Paranoia

Table of ContentsView AllTable of ContentsSymptomsDiagnosisCausesRelated Mental Health ConditionsTreatmentCoping

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Table of Contents

Symptoms

Diagnosis

Causes

Related Mental Health Conditions

Treatment

Coping

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Paranoiais apattern of thinkingthat involves intense, irrational distrust and suspicion. It can range from mild discomfort, nervousness, or unease about a situation or person to intense, distressing thoughts that can put mental well-being at risk.Anyone can experience slight paranoia symptoms occasionally; however, in people who have mental illnesses such as bipolar disorder, schizophrenia, and paranoid personality disorder, the experience of paranoia can be persistent, extremely unpleasant, and even dangerous.

Although most people have paranoid thoughts on occasion, clinical paranoia refers to a more persistent state of constant, irrational, and unfounded distrust.

Signs and Symptoms of Paranoia

How do you know if you or someone you love might have paranoia? Here are some signs:

Examples of Paranoid Thoughts

Paranoia manifests differently for everyone, but common themes include believing that:

Paranoia isn’t a diagnosis in and of itself. Instead, it’s typically regarded as a symptom of (or diagnostic criteria for) an underlying physical or mental health issue.

Getting to the root cause of paranoia generally begins with a healthcare provider collecting the person’s medical history. They may also perform a physical exam and order lab tests torule out medical conditionssuch asAlzheimer’s disease,dementia,Parkinson’s, epilepsy, stroke, and brain cancer that can affect cognition.

If there are no medical issues, the person will be referred to a psychologist, who will do apsychological evaluationto better understand their symptoms and mental status.

Causes of Paranoia

The cause of paranoia isn’t clear, but contributing factors might include:

Paranoia and Mental Health Conditions

Paranoia can signal a physical health condition such as brain disease or stroke. Paranoia also occurs with certain mental health conditions, particularly those involvingpsychosis.

Borderline Personality Disorder (BPD)

In contrast to many other conditions in which paranoia is a fixed or continuous symptom,BPD-related paranoiais usually transient and occurs when stress levels are high.

Paranoid personality disorderis a distinctpersonality disorder(separate from BPD and other personality disorders). People with paranoid personality disorder have a chronic and pervasive distrust and suspicion of others.

Bipolar Disorder

Paranoid delusions can occur duringmanicor depressive episodes inbipolar disorder.

Psychotic Disorders

Paranoia andparanoid delusionscan occur with psychotic disorders such asschizophreniaandschizoaffective disorder.Other symptoms of psychosis include:

Treatment of Paranoia

Treatment for paranoia depends on symptom severity and the underlying cause. A healthcare provider may recommend medication, psychotherapy, or—most frequently—a combination of the two.

Medication

Antipsychotic medicationmay be prescribed, particularly with underlying psychiatric conditions such as schizophrenia and bipolar disorder. Other medications that might be used includeantidepressants,mood stabilizers, andanti-anxiety drugs.

Psychotherapy

Psychotherapycan help people with paranoia improve their coping and communication skills.It can also help the person “reality-test” aspects of their beliefs.

Therapy also can help people who are experiencing paranoia develop greater trust in others, find adaptive ways to manage and express their emotions, and improve their self-esteem and confidence.

Digital Treatments

Technology has changed the way paranoia and other mental health issues are treated. The options thus far include mobile apps, web apps, virtual reality, SMS, and more.In a 2024 research review, 30-40% of people who have psychotic disorders said they’d used these tools.

In particular, SlowMo therapy has shown success in helping people with paranoia develop healthier thinking patterns and reduce worry. The approach combines digital and in-person therapy to show people how to slow down fast thinking, notice their thoughts, and take in new information. A 2021 study with 361 participants showed benefits after using SlowMo, though more research is needed to understand its effects.

Coping With Paranoia

It’s crucial to discuss feelings of paranoia with a healthcare provider orpsychiatrist. If you’ve already been diagnosed with another mental health condition, the emergence of paranoid delusional thinking may be a sign that your treatment or medications need to change.

The Takeaway

The distressing symptoms of paranoia can disrupt activities at home, work, and school and affect your social life and relationships. Finding the most effective treatment may take time, but don’t lose hope. There areresources and supportthat can help you learn to manage paranoid thinking and other aspects of living with a mental illness.

If you or a loved one are struggling with paranoia, contact theSubstance Abuse and Mental Health Services Administration (SAMHSA) National Helplineat1-800-662-4357for information on support and treatment facilities in your area.For more mental health resources, see ourNational Helpline Database.

If you or a loved one are struggling with paranoia, contact theSubstance Abuse and Mental Health Services Administration (SAMHSA) National Helplineat1-800-662-4357for information on support and treatment facilities in your area.

For more mental health resources, see ourNational Helpline Database.

21 SourcesVerywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Asenio-Aguerri L, Beato-Fernández L, Stavraki M, Rodríguez-Cano T, Bajo M, Díaz D.Paranoid thinking and wellbeing. The role of doubt in pharmacological and metacognitive therapies.Front Psychol. 2019;10:2099. doi:10.3389/fpsyg.2019.02099Raihani N, Bell V.An evolutionary perspective on paranoia.Nature Human Behav. 2019;3:114-121. doi:10.1038/s41562-018-0495-0Bouchard JP.[Mental disorders and dangerous acting out].Soins Psychiatr. 2015;296:12-6.Mental Health America.Paranoia and delusional disorders.Society of Nuclear Medicine & Molecular Imaging.Types of brain disorders.Linszen MM, Brouwer RM, Heringa SM, Sommer IE.Increased risk of psychosis in patients with hearing impairment: Review and meta-analyses.Neurosci Biobehav Rev. 2016;62:1-20. doi:10.1016/j.neubiorev.2015.12.012Kerna NA, Flores JV, Holets HM, et al.Adderall: On the razor’s edge of ADHD treatment, enhanced academic and physical performance, addiction, psychosis, and death.EC Psychol Psychiat. 2020;9(12):65-71. doi:10.31080/ecpp.2020.09.00801Bramness JG, Gundersen OH, Guterstam J, et al.Amphetamine-induced psychosis - a separate diagnostic entity or primary psychosis triggered in the vulnerable?.BMC Psychiat. 2012;12:221. doi:10.1186/1471-244X-12-221Crespi B, Read S, Salminen I, Hurd P.A genetic locus for paranoia.Biology Letters. 2019;14(1). doi:10.1098/rsbl.2017.0694Newbury J, Arseneault L, Beevers S, et al.Association of air pollution exposure with psychiatric experiences during adolescence.JAMA Psychiat. 2019;76(6):614-623. doi:10.1001/jamapsychiatry.019.0056Singer E, Thames A.Neurobehavioral manifestations of HIV/AIDS: Diagnosis and treatment.Neurol Clin. 2016;34(1):33-53. doi:10.1016/j.ncl.2015.08.003Waters F, Chiu V, Atkinson A, Dirk Blom J.Severe sleep deprivation causes hallucinations and a gradual progression toward psychosis with increasing time awake.Front Psychiat. 2018;9:303. doi:10.3389/fpsyt.2018.00303Fiorentini A, Cantu F, Crisanti C, Cereda G, Oldani L, Brambilla P.Substance-induced psychoses: An updated literature review.Front Psychiat. 2021;12:694863. doi:10.3389/fpsyt.2021.694863D’Agostino A, Rossi Monti M, Starcevic V.Psychotic symptoms in borderline personality disorder: an update.Curr Opin Psychiat. 2019;32(1):22-26. doi:10.1097/YCO.0000000000000462National Institute of Mental Health.Bipolar disorder.National Library of Medicine.Psychosis.Staudt M, Herring E, Gao K, Miller J, Sweet J.Evolution in the treatment of psychiatric disorders: From psychosurgery to psychopharmacology to neuromodulation.Front Neurosci. 2019;13:108. doi:10.3389/fnins.2019.00108National Institute of Mental Health.Mental health medications.Cleveland Clinic.Paranoid personality disorder.Dennard S, Patel R, Garety P, Edwards C, Gumley A.A systematic review of users experiences of using digital interventions within psychosis: A thematic synthesis of qualitative research.Soc Psychiatry Psychiatr Epidemiol. doi:10.1007/s00127-024-02692-4Garety P, Ward T, Emsley R, et al.Effects of SlowMo, a blended digital therapy targeting reasoning, on paranoia among people with psychosis: A randomized clinical trial.JAMA Psychiat. 2021;78(7):714-725. doi:10.1001/jamapsychiatry.2021.0326

21 Sources

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Asenio-Aguerri L, Beato-Fernández L, Stavraki M, Rodríguez-Cano T, Bajo M, Díaz D.Paranoid thinking and wellbeing. The role of doubt in pharmacological and metacognitive therapies.Front Psychol. 2019;10:2099. doi:10.3389/fpsyg.2019.02099Raihani N, Bell V.An evolutionary perspective on paranoia.Nature Human Behav. 2019;3:114-121. doi:10.1038/s41562-018-0495-0Bouchard JP.[Mental disorders and dangerous acting out].Soins Psychiatr. 2015;296:12-6.Mental Health America.Paranoia and delusional disorders.Society of Nuclear Medicine & Molecular Imaging.Types of brain disorders.Linszen MM, Brouwer RM, Heringa SM, Sommer IE.Increased risk of psychosis in patients with hearing impairment: Review and meta-analyses.Neurosci Biobehav Rev. 2016;62:1-20. doi:10.1016/j.neubiorev.2015.12.012Kerna NA, Flores JV, Holets HM, et al.Adderall: On the razor’s edge of ADHD treatment, enhanced academic and physical performance, addiction, psychosis, and death.EC Psychol Psychiat. 2020;9(12):65-71. doi:10.31080/ecpp.2020.09.00801Bramness JG, Gundersen OH, Guterstam J, et al.Amphetamine-induced psychosis - a separate diagnostic entity or primary psychosis triggered in the vulnerable?.BMC Psychiat. 2012;12:221. doi:10.1186/1471-244X-12-221Crespi B, Read S, Salminen I, Hurd P.A genetic locus for paranoia.Biology Letters. 2019;14(1). doi:10.1098/rsbl.2017.0694Newbury J, Arseneault L, Beevers S, et al.Association of air pollution exposure with psychiatric experiences during adolescence.JAMA Psychiat. 2019;76(6):614-623. doi:10.1001/jamapsychiatry.019.0056Singer E, Thames A.Neurobehavioral manifestations of HIV/AIDS: Diagnosis and treatment.Neurol Clin. 2016;34(1):33-53. doi:10.1016/j.ncl.2015.08.003Waters F, Chiu V, Atkinson A, Dirk Blom J.Severe sleep deprivation causes hallucinations and a gradual progression toward psychosis with increasing time awake.Front Psychiat. 2018;9:303. doi:10.3389/fpsyt.2018.00303Fiorentini A, Cantu F, Crisanti C, Cereda G, Oldani L, Brambilla P.Substance-induced psychoses: An updated literature review.Front Psychiat. 2021;12:694863. doi:10.3389/fpsyt.2021.694863D’Agostino A, Rossi Monti M, Starcevic V.Psychotic symptoms in borderline personality disorder: an update.Curr Opin Psychiat. 2019;32(1):22-26. doi:10.1097/YCO.0000000000000462National Institute of Mental Health.Bipolar disorder.National Library of Medicine.Psychosis.Staudt M, Herring E, Gao K, Miller J, Sweet J.Evolution in the treatment of psychiatric disorders: From psychosurgery to psychopharmacology to neuromodulation.Front Neurosci. 2019;13:108. doi:10.3389/fnins.2019.00108National Institute of Mental Health.Mental health medications.Cleveland Clinic.Paranoid personality disorder.Dennard S, Patel R, Garety P, Edwards C, Gumley A.A systematic review of users experiences of using digital interventions within psychosis: A thematic synthesis of qualitative research.Soc Psychiatry Psychiatr Epidemiol. doi:10.1007/s00127-024-02692-4Garety P, Ward T, Emsley R, et al.Effects of SlowMo, a blended digital therapy targeting reasoning, on paranoia among people with psychosis: A randomized clinical trial.JAMA Psychiat. 2021;78(7):714-725. doi:10.1001/jamapsychiatry.2021.0326

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Asenio-Aguerri L, Beato-Fernández L, Stavraki M, Rodríguez-Cano T, Bajo M, Díaz D.Paranoid thinking and wellbeing. The role of doubt in pharmacological and metacognitive therapies.Front Psychol. 2019;10:2099. doi:10.3389/fpsyg.2019.02099Raihani N, Bell V.An evolutionary perspective on paranoia.Nature Human Behav. 2019;3:114-121. doi:10.1038/s41562-018-0495-0Bouchard JP.[Mental disorders and dangerous acting out].Soins Psychiatr. 2015;296:12-6.Mental Health America.Paranoia and delusional disorders.Society of Nuclear Medicine & Molecular Imaging.Types of brain disorders.Linszen MM, Brouwer RM, Heringa SM, Sommer IE.Increased risk of psychosis in patients with hearing impairment: Review and meta-analyses.Neurosci Biobehav Rev. 2016;62:1-20. doi:10.1016/j.neubiorev.2015.12.012Kerna NA, Flores JV, Holets HM, et al.Adderall: On the razor’s edge of ADHD treatment, enhanced academic and physical performance, addiction, psychosis, and death.EC Psychol Psychiat. 2020;9(12):65-71. doi:10.31080/ecpp.2020.09.00801Bramness JG, Gundersen OH, Guterstam J, et al.Amphetamine-induced psychosis - a separate diagnostic entity or primary psychosis triggered in the vulnerable?.BMC Psychiat. 2012;12:221. doi:10.1186/1471-244X-12-221Crespi B, Read S, Salminen I, Hurd P.A genetic locus for paranoia.Biology Letters. 2019;14(1). doi:10.1098/rsbl.2017.0694Newbury J, Arseneault L, Beevers S, et al.Association of air pollution exposure with psychiatric experiences during adolescence.JAMA Psychiat. 2019;76(6):614-623. doi:10.1001/jamapsychiatry.019.0056Singer E, Thames A.Neurobehavioral manifestations of HIV/AIDS: Diagnosis and treatment.Neurol Clin. 2016;34(1):33-53. doi:10.1016/j.ncl.2015.08.003Waters F, Chiu V, Atkinson A, Dirk Blom J.Severe sleep deprivation causes hallucinations and a gradual progression toward psychosis with increasing time awake.Front Psychiat. 2018;9:303. doi:10.3389/fpsyt.2018.00303Fiorentini A, Cantu F, Crisanti C, Cereda G, Oldani L, Brambilla P.Substance-induced psychoses: An updated literature review.Front Psychiat. 2021;12:694863. doi:10.3389/fpsyt.2021.694863D’Agostino A, Rossi Monti M, Starcevic V.Psychotic symptoms in borderline personality disorder: an update.Curr Opin Psychiat. 2019;32(1):22-26. doi:10.1097/YCO.0000000000000462National Institute of Mental Health.Bipolar disorder.National Library of Medicine.Psychosis.Staudt M, Herring E, Gao K, Miller J, Sweet J.Evolution in the treatment of psychiatric disorders: From psychosurgery to psychopharmacology to neuromodulation.Front Neurosci. 2019;13:108. doi:10.3389/fnins.2019.00108National Institute of Mental Health.Mental health medications.Cleveland Clinic.Paranoid personality disorder.Dennard S, Patel R, Garety P, Edwards C, Gumley A.A systematic review of users experiences of using digital interventions within psychosis: A thematic synthesis of qualitative research.Soc Psychiatry Psychiatr Epidemiol. doi:10.1007/s00127-024-02692-4Garety P, Ward T, Emsley R, et al.Effects of SlowMo, a blended digital therapy targeting reasoning, on paranoia among people with psychosis: A randomized clinical trial.JAMA Psychiat. 2021;78(7):714-725. doi:10.1001/jamapsychiatry.2021.0326

Asenio-Aguerri L, Beato-Fernández L, Stavraki M, Rodríguez-Cano T, Bajo M, Díaz D.Paranoid thinking and wellbeing. The role of doubt in pharmacological and metacognitive therapies.Front Psychol. 2019;10:2099. doi:10.3389/fpsyg.2019.02099

Raihani N, Bell V.An evolutionary perspective on paranoia.Nature Human Behav. 2019;3:114-121. doi:10.1038/s41562-018-0495-0

Bouchard JP.[Mental disorders and dangerous acting out].Soins Psychiatr. 2015;296:12-6.

Mental Health America.Paranoia and delusional disorders.

Society of Nuclear Medicine & Molecular Imaging.Types of brain disorders.

Linszen MM, Brouwer RM, Heringa SM, Sommer IE.Increased risk of psychosis in patients with hearing impairment: Review and meta-analyses.Neurosci Biobehav Rev. 2016;62:1-20. doi:10.1016/j.neubiorev.2015.12.012

Kerna NA, Flores JV, Holets HM, et al.Adderall: On the razor’s edge of ADHD treatment, enhanced academic and physical performance, addiction, psychosis, and death.EC Psychol Psychiat. 2020;9(12):65-71. doi:10.31080/ecpp.2020.09.00801

Bramness JG, Gundersen OH, Guterstam J, et al.Amphetamine-induced psychosis - a separate diagnostic entity or primary psychosis triggered in the vulnerable?.BMC Psychiat. 2012;12:221. doi:10.1186/1471-244X-12-221

Crespi B, Read S, Salminen I, Hurd P.A genetic locus for paranoia.Biology Letters. 2019;14(1). doi:10.1098/rsbl.2017.0694

Newbury J, Arseneault L, Beevers S, et al.Association of air pollution exposure with psychiatric experiences during adolescence.JAMA Psychiat. 2019;76(6):614-623. doi:10.1001/jamapsychiatry.019.0056

Singer E, Thames A.Neurobehavioral manifestations of HIV/AIDS: Diagnosis and treatment.Neurol Clin. 2016;34(1):33-53. doi:10.1016/j.ncl.2015.08.003

Waters F, Chiu V, Atkinson A, Dirk Blom J.Severe sleep deprivation causes hallucinations and a gradual progression toward psychosis with increasing time awake.Front Psychiat. 2018;9:303. doi:10.3389/fpsyt.2018.00303

Fiorentini A, Cantu F, Crisanti C, Cereda G, Oldani L, Brambilla P.Substance-induced psychoses: An updated literature review.Front Psychiat. 2021;12:694863. doi:10.3389/fpsyt.2021.694863

D’Agostino A, Rossi Monti M, Starcevic V.Psychotic symptoms in borderline personality disorder: an update.Curr Opin Psychiat. 2019;32(1):22-26. doi:10.1097/YCO.0000000000000462

National Institute of Mental Health.Bipolar disorder.

National Library of Medicine.Psychosis.

Staudt M, Herring E, Gao K, Miller J, Sweet J.Evolution in the treatment of psychiatric disorders: From psychosurgery to psychopharmacology to neuromodulation.Front Neurosci. 2019;13:108. doi:10.3389/fnins.2019.00108

National Institute of Mental Health.Mental health medications.

Cleveland Clinic.Paranoid personality disorder.

Dennard S, Patel R, Garety P, Edwards C, Gumley A.A systematic review of users experiences of using digital interventions within psychosis: A thematic synthesis of qualitative research.Soc Psychiatry Psychiatr Epidemiol. doi:10.1007/s00127-024-02692-4

Garety P, Ward T, Emsley R, et al.Effects of SlowMo, a blended digital therapy targeting reasoning, on paranoia among people with psychosis: A randomized clinical trial.JAMA Psychiat. 2021;78(7):714-725. doi:10.1001/jamapsychiatry.2021.0326

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