What is paranoia?

Paranoia is when we have thoughts or feelings that we are in danger or under threat when the evidence is against this. This can come in varying forms, including believing that we are being followed, watched or plotted against. Of course, we can all experience these types of thoughts sometimes. Still, for some people, these beliefs can be powerful and interfere with our day-to-day lives in various ways.


While your paranoia may not necessarily be classified as a mental health disorder, it can still hugely impact your life.

People with paranoid tendencies may benefit from counselling or therapy. Therapy can help people identify and challenge their delusional thoughts. It can also help them develop coping mechanisms for dealing with anxiety and paranoia. Medication may also be prescribed in some cases to help manage symptoms of paranoia.

What are the symptoms of paranoia?

The symptoms of paranoia can be challenging to spot, as they can vary significantly from person to person. In general, people with paranoia will experience suspicion and mistrust. They may also feel they are constantly being watched or followed and that others are out to get them. Paranoia can lead to social isolation, anxiety, depression and problems at work or school.

Some symptoms to look out for that might suggest paranoia may include:

  • We find ourselves suspicious about things without evidence supporting our beliefs.
  • We're the only one that shares our suspicions about things.
  • When we see no reassurance from other peoples reassurances.
  • Where your beliefs are based primarily on hunches, feelings or ambiguous events.

Is paranoia a mental health disorder?

There is no definitive answer to whether or not paranoia is a mental health disorder. The definition of mental health disorders is constantly evolving and changing. Paranoia does not fit neatly into any one category. That being said, some people may experience paranoia and have a diagnosable mental health disorder, such as schizophrenia or anxiety disorders.

Paranoia can be a symptom of many mental health disorders. Still, it can also occur in people with no diagnosable mental illness.

How is paranoia treated?

Treatment for paranoid thoughts and feelings can vary significantly from person to person. However, treatment will generally focus on reducing symptoms through medication, counselling, or therapeutic support.

Medication: Several medications can be used to treat symptoms of paranoia.

The most common form of therapeutic support people receive for paranoia tends to be Cognitive Behavioural Therapy (CBT), although clients may choose to access various other forms of counselling too. Counselling and CBT can help you examine your thoughts and establish the evidence to support your beliefs. This, in turn, can lead to you drawing different interpretations of how you interpret things. CBT and counselling can also help you manage and work through symptoms of paranoia, such as anxiety.

What are the causes of paranoia?

Paranoia has many possible causes, as it is a complex condition with a range of symptoms. Some reasons may be psychological, such as anxiety or stress. Others may be biological, such as a brain injury or chemical imbalance. Paranoia can also be caused by certain medications or substances, such as alcohol or drugs. In some cases, the cause of paranoia is unknown.

Some external factors that can be associated with paranoia include:

  • trauma (such as childhood experiences or traumatic life events)
  • stress
  • sleep deprivation
  • drug use

More internal factors may also be associated with paranoia, such as:

  • anxiety
  • depression
  • hearing Loss
  • Alzheimer's disease
  • Parkinson's
  • Huntington's
  • and even strokes

The underlying factors can also be a combination of external and internal factors. However, regardless of the cause, paranoia can be a debilitating condition that significantly affects people's quality of life.

Can counselling help with paranoia?

Paranoia can be a difficult thing to deal with. It can make you feel like everyone is out to get you and that you can't trust anyone. Counselling can help you to understand your paranoia and where it's coming from. It can also help you learn how to cope and manage it daily.

Counselling can help people with paranoia to understand and manage their condition. It can also help them process and come to terms with past situations and traumas that have contributed to their paranoia.

Counselling can provide a safe space for people with paranoia to explore their thoughts and feelings. It can help them to recognise and challenge any distorted beliefs they have which are contributing to their paranoia. Counselling can also provide support and guidance on how to cope with symptoms and manage day-to-day life.

People struggling with paranoia may commonly struggle with various associated mental health challenges, such as anxiety. Counselling can help people with paranoia to learn how to relax and better manage their anxiety and panic. It also teaches paranoid people to manage stress, which is often a trigger for paranoia.

The process of counselling for paranoia

The first step in paranoia counselling is building trust with the client. This is incredibly important and is central to most therapeutic approaches. This may take some time, as the nature of paranoia means that the client may be suspicious of the counsellor's motives.

Once trust is established, the counsellor can begin to explore the origins of the client's paranoia. Underlying issues, such as anxiety or depression, often contribute to paranoid beliefs. The counsellor can support the understanding of these beliefs and aid the development of appropriate coping strategies.

What are the benefits of counselling for paranoia?

There are many benefits to counselling for people who suffer from paranoia. Counselling can help people to understand their condition and learn how to manage their symptoms. It can also help people to come to terms with their fears and anxieties and to develop healthy coping mechanisms.

Counselling can also provide support and guidance for people struggling to cope with the day-to-day impact of paranoia. It can help them to find ways to manage their symptoms and live a more balanced life.

If you're experiencing paranoid thoughts, reaching out to a professional can be important in managing your symptoms and regaining control of your life.

Hope Therapy offers counselling in Oxford as well as UK-wide through our network of counsellors and therapists. This includes both counselling and cognitive behavioural therapy (CBT). We understand how challenging paranoid thoughts and beliefs can be for the individual, family and loved ones. As such, we can offer access to a team of counsellors in various locations throughout England that can support you either face-to-face or virtually, depending on the support you are looking for.

The views expressed in this article are those of the author. All articles published on Counselling Directory are reviewed by our editorial team.

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Wantage OX12 & Rickmansworth WD3
Written by Hope Therapy & Counselling Services, Offering Counselling, CBT, Hypnotherapy, EMDR & Mindfulness.
Wantage OX12 & Rickmansworth WD3

Ian Stockbridge is the founder and lead counsellor at Hope Therapy and Counselling Services. 

As an experienced Counsellor, Ian recognised a huge societal need for therapeutic services that were often not being met. As such the 'Hope Agency'was born and its counselling team now offers counselling and therapeutic support throughout the UK.

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