD FAITH to inform me of the fact that a label I'm using may bring up terrible feelings for people because of its origins, I'd legit listen and go change it?

I probably will change it anyway because I identify more with "autism" (because I get to say "I have awootism" and that's hilarious—also I can just say "I'm autistic", but there doesn't seem to be a grammatical equivalent for Asperger's).

But this is not how you have a fucking conversation.

This is not how you inform innocent people of a dark history behind something they grew up with.

This person is not AT ALL concerned with me becoming a better person or being more sensitive to others or learning a lesson. This person JUST wants to take their own self-hatred out on some rando online, to make me feel guilty for shit I was unaware of, and to make themself feel superior in whatever desperate way they can.

I see right through this garbage because I witness it daily.

My brother and my closest high school friend were both diagnosed with Asperger's YEARS before I ever was. I grew up with this. I grew up proud to be this, because I recognized that it made me different from my peers in a way that would gain me discrimination and bullying, but that I could also have solidarity with the other kids who understood what it was like.

So.

Genuinely.

I will change the name for MYSELF, because of MY new experiences and information from my doctors.

And I will not rush to do so because I have better things to do with my time than sweat and panic over what some little insect thinks about my Carrd. I have a game to work on, a dog to let out, a job to go to, and a husband to cuddle. Oh, and of course, I gotta finish my replay of BotW so I can jump on TotK when my husband is done playing it! Priorities, hello! xP

[sucktacular]

So did anyone else have crippling irrational fears growing up that made it so they couldn't do things like shower alone because they were so scared, or was that just me?

[rachymarie]

FML i am yet again reminded that info on the internet is still so outdated on schizospec illnesses and there is much to be done in changing that and thus fighting stigma and i feel like we have to singlehandedly fight it on top of all our issues + comorbidities that make us nonfunctioning + stigma that make us outcasts of society it wears me out (but not enough to stfu and go to sleep apparently cos we on that stress hormone energy now)

If i read about "schizophrenic subtypes" one more time i will scream*