Could anyone tell me how a therapist would diagnose a patient who exhibited these symptoms? He meticulously documents all events and people in his life, keeping a journal with him at all times. He also takes photographs of his surroundings. He believes that Communist spies are lurking. Would this be OCD or paranoia? Is it something completely different? I just want to know if I'm classifying things correctly.
You need to look up the list of symptoms in the DSM and see if the criteria for the diagnosis you are considering fit. https://en.wikipedia.org/wiki/Diagnostic_and_Statistical_Manual_of_Mental_Disorders The current manual is the DSM 5, I don't know if there is a copy online without buying it but you can find the DSM-IV online and use that. I'd say you are describing more of a paranoid personality disorder than an OCD.
My husband is an LCSW who works with residential treatment kids. I'll ask him what his first thoughts would be.
There are a lot of psychological tests/assessments, and many nuances in why one is better than another in certain circumstances. If you want it to be realistic, you'll either need to do a good amount of research through free sources online or buy a clinical practice book. It's also worth noting many therapists are only licensed to give therapy and cannot administer assessments/tests themselves. You'll either want to be vague enough to avoid this issue or look up the differences between PhDs, MFLTs, LCSWs, etc and what each is licensed to do in different states. I believe LCSWs cannot legally administer assessments in any state. Maybe they can under supervision of a psychologist, though.
He is legally able to adminiter assessments. Anyway, @Masked Mole , upon presenting the information you gave to him, he said his first instinct would be Paranoid Schizophrenia. Obviously he would want some time to meet with the patient/character to be certain and explore other symptoms/issues the character has, but from strictly the information you gave, that would be what he would first suspect. Of course, it's common for therapists and psychiatrists alike to widely disagree on a diagnosis, which is why you end up with adults (and more often children) on an array of drugs to treat various diagnoses. Unfortunately, the mental health field isn't an exact science and no single test can be proven 100% accurate. Human behavior is a tricky thing to organize into neat boxes.
I really appreciate the help, Lyrical. That's really convenient that your husband happened to be a LCSW.
Interesting. Care to say which state he practices in? I know several states have statutes legally prohibiting it, and other states have case law precedents legally prohibiting it. I'm not implying you're lying; I'm genuinely interested to know.
You're welcome! He is a good resource when it comes to figuring out my characters' behaviors. He added that if you are going to work the Paranoid Schizophrenic route, a nice touch would be to add that the guy does't like to sit by windows and almost always has to sit at an angle where he can keep an eye on the entrance to the room. We are in Utah. I asked him about this. He said that if he were in private practice, you would be correct, he wouldn't be able to legally administer tests. Since he currently works in a Residential Treatment program and is therefore overseen by a PhD Clinical Psychologist, then he is able to. I know he had to go through some special training on these tests when he first decided to go into RT. Anecdotally, he is launching into a PhD program to become a Clinical Psychologist eventually, so he will legally be able to do these things on his own in his own practice when he tires of residential work.
Many mental disorders overlap. For instance, if someone has a depressive disorder, it's common for them also to have an anxiety disorder. What you're describing sounds to me like PPD, which has a high rate of comorbidity with other mental disorders like OCD, DPD, and Schizophrenia. In short, it could be both.
