Q: My friend is 34 years old, working as an engineer in a reputed company at a senior position. He has always been an excellent student. He has also received a lot of awards. But now he has developed a problem where he talks to himself and thinks someone is following him. He feels someone is taking his photographs with hidden cameras but this is not true. He also thinks that someone is recording his voice on the telephone and he will be harmed. He is afraid that someone wants to involve him in a court case to give him loss and all his friends have turned enemies. Why does he feel like this?

A:A diagnosis cannot be made just from a letter. However, the symptoms you describe in your friend are commonly seen when a person has a mental illness such as paranoia, or paranoid schizophrenia. Such an illness must be treated by a psychiatrist, perhaps in a hospital, and medication is necessary. Unfortunately, a person with such an illness usually doesn't know that they are ill, doesn't know that they are imagining all these bad things, and therefore refuses to see a doctor or take medicine. Sometimes nothing can be done until the person realises they are ill or need help, or until there is a crisis that involves the police. Once the person is seen in a hospital emergency room, the diagnosis is made and treatment is provided, even against the person's wishes. In the United States, where I practice, such a person cannot be forced to take treatment unless a judge agrees with a family member and a doctor that the person is a danger to himself or to someone else. I do not know if the law in India is the same.