Paranoia: Complete guide to this intense feeling

What is paranoia? What do you mean someone’s paranoid? We’ve all had mild paranoid thoughts at some point, but what exactly is it? What are the causes of paranoia? When does paranoia become a problem? Are there different types of paranoia? What can you do if you have a family member suffering from paranoid thoughts? What if I’m paranoid? Find out everything in this article. If you have any questions, you can leave us your question below.

What is Paranoia? Definition

Paranoia involves intense feelings and thoughts of anxiety and fear often related to persecution, threat or conspiracy. Paranoia occurs in many mental disorders but is often present in psychotic disorders. Paranoia can turn into delusions. This happens when irrational thoughts and beliefs become so fixed that nothing (including evidence of the contrary) can convince a person that what they think or feel is wrong.

When a person has paranoia or delusions but no other symptoms (such as hallucinations) it is called a delusional disorder.

Because only thoughts are affected, a person with delusional disorder can function in everyday life, although they are often isolated from others.

Paranoid thoughts can be highly exaggerated suspicions. For example, someone who has ever made an unpleasant comment to you and you think they are directing a hate campaign towards you.

In paranoia your fears are amplified, you become the center of a threatening universe.

Paranoia and delirium

Is paranoid delusion the same as paranoia?

A delusion is a strange belief that a person insists that it is true despite evidence of the contrary and that it is not shared by most people in that culture. Two of the most common delusions are those of persecution and grandeur.

Delusional disorder is characterized by the presence of these delusions for at least 1month or more.  Such delusions may be impossible or possible.

Paranoia is the feeling that people are going against you or want to hurt you. If paranoia is persistent it can become a firm belief, this is a delusion. There are many more kinds of delusions, such as erotomania (characterized by an individual’s delusions of another person being infatuated with them), or somatic (believing that you have a disease).

Paranoia and schizophrenia

Paranoia can be a symptom of some types of schizophrenia.

Paranoia and depression

Although rare, paranoia and depression can happen together. When this happens it may be psychotic depression, schizophrenia or bipolar disorder.

If left untreated, people with signs of depression and paranoia can be a danger to themselves and/or others. When these symptoms happen together it can be a challenge to treat them.

Paranoia and anxiety

The relationship between paranoia and anxiety is complicated. A paranoid thought can be described as a kind of anxious thought. They have to do with the reaction to the possible threat.

Anxiety can cause paranoia. Research suggests that anxiety may affect paranoia, specifically how long it lasts and how much discomfort it causes. Paranoid thoughts can promote anxiety.

Symptoms and signs of paranoia

How do you detect paranoia? When someone experiences paranoia they may show symptoms such as:

• Difficulty believing or trusting others.
• Easily offended.
• Unable to understand or handle criticism.
• Takes comments personally with a damaging connotation.
• Defensive.
• Incapable of compromise.
• Unable to pass up transgressions even after an apology.
• Believe people don’t like them, even if there is evidence of the contrary.
• Feels others are against them or lying.
• Difficulty maintaining relationships because of trust issues.
• Feels persecuted when negative things happen, no matter how big or small.
• Believes in conspiracy theories.

Causes of paranoia

The exact cause of the paranoia is unknown. There are many theories that provide different explanations. It’s most likely a combination of all of them.

Research has identified general risk factors that may make an individual more likely to experience paranoia:

• Having confusing or disturbing experiences that cannot be easily explained.
• Excessive worry or low self-esteem (expecting others to criticize or reject you)
• They tend to jump to conclusions easily, are very attached to their beliefs and do not change their mind easily.
• Being isolated.
• Having had a traumatic experience in the past.

Other, more specific factors include:

• Vital experiences. You are more likely to experience paranoid thoughts when you are vulnerable, isolated, or in stressful situations that can lead to negative feelings about yourself. If you are harassed at work, or robbed at home, your thoughts of suspicion are more likely to turn to paranoia.
• Childhood experiences can lead you to believe that the world is unsafe or make you suspect others. This can also affect your self-esteem or how you think as an adult.
• External environment. Paranoid thoughts are more common if you live in an urban environment or community from which you feel isolated. The media reporting on crime, terrorism and violence can play an important role in triggering paranoid feelings.
• Mental health. If you experience anxiety, depression, or low self-esteem, you are more likely to experience paranoid thoughts. This may be because you already have a bias that makes you more likely to interpret things that happen negatively. Paranoia can also be a symptom of some mental health problems, such as schizophrenia or a psychotic episode, as mentioned above.
• Physical illness. Paranoia is sometimes a symptom of certain physical illnesses such as Huntington’s disease, Parkinson’s, stroke, Alzheimer’s and other forms of dementia. Hearing loss can trigger paranoid thoughts in some people.

• Lack of sleep: Lack of sleep can trigger feelings of insecurity and even disturbing sensations and hallucinations. The fears and worries are more common to develop at the early hours of the morning.
• Effects of drugs and alcohol. Drugs such as cocaine, cannabis, alcohol, ecstasy, LSD, and amphetamines can trigger paranoia. Some steroids taken by athletes and weightlifters can also cause symptoms of paranoia. Some insecticides, fuel, and paint have also been associated with paranoia.
• Genetics. Some of our genes predispose us to develop paranoia or not.

Types of paranoia

There are different types of paranoia, as well as delusions. As we have seen, a delusion is like paranoia but when that belief has taken hold and is resistant to the contrary evidence.

Persecution or persecution paranoia

It’s the most common type of paranoia. The person believes that the people around them are enemies that want to harm them. They believe they are being spied on, poisoned, abused or plotted against. The person may react violently or turn to the police for help.

Paranoia or delusional jealousy

You develop a fear that your partner is or will cheat on you. These doubts may be unfounded and cause severe damage to the relationship. Those who suffer from this delusion or paranoia can go to great lengths to find evidence that their partner is having “affairs” they are capable of even hiring a private detective to do so. Studies have shown that this form of paranoia is more common in men than in women. It is sometimes called pathological jealousy.

Grandiose delusions or paranoia

In this form of paranoia, the person thinks they are much better, more influential than they really are. For example, you may think you have exceptional talent, extravagant wealth, or a special relationship with an important famous person.

Erotomania paranoia

The person believes that others are in love with them, even they have little to no relationship with. This type of paranoia is common in people with bipolar disorder in the manic episode. They might say they’re married to a movie star, for example.

Somatic or hypochondriacal paranoia

The person thinks they have all kinds of illnesses and the doctor conspires against them in order not to give the proper treatment.

How is paranoia diagnosed?

Paranoia is not a disorder in itself, so paranoia cannot be diagnosed. It’s more of a symptom of other disorders, as we mentioned. We have all been victims of paranoid thoughts at some point.

When does paranoia become a disorder?

Paranoid thoughts can be mild to severe, and experiences can be very different. This depends on how much you:

• Believe your paranoid thoughts.
• Think about your paranoid thoughts
• Discomfort or pain they might cause
• Interfere with your daily life

Many people experience mild paranoia at some point in their lives, called non-clinical paranoia. These kinds of paranoid thoughts change over time so you may find that they are justified or you just stop having them.

Paranoia becomes a disorder when it becomes constant and clinical, needing treatment.

Paranoia may be a symptom of paranoid personality disorder, delusional disorder, or paranoid schizophrenia.

Paranoid personality disorder

A personality disorder is a pattern consisting of thought, emotion, and behavior. People with paranoid personality disorder have a tendency to think that others will harm, disappoint, or take advantage of them. They may seem quiet, cold or argumentative, and can be difficult to get along with. This disorder is uncommon and usually improves with age.

Delusional disorder

People with a delusional disorder may have delusions without any other symptoms of a mental disorder. Paranoid delusions are the most common, although there are different types of delusions.

Paranoid schizophrenia

Schizophrenia is a form of psychosis that causes difficulties in interpreting reality. The main symptoms of paranoid schizophrenia are delusions and hallucinations (usually hearing something that is not there).

Treatment for paranoia

Treatment of paranoia is often done through medication and psychological therapy.

One of the most important elements of treatment is to create a relationship of trust and collaboration to reduce the impact of irrational beliefs and improve social skills.

It can be difficult to treat a person with paranoia because the symptoms are often irritability, hostility, and emotional withdrawal. Treatment may be long but recovery and reconnection are possible.

Psychological therapy can help you understand your experiences and develop strategies to manage them.

Cognitive behavioral therapy is the most common form of psychotherapy for paranoia. During this therapy, the patient’s way of thinking is examined and the evidence for their beliefs is discussed, looking at other ways of interpreting reality. It also reduces worrying, stress, and anxiety that may worsen paranoia.

Other forms of treatment are psychodynamic therapy or systemic family therapy.

How to handle a paranoid person?

If you have a family member who may be experiencing paranoid thoughts, it can be difficult to figure out how to help them. You may not be sure how to react, especially if you disagree with their beliefs.

• Consider whether their beliefs may be justified. It’s easy to label a thought as paranoid if you disagree with it. It is even easier if that person has experienced other paranoid thoughts or delusions in the past. However, it’s important to make sure you’re not taking their thoughts for granted.
• Consider whether there is a basis for these beliefs. Even if you believe that their thoughts are not justified, it is worth remembering that many paranoid thoughts developed due to anxieties about a real situation. Try to explore whether there is a basis for their fears. This can help you both understand how these thoughts have developed.
• Speak openly. Paranoid beliefs can make a person feel isolated, but talking about it can help reduce or manage stress.
• Don’t dismiss their fears. Even if you don’t agree that they are under a real threat, try to understand how it feels. It is important to recognize that their emotions are very real, even though the beliefs behind them are unfounded.
• Focus on their emotions. Focus on the level of discomfort they are feeling and offer comfort. It is possible to understand their emotions without agreeing with the reason why they feel this way. General phrases such as “Everything is fine, you are safe, there is nothing to worry about” may help. It also helps to break the cycle of paranoid thoughts with other distracting and enjoyable activities.
• Support them in getting help. You can’t force anyone to get help if they don’t want it, so it’s important to remind them that it’s okay to ask for help and that help is out there.
• Respect their wishes. Even if you feel it’s not for the best, it’s important to respect their wishes and not try to make decisions without them.
• Know when to call for help in an emergency. If your loved one has not been able to talk about their experiences, they may feel really bad before they realize they need help. If you are concerned that they may be having a crisis provide them with an emergency plan.
• Take care of yourself. Seeing someone you care about experiencing paranoia can be stressful and distressing. Take care of your physical and mental health, find time for yourself, build positive relationships and ask for help if you need it.

What if I’m paranoid? How do I stop being paranoid?

Here are some tips and exercises to control paranoia and anxiety.

Keep a diary

It may help to have a journal where you write, for example:

• What are your paranoid thoughts
• How they make you feel
• How often you have them
• How do you sleep
• Other life situations

You can do it in a notebook or use digital applications too. It may help to give your thoughts a score from 1 to 10 a sense of how much you believe them and how much discomfort they cause you. Being 10 the most uncomfortable and paranoid thoughts.

It may help to:

• Identify what may be triggering your paranoia and when your thoughts are most likely to appear.
• Recognize paranoid thoughts when they occur and question them. For this purpose, the cognitive restructuring technique is used in consultation.
• Think about what has been helpful in the past.

Question your thoughts

By asking yourself these questions you can find out whether or not these thoughts are justified.

• Would other people think my suspicions are real?
• What would my friends say?
• Is it possible I exaggerated the threat?
• Is there unquestionable evidence to my suspicions?
• Are my concerns based on situations that can be viewed in other ways?
• Is there evidence against my thoughts?
• Do I still suspect even when other people have assured me that there is no reason for being suspicious?

Take perspective on your thoughts

Many times we merge with our thoughts, we identify with them, we believe them 100%. Our mind loves to work constantly, creating and developing thoughts that have no certainty. Sometimes those thoughts can be nonsensical, sometimes they seem very real. But it is important to learn to question them. Mindfulness meditation can be helpful to take distance.

Our thoughts are not a totally accurate reflection of reality. Keep that in mind, when a thought of suspicion or distrust comes your way.

Seek support around you

• Talk about your thoughts with someone you trust. This can reduce your stress and help you question and challenge your paranoid thoughts.
• Keep in touch. Contact the people around you and find time for activities that make you feel good. Avoiding family and friends and leaving enjoyable hobbies can make it easier for you to feel lonely and isolated.
• Try mutual support networks. This brings people together who have had similar experiences and can help you feel understood and less alone. Search for networks in your area and online.

Learn to relax

• Try the mindfulness. This may help with mild paranoia.
• Learn to manage stress.
• Try relaxation techniques, such as breathing techniques and progressive relaxation

Take care of yourself

• Get enough sleep. Sleep gives you the energy to deal with difficult emotions and experiences.
• Eat healthy food. Find out here superfoods for your brain.
• Be physically active. Exercise not only has a good impact on our physical but also psychological health. Find out how exercise is good for the brain.
• Doing practical things like gardening, cooking, crafts or going out into nature can help you stay more connected to the world around you.

This article is originally in Spanish. This translation is done by Alejandra Salazar.

Andrea García Cerdán

Psicóloga General Sanitaria, experta en terapia sexual y de pareja. Ayudo a mejorar la calidad de vida de las personas mediante terapia psicológica y la comunicación a través de la red.