第77页 Where Else Do We Find Paranoia?

There are two non-exclusionary explanations for paranoia in patients with delirium. The first is that critical brain regions where paranoia is thought to "live" are directly affected by whatever caused the delirium in the first place, turning it on like a light switch. The second is that the paranoia is derivative of the overall mental state. In other words, as the person's ability to reason, perceive, and otherwise make sense of the world diminishes, the brain engages a primitive circuit that essentially decides "If I can't make sense of this situation it is best to be suspicious and not trust anyone, as they might pose a danger." If there was no real danger then no harm has occurred, with the exception of a bruised ego on the part of those accused. If there was a real danger, then the delirious person was in a position to protect himself by not trusting his fate to someone, thereby increasing his chances for survival.