Last reviewed:
Sep 22nd 2023
M.A., LPCC
Paranoia is a form of delusional thinking, where a person believes they are being persecuted or threatened when they are not. It is a symptom of several mental health disorders and can be successfully treated with medication and therapy.
Paranoia is a state of mind in which a person believes they are being persecuted or threatened, despite a lack of evidence. Paranoid thoughts are a form of delusional thinking, which is a belief in something that isn’t real.
Paranoia isn’t a diagnosis in itself, but it is a symptom of several mental health problems, including paranoid personality disorder, paranoid schizophrenia, and bipolar disorder, among others.
The main sign of paranoia is the delusions themselves. You may believe:[1]
As a result, a person with paranoia may display additional behaviors such as:[2]
Research has identified several possible factors that can increase the risk of experiencing paranoia.[1]
Paranoia is a symptom of a number of mental health problems that are listed in the Diagnostic and Statistical Manual of Mental Disorders [3], which is used by mental health professionals in the US to diagnose mental health problems.
Paranoid personality disorder has paranoia as a key symptom. This personality disorder is believed to affect between 2.3% and 4.4% of the population [3]. It is a personality disorder characterized by persistent mistrust of others, usually beginning in early adulthood. People with paranoid personality disorder are hypervigilant to signs that someone can’t be trusted, and, as a result, struggle to develop and maintain close relationships.
Delusional disorder may be diagnosed if a person experiences delusions – beliefs that aren’t real – for more than a month[3]. These delusions can include beliefs that they are unusually important or talented, or that someone is in love with them. It can also include paranoid delusions, such as their partner is being unfaithful or that someone is trying to harm them.
Schizophrenia is a serious mental health condition that includes symptoms such as delusions, hallucinations, disorganized thinking and speech, and strange behavior [3]. Delusions often take the form of paranoid thoughts and beliefs, so much so that ‘paranoid schizophrenia’ is sometimes used to describe the condition in someone who frequently experiences paranoia.
Borderline personality disorder (BPD) is a mental illness characterized by an intense fear of abandonment, problems with self-image, and impulsive behavior [3]. People with BPD can experience paranoia when they are particularly stressed.
Bipolar disorder used to be called manic depressive disorder and is a kind of mood disorder characterized by periods of both mania and depression.[3] During mania, someone with bipolar disorder may experience delusions, which can take the form of paranoid thoughts and beliefs.
As paranoia can be a symptom of a mental health problem, it is often treated within the context of a person’s diagnosis. The two main treatments are medication and therapy.
Medication will likely depend on what other symptoms are present but various types can help with paranoia. For example, people with schizophrenia, delusional disorder, or bipolar disorder may be prescribed an antipsychotic or mood stabilizer, which can help to lessen paranoid thoughts [1].
The most common therapy for paranoia is cognitive behavioral therapy (CBT)[1], which explores how we think and feel. CBT can be used to examine paranoid thoughts and beliefs and look at different ways of interpreting how people behave and treat us.
Other forms of therapy may include psychodynamic therapy, interpersonal therapy, or family therapy.[1]
There are several self-help techniques available to support people experiencing paranoia. It is typically recommended that these techniques are used alongside medication and/or therapy.[1]
It can be difficult to know if your thoughts are paranoid or not. To test whether a thought is paranoid, you can consider:[1]
Keeping a journal of your thoughts as well as details of your stress levels, sleep patterns, and eating and exercise habits can help you identify when paranoid thoughts appear and whether they are triggered by things like stress or sleep deprivation.
Paranoia and anxiety are different but linked. Paranoid thoughts and anxious thoughts are similar in that they both stem from perceived threats. However, paranoia is rooted in delusional thinking surrounding a mistrust of and suspicion about others and their motives, while anxiety is usually a more general set of worries about events, activities, or circumstances.[3]
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