Elizabeth Holmes fake deep voice (or maybe not fake? ) wasnt the only odd behavior she displayed when running her now defunct blood-testing company Theranos. In light of the new HBO documentary The Inventor: Out For Blood In Silicon Valley, details about Holmes paranoid behavior toward her employees are emerging.

In journalist John Carreyrous book on Theranos, called Bad Blood , he wrote that Holmes administrative assistants would friend employees on Facebook and tell her what they were posting there" and that she demanded absolute loyalty from her employees and if she sensed that she no longer had it from someone, she could turn on them in a flash.

That meant Holmes would seek out incriminating material from an employees past. One employee reported that she asked him to create a dossier on another employee that she could use against them to get what she wanted. Whoa.

Sowhat would make someone act like that?

Her behavior seems deeply paranoid. Basically, paranoia is defined as pervasive and unwarranted mistrust and suspiciousness of others. People who are paranoid are locked into a rigid and maladaptive pattern of thought, feeling, and behavior based on the conviction that others are out to get them, according to the APA . "The hallmark of paranoia is that youre afraid of something thats irrational, says Chloe Carmichael , Ph.D., WH advisor and therapist in New York City. Its different from PTSD, when fear is based off a past negative experience.

There are different levels of paranoia as well. It can range from something an innocuous as worrying that your coworkers are talking about you, to a condition known as paranoid schizophrenia, which would cause you to not only worry about your coworkers gossiping, but possibly hallucinate that you hear them talking about you, says Carmichael. Its unclear if Holmes had any condition like this, or if she was just an extremely controlling boss.

Still, stressful situations and anxiety can exacerbate paranoid thoughts, says Carmichael, and Holmes was definitely facing a tough reality about the future of her company. When youre experiencing paranoia, you assume other people are being aggressive, and it makes it easy to justify your own aggressive and hostile behavior toward them, Carmichael says. Lashing out is a common reaction to paranoia, as is the opposite: retreating and withdrawing from people.

Clearly, Holmes was not creating a work environment built off trust and respect, whether or not she was dealing with paranoia.