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What is paranoia?

Paranoia is a thought process that causes you to have an irrational suspicion or mistrust of others. People with paranoia may feel like they’re being persecuted or that someone is out to get them. They may feel the threat of physical harm even if they aren’t in danger. People with dementia sometimes have paranoia, and it also can occur in people who abuse drugs. Paranoid thoughts can also be a symptom of a mental illness or a personality disorder.

Symptoms of paranoia

Everyone experiences paranoid thoughts at some point in their life, but paranoia is the constant experience of symptoms and unfounded feelings of paranoia. The symptoms of paranoia vary in severity and can interfere with all areas of life. The symptoms include:

  • a constant stress or anxiety related to beliefs they have about others
  • a mistrust of others
  • feeling disbelieved or misunderstood
  • feeling victimized or persecuted when there isn’t a threat
  • isolation

Mistrust of others and constant anxiety can make relationships and interactions with others difficult, causing problems with employment and personal relationships. People with paranoia may feel that others are plotting against them or trying to cause them physical or emotional harm, and maybe even stealing from them. They may be unable to work with others and can be hostile or detached, leading to isolation.

Paranoid schizophrenia is a form of mental illness, and people with it can be distrustful of others and may be suspicious and guarded. They may also have delusions or believe that others are trying to hurt them. A person with schizophrenia may also experience hallucinations.

What causes paranoia?

Paranoid behavior usually occurs due to personality disorders or other mental illnesses such as schizophrenia, and drug use or abuse can also cause it.

It’s not fully understood why some people develop personality disorders or mental illness. It may be a combination of factors, including:

  • genetics
  • stress
  • brain chemistry

Drug abuse can also cause paranoia. According to the Center for Substance Abuse Research, the use of methamphetamines can cause paranoid behavior and delusions. Other drugs that can also lead to paranoid thought processes are PCP and LSD.

How is paranoia diagnosed?

Your doctor will perform a medical exam and take a complete medical history to help them rule out a physical or medical reason for your symptoms, such as dementia.

If your paranoia is part of a psychiatric issue, your doctor will refer you to a psychiatrist or a psychologist who will then perform an evaluation and clinical psychological tests to help them determine your mental status.

Other conditions that can occur in people with paranoia are:

  • bipolar disorder
  • anxiety
  • depression

How is paranoia treated?

Treatment depends on the cause and severity of symptoms and may include medication and psychotherapy. Psychotherapy aims to help people with paranoia:

  • accept their vulnerability
  • increase their self-esteem
  • develop trust in others
  • learn to express and handle their emotions in a positive manner

Treatment for paranoid personality disorder usually involves psychotherapy to help you develop coping skills to improve socialization and communication. Sometimes, doctors prescribe anti-anxiety medication to treat paranoid personality disorder for people who are often anxious or fearful. Atypical antipsychotic medications may also help relieve symptoms.

People with paranoid schizophrenia usually require medication, as they often have lost touch with reality. Initial treatment usually includes antipsychotic medication. Your doctor may also prescribe anti-anxiety medications and antidepressants.

Your doctor may recommend additional treatment once your condition has stabilized. This can include psychotherapy and individual or family counseling.

When paranoia is a result of drug abuse, treatment is often supportive until the drug effects wear off. After that, your doctor will likely encourage you to participate in a drug treatment program.  

What is the outlook for people with paranoia?

For people who have paranoia, seek treatment, and follow through with it, the outlook is usually positive. However, treatment may be a slow process. Therapy and medication are effective in treating it. People with paranoia are usually distrustful of others and perceive paranoid thoughts as real. This makes the process of seeking treatment difficult.

If someone you know is showing the symptoms of paranoia, they may not think they need medical attention. However, you should encourage them to see a doctor for a diagnosis as soon as possible. 

Content licensed from:

Written by: MaryAnn DePietro
Published on: Jan 08, 2014
Medically reviewed on: Jun 03, 2016: [Ljava.lang.Object;@72dd8f3d

This feature is for informational purposes only and should not be used to replace the care and information received from your health care provider. Please consult a health care professional with any health concerns you may have.
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