It is not often that we consider taking someone to therapy for being suspicious. But sometimes, we do not have a choice. Considering that the patient is unwilling to undergo treatment in most cases, what is the best treatment for suspiciousness?

The question we first ask is when does one need treatment for harboring suspicions? A simple answer is whenever their normal functioning is disrupted or impaired as a result of this. For example, a person who strongly believes that his/her spouse is unfaithful and therefore goes into depression, has intense anger outbursts or neglect their job to keep an eye on the spouse would fit the criteria. Their mental well-being, social relations and occupational functioning is hampered, just because of a singe baseless belief.

Another example would be a man who strongly believes the terrorists are out to get him. He is sure that they have put up cameras around his house and are having him followed. He therefore refrains from leaving his room, ignoring his work and societal commitments and repeatedly asks authorities for help. No amount of reasoning can persuade him to believe otherwise.

Yet others are fully convinced that they have a lethal disease. They visit various doctors, undergo extensive investigations and medical procedures, all in vain. They however stick to the belief that it is just a matter of time before their disease in detected. Till then, they continue their quest for finding the perfect doctor.
The family members of these individuals are as distressed as the patient. By the time they seek help from a psychiatrist, they have usually exhausted all possible methods to make the patient see reason. Not only have they failed miserably, their relationship with the patient has been strained in the process.

What does the psychiatrist do in such cases? The doctor’s job is to gain the patient’s confidence. Thereafter, the patient is slowly but surely persuaded to undergo treatment. With time, on treatment, the patient’s conviction regarding the misbeliefs begins to dwindle, the mood and functioning improve gradually. However, a word of caution here. This process is sometimes quite slow and is a test of patience for the doctor and family members. However, giving up should never be an option. Another mistake that the family commonly makes is to change doctors midway because the progress is slow. This is not a good idea. The next psychiatrist has to start from scratch and re-evaluate the patient before starting therapy. This delays the progress even more.

The treatment method is often a mix of medicines and counselling. The medications are usually resisted but are indispensable for proper treatment. It is in the patient’s best interest that the family members supervise the medications and accompany the patient regularly for therapy sessions.

To sum up, the best treatment for suspiciousness is one that has the right balance of medicines and therapy, including family counselling for the caregivers, and has a patient approach to healing, both on part of the treating doctor and the patient’s relatives.
drdebasmitapsychiatrist