Schizophrenia Paranoia as a Symptom of Schizophrenia By Jodi Clarke, MA, LPC/MHSP Jodi Clarke, MA, LPC/MHSP LinkedIn Twitter Jodi Clarke, LPC/MHSP is a Licensed Professional Counselor in private practice. She specializes in relationships, anxiety, trauma and grief. Learn about our editorial process Updated on February 12, 2022 Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Steven Gans, MD Medically reviewed by Steven Gans, MD Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital. Learn about our Medical Review Board Print Verywell / Emily Roberts Table of Contents View All Table of Contents Delusions Hallucinations Coping Treatment Supporting a Loved One In the current version of the DSM (DSM-5, released in 2013), there are no longer subtypes of schizophrenia. Previously, there was paranoid schizophrenia, along with disorganized, catatonic, undifferentiated, and residual types. It was determined that these were not helpful to clinicians when treating the disorder. While you can no longer be diagnosed with paranoid schizophrenia, you can experience "paranoid" symptoms. In fact, paranoia remains one criterion for diagnosing schizophrenia and is known as a "positive symptom." This means it is part of the normal day-to-day living for people with schizophrenia and is in excess or added to normal mental functioning. In the most general sense, the term paranoia is used to imply a sense of distrust. In schizophrenia, it can be an irrational fixed belief that one is going to be harmed. Those struggling with this symptom of schizophrenia experience hallucinations and delusions that often leave them feeling confused, fearful, and mistrusting of others. Positive Symptoms in Schizophrenia Delusions Someone with schizophrenia with paranoia will experience a preoccupation with delusions. Delusions refer to a fixed false belief. No matter how much information is presented to you showing that the belief is false or misperceived, you continue to hold on to the belief. There are many types of delusions, although the following are most common: Control: Belief of being controlled or manipulated by an outside influenceGrandiosity: Beliefs of special or exceptional powers or abilitiesJealousy: Belief that a spouse or partner is being unfaithfulPersecution: Belief of being interfered with or the center of a conspiracyReference: Belief that certain environmental cues, such as the radio, are directed at oneself.Somatic: Irrational beliefs about the body or illness.Thought insertion: Belief that ideas are being put into your mind by others Paranoid delusions can leave you feeling like you are being judged, at risk of harm, unable to trust others, feeling alone in your experiences, and misunderstood by those around you. Hallucinations A hallucination is a false sensory perception and can affect any of the five senses. The types of hallucinations are referred to as: Auditory (sound) Visual (sight) Olfactory (smell) Tactile (touch) Gustatory (taste) The senses that are often impacted by schizophrenia with paranoia are sight and sound. In other words, you may see and hear things that are not present. It is important to note these hallucinations happen while the person is awake and conscious. Examples of auditory (sound) and visual (sight) hallucinations in someone with paranoia may include: Hearing voices coming from an outside source, such as a speaker or other objectHearing voices commanding or conversing inside your mindHearing abrupt sounds or music when there is nothing presentHearing sounds such as humming, whistling or laughing when no one is aroundSeeing faces and bodiesSeeing images of a situation or event If you're dealing with paranoia, these hallucinations can feel unsettling and unwelcome, which can result in confusion and anxiety about where the hallucinations are coming from and if, or when, they will happen again. Living With Paranoia Because the experience of delusions and hallucinations can be so intrusive, confusing and unsettling, you may find it difficult to let anyone know what you are experiencing. It can be challenging when you are left feeling scared, alone, and unable to trust others. If you feel unsafe, it can be a challenge to build or maintain relationships, keep employment, or engage in tasks of daily living. Interactions with others can feel threatening and attending social events can feel risky, which can lead people to become reclusive in an effort to feel safe. Schizophrenia treatment specialist, Dr. Lisa Cowley, shares that one of the greatest challenges in reaching out for help for those with paranoia and schizophrenia is a lack of awareness or understanding of their condition. "To these folks, their symptoms appear like they are really happening," Dr. Cowley shares. "So, if they feel like the government is spying on them through cameras in their home, they wouldn't go see a psychiatrist or psychologist, they would try to contact authorities." As symptoms progress, someone dealing with paranoia may become aware that they have an illness and seek help. In this case, family members or support services may be necessary to help with treatment challenges like transportation and lack of problem-solving skills when their symptoms are high and their thinking is muddled, Dr. Cowley notes. The Internal Experience of Schizophrenia Treatment for Paranoia Although there is no known cure for schizophrenia with paranoia, there are treatment options available that can help you live a full and productive life. Medications, particularly antipsychotics, can help calm disruptive delusions and hallucinations. Try to keep in mind that your doctor may have you try a few different medications before finding a regimen that works best for you. Once the best medication regimen is determined, then things like individual therapy, group therapy, and other support services can be of help, depending on the resources available in your area. The Best Online Therapy Programs We've tried, tested and written unbiased reviews of the best online therapy programs including Talkspace, Betterhelp, and Regain. Supporting a Loved One Dr. Cowley urges loved ones offering help and support to someone with schizophrenia with paranoia read the book I am Not Sick, I Don't Need Help! by Xavier Amador. "This book directly addresses how families can help, especially with people who don't realize they are ill," she says. She also recommends setting healthy limits and doing your best to stay patient; the stabilization process can take time. Getting family therapy or joining an online or in-person support group is also helpful, adds Cowley. Here are a few more tips to help you cope with and support your loved one with schizophrenia and paranoia. Be an advocate. Encourage your loved one to work with his or her mental health professional to find the right medication and therapy—and to comply with the determined plan of treatment. Don’t argue. Instead, do your best to make your loved one feel safe and truly listen if he wants to talk about the paranoia.Provide space. Your loved one may feel trapped or surrounded, so it’s important to stay close to your loved one while providing ample personal space.Plan for paranoia. During a time when your loved one is not paranoid, make a plan for handling any fears or threats that occur during paranoia.Shift the focus on what's real. It may be helpful to redirect your loved one away from the paranoid fears to more reality-based concerns.Get help. If you think your loved one is in danger of harming herself or someone else, don’t hesitate to reach out to his mental health professional and/or call 911. Practice self-care. Self-care is not selfish; just the opposite. By caring for your own physical and mental health, you will have more energy to help your loved one get a handle of schizophrenia with paranoia. 5 Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Carpenter WT, Tandon R. Psychotic disorders in DSM-5: summary of changes. Asian J Psychiatr. 2013;6(3):266–268. doi:10.1016/j.ajp.2013.04.001 Holder SD, Wayhs A. Schizophrenia. Am Fam Physician. 2014;90(11):775–782. Kreinin A. "Hearing voices" in schizophrenia: who's voices are they?. Med Hypotheses. 2013;80(4):352–356. doi:10.1016/j.mehy.2012.12.022 Goghari VM, Harrow M. Twenty year multi-follow-up of different types of hallucinations in schizophrenia, schizoaffective disorder, bipolar disorder, and depression. Schizophr Res. 2016;176(2-3):371–377. doi:10.1016/j.schres.2016.06.027 Lally J, MacCabe JH. Antipsychotic medication in schizophrenia: a review. Br Med Bull. 2015;114(1):169–179. doi:10.1093/bmb/ldv017 Additional Reading National Institute of Mental Health. Schizophrenia. https://www.nimh.nih.gov/health/topics/schizophrenia/index.shtml. By Jodi Clarke, MA, LPC/MHSP Jodi Clarke, LPC/MHSP is a Licensed Professional Counselor in private practice. She specializes in relationships, anxiety, trauma and grief. See Our Editorial Process Meet Our Review Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit Speak to a Therapist Online Advertiser Disclosure × The offers that appear in this table are from partnerships from which Verywell Mind receives compensation.