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Acute Symptoms of Psychosis & Paranoia

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My family member, age 50 female, worked as a social worker. She led a healthy life, went on frequent hikes, ate healthy, etc. My family has no history of psychosis. One day she left work and came back with symptoms of psychosis, delusions (visual and auditory), very anxious, with incoherent chain of thought. She has had severe migraines for many years. I took her to several psychiatrists and all of them have attributed the symptoms to stress, but searching online I can see pretty much all of the symptoms of schizophrenia in her. However, from what I understand, symptoms of schizophrenia appear at a much earlier age. Currently, she is very paranoid, thinking that she is being watched, and doctor prescribed medicine’s sole purpose is control. Again, her symptoms just appeared out of the blue one day when she came back from work. Have you encountered anything like this in your practice and could the reason for this be physical rather than psychological? (Say due to a severe migraine episode) Thanks in advance.

Acute Symptoms of Psychosis & Paranoia

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Though it is a very rare occurrence, there are cases in the literature about individuals with migraines developing psychosis. Yes, it is possible that her symptoms are related to her migraines or some other organically-induced psychiatric condition.

You are right about it being unusual that she would experience symptoms of psychosis at this time in her life. It is inconsistent with what is known about the development of schizophrenia, which occurs in early adulthood. This further supports the possibility that she is experiencing an organically-induced psychiatric condition.

You consulted several psychiatrists, but she should be evaluated by a neurologist or a specialist in organic brain disorders. These specialists will likely have her undergo various types of tests. These might help to determine the origin of her unusual symptoms.

It is imperative that her symptoms are thoroughly investigated. Choose a clinician who has the most experience with organic brain syndromes. Please take care.

Dr. Kristina Randle

Acute Symptoms of Psychosis & Paranoia

Kristina Randle, Ph.D., LCSW

Kristina Randle, Ph.D., LCSW is a licensed psychotherapist and Assistant Professor of Social Work and Forensics with extensive experience in the field of mental health. She works in private practice with adults, adolescents and families. Kristina has worked in a large array of settings including community mental health, college counseling and university research centers.

APA Reference
Randle, K. (2018). Acute Symptoms of Psychosis & Paranoia. Psych Central. Retrieved on May 24, 2019, from
Scientifically Reviewed
Last updated: 8 May 2018
Last reviewed: By a member of our scientific advisory board on 8 May 2018
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