Symptoms, Causes, and Treatments for Paranoia

Paranoia can make you overly suspicious.

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Paranoia is a type of thought process known as a delusion. People who are paranoid have suspicions or even beliefs that are not truly grounded in reality, that they are being watched, or that other people, organizations or forces are acting against them or out to get them.

Understanding what is paranoia can help you decide how to cope with or get treatment for it.

Symptoms

Paranoia can take many different forms, but the most common are:

  • Suspicion of other peoples' motives or actions—why people are doing what you observe them doing, or what you believe they are doing, but have not observed.
  • Unrealistic or exaggerated mistrust of strangers, acquaintances, or loved ones.
  • Questioning what other people are up to, either in your own mind or out loud.
  • Thinking there is a special meaning in the way people look at you, their tone of voice or other aspects of their behavior that do not actually have any special meaning in reality.
  • Believing that special hidden messages—other than advertising—are being transmitted to you through the TV, newspapers, mailings, mass emails, or the internet. These thoughts are known as ideas of reference.
  • Believing you have a special role or significance in the world that is unrecognized, unacknowledged or is being thwarted by others.

These are just examples of how paranoia can be experienced so you might have an experience of feeling that someone else, or some other force, is acting against or undermining you, which is not on this list but is still a type of paranoia.

Causes

Paranoid feelings are a normal part of the human experience and are particularly common among people who are vulnerable. For example, when you're walking alone late at night, you might believe you are being followed or watched, even if you are not; if you're under a lot of stress, you might think people are deliberately undermining you; or when you haven't had enough sleep, you might develop unrealistic paranoid ideas, simply because you are tired and your brain is not performing at its best. These paranoid feelings generally don't cause for concern and will go away once the situation is over.

When paranoia is outside of the range of normal human experiences, it can become problematic. The two most common causes of problematic paranoia are mental health problems and drug use.

Paranoia can be a feature of many mental health problems, including depression and bipolar disorder, but it is most commonly associated with psychotic disorders, such as schizophrenia. Paranoia is also the defining characteristic of paranoid personality disorder. Generally, the more severe the mental illness, the less awareness or insight the person has that she is actually experiencing paranoia, rather than the suspected threat from other people or the world.

Paranoia is associated with both intoxication and withdrawal effects of several drugs, including marijuana, alcohol, cocaine, meth, LSD, and bath salts. The more intoxicated the person is, the more likely he may be to believe that others are against him. While a mildly intoxicated marijuana user may laugh at himself for having paranoid feelings, someone who is high on meth, or withdrawing from alcohol, may be so convinced others are against him that he becomes violent, in what he perceives as self-defense.

Treatments

Because paranoia can be a serious symptom of mental illness, it is important to see a doctor as soon as possible if you have experienced significant paranoid feelings—particularly if they have gone on for several days and you are starting to believe that others actually are against you. Remember: it is natural for people who are feeling paranoid to fear to talk to those in authority, including doctors, so try to keep it at the forefront of your mind that your doctor's only interest is helping you to feel better.

Your doctor will be able to assess your mental and physical health and advise you on the cause of your paranoia. If you have been using drugs, it may include a period of detox. You might not like this idea but remember: drug use can trigger dormant mental health problems, so if you continue to use drugs while you're having paranoid feelings, it could lead to serious consequences.

Treatment for paranoia is often successful and will depend on the underlying cause of your symptoms. Pharmaceutical treatments or drugs for paranoia are very effective in treating the condition when it is caused by depression, bipolar disorder, and psychosis, but only a physician can determine the right medication for you. CBT may also be helpful for paranoia when it is substance or medication-induced, and paranoia as a symptom of mental health problems.

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Article Sources

  • American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders - DSM 5. 5th Edition. Washington, DC: American Psychiatric Association; 2013.
  • Cromarty P, Dudley R. Understanding paranoia and unusual beliefs. Turkington D, Kingdon D, Rathod S, Wikcock S, Brabban A, Cromarty P, Dudley R, Gray R, Pelton J, Siddle R, Weiden P. eds.. Back to Life, Back to Normality: Cognitive Therapy, Recovery and Psychosis. Cambridge: Cambridge University Press; 2009:35-60.