Professor of Psychiatry and former president of the Association of Psychiatrists in Nigeria (APN), Taiwo James Obindo, has said that severe depression may cause sufferers to develop paranoid beliefs that their relatives or other loved ones intend to harm or kill them.
Obindo, in an interview with Saturday Tribune said such beliefs, when firmly held despite evidence to the contrary, could amount to delusions and indicate that the individual was experiencing depression with psychotic symptoms.
He explained that the condition could also make sufferers interpret innocent conversations, actions and public messages as deliberate attacks or coded references to them.
“Paranoid beliefs can accompany depression. When they reach the level of delusions, they are regarded as psychotic symptoms, and the condition may be diagnosed as depression with psychotic symptoms,” he said.
According to the psychiatrist, interpreting neutral words or actions as personally directed and hostile may be a form of delusion known as a “delusion of reference.”
“It is a form of delusion which we refer to as a ‘delusion of reference,’ where normal perceptions or actions are seen as referring to the sufferer.
“People having normal conversations may be accused of talking about the sufferer. What is said in church or on television may also be misinterpreted as a message directed at the person,” Obindo stated.
He said the prominence of severe mood symptoms, particularly when accompanied by delusions or hallucinations, should prompt an urgent professional assessment.
“When mood symptoms become pronounced and are accompanied by psychotic symptoms, a diagnosis of depression with psychotic symptoms may be made. More often than not, there may also be an accompanying delusion of guilt or hallucination,” he said.
On how relatives should respond, Obindo advised family members to avoid prolonged arguments or direct confrontations after attempts to reassure the sufferer had proved unsuccessful.
He warned that repeatedly insisting that the person’s beliefs were false could deepen the suspicion and make the sufferer more convinced that relatives were concealing a plan to cause harm.
“After attempts to convince the sufferer that such thoughts are untrue have failed, relatives should avoid confrontation.
“The more people continue to insist that the sufferer’s thoughts, ideas or beliefs are false, the more convinced the person may become and the stronger those beliefs may grow.
“It may appear to the sufferer that the relatives are merely trying to cover up their efforts to cause harm,” he explained.
Obindo added that families faced with a sufferer who denied being ill and refused medical attention should be guided by the provisions of the Mental Health Act 2021.