What Is Paranoia?

Medically reviewed by Elle Markman, PsyD

Paranoia is a feeling you might get if you believe you're in danger, but there is little to no evidence of any threat that can harm you. It's common for most people to experience some level of paranoia at least once in their lifetime. For most people, these feelings come and go pretty quickly, but for others, paranoia can continue for longer periods of time.

Experiencing paranoia for an extended amount of time may mean that you're living in a paranoid state. Being in a paranoid state can affect your ability to function in daily life, create and maintain social relationships, and trust others. The exact cause of paranoia is unclear, but research suggests that certain mental health conditions, stress, and trauma may all play a role in how often you're experiencing paranoid thoughts.

Types of Paranoia

Many people experience mild thoughts of paranoia throughout their lifetime, while others may have paranoid thoughts much more frequently. Research suggests that being in a paranoid state for a longer period of time may be a result of an underlying mental health condition. There are three types of paranoia-related mental health conditions that can influence your thoughts and behaviors. These include:

• Paranoid personality disorder: This condition can occur when a person has an extensive history of distrust or suspicion of others. Common symptoms include social isolation, a concern that others have hidden motives, and an inability to work with others. This disorder is considered to be the mildest type.

• Delusional disorder: This psychotic disorder often makes it tough for a person to understand the difference between what's real and what they're imagining. People with this type primarily experience delusions—or, irrational beliefs that are untrue. The person experiencing the delusions believes that their thoughts are real, whereas most people around them are aware that their delusion is false.

• Schizophrenia with paranoia: The most severe type of paranoia you can experience, this condition causes extreme delusions and frequent hallucinations. It may be especially difficult for someone living with schizophrenia to function in daily life, speak to others, or understand and control their own thoughts and behaviors—especially without proper treatment.

Symptoms

Paranoia is not considered a medical condition alone. Rather, paranoia is considered an underlying symptom of other health conditions. However, having paranoid thoughts can cause a domino effect of other symptoms, including:

• Intense or irrational distrust of others

• Hypervigilance, or always being on the lookout for threats

• Preoccupation with the hidden motives of others

• Difficulty forgiving others

• Fear of being taken advantage of or tricked

• Trouble resting and relaxing

• Being argumentative in conversations

Causes

The exact cause of paranoia is unknown, but researchers theorize that a combination of factors can contribute to paranoid thoughts, such as:

• Emotional and physical neglect during childhood

• Traumatic life events, such as abuse, betrayal, or assault

• Extreme or chronic stress

• Using substances such as alcohol, cocaine, marijuana, or methamphetamines

• Social or political events, such as war, violence, or terrorism

• Living with anxiety or depression

• Not getting enough sleep

• Having an underlying neurological (brain-related) condition, such as dementia or Alzheimer's disease

Diagnosis

If you or a loved one are experiencing long episodes of paranoia, it's important to talk to your primary care provider or seek support from a mental health professional. They can help you understand why you're having symptoms or diagnose you with an underlying condition that may be causing paranoid thoughts.

When you go in for your appointment, it's standard procedure for your provider to ask you about your personal and family medical history, learn more about your current lifestyle habits, and perform a physical exam. Your primary care provider may also refer you to a psychologist, psychiatrist, or other mental health specialist for more testing. A specialist may:

• Ask about your current relationships

• Inquire about past traumas, stressors, or childhood experiences

• Use clinical interviews or questionnaires to learn more about your symptoms

Treatment

If you receive a diagnosis for an underlying condition or reason that is causing your paranoia, there are a variety of treatment options your provider may use to help you feel relief. Your exact treatment plan will depend on your diagnosis and severity of symptoms. Treatment may involve:

• Medication: There are no current FDA-approved medications that just treat paranoia. However, if you paranoia is due to an underlying condition such as paranoid personality disorder, schizophrenia, anxiety, or dementia, your provider can prescribe medication to treat the health condition that is causing your symptoms.

• Cognitive behavioral therapy: Cognitive behavioral therapy (CBT) is a form of therapy that mental health professionals use to help you identify harmful thoughts and feelings that might be affecting your behavior and overall quality of life. CBT is a type of short-term therapy that may utilize relaxation techniques, problem-solving skills, and reframing negative thoughts to help you cope with paranoia.
  

Prevention

Because researchers believe that a combination of factors can cause paranoia, there's no surefire way to prevent paranoid thoughts. However, there are some things you can do to reduce your risk of experiencing paranoia, such as:

• Limiting your intake of alcohol, drugs, and other substances

• Practice stress management or self-care techniques such as yoga, meditation, journaling, physical activity, or engaging in hobbies that you enjoy

• Getting enough sleep throughout the night and sticking to a sleep schedule

• Confiding in your loved ones if you're experiencing any stressors or need emotional support

Related Conditions

Paranoia is not a condition itself, but rather a symptom of other underlying conditions. As such, the following conditions are all related to paranoid thoughts:

• Schizophrenia or schizotypal personality disorder

• Dementia

• Alzheimer's disease

• Bipolar disorder

• Depression

• Anxiety

• Psychosis
  

• PTSD

Living With Paranoia

Feelings of paranoia can happen to anyone. While these feelings may seem frustrating or scary, it's OK if you're feeling them. It's more important to remember that help is available to support you and provide relief from paranoid thoughts.

Frequent thoughts of paranoia can be difficult to manage alone. Talk to your healthcare provider if you are experiencing these thoughts more frequently than before. Your provider can help to find the underlying cause, refer you to a mental health professional, and offer treatment options.

For the treatment of paranoia to be most effective, it's important to build a relationship with your providers. It's important that you trust your provider so that you feel supported as you try to reframe fearful thoughts and improve your social relationships. If you're receiving treatment, such as therapy, it's worth noting that treatment can look or feel slow. But, it's vital to remember that recovering is possible, regardless of how long the process takes.

Frequently Asked Questions

Is paranoia a form of anxiety?

Anxiety involves worry, fear, dread, or uneasiness and sometimes panic. A paranoid state involves the unwarranted mistrust of others and their actions. You can have paranoid thoughts and anxiety at the same time, but these are two separate states. However, having anxiety can increase your risk of experience paranoid thoughts.

Is there any medication for paranoia?

There is currently no FDA-approved medication for paranoia alone. Your healthcare provider may suggest medications that treat the underlying condition that may be causing your paranoia.

Is paranoia a personality disorder?

Paranoia can be a symptom of a personality disorder. Paranoid personality disorder, specifically, is a condition that occurs when a person has a long history of distrust and suspicion of others, which can cause paranoid thinking.

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