Written by Katherine Nicholls

Katherine Nicholls

Counselling Directory Content Team

Last updated on 3rd September, 2018

Paranoia is when we have thoughts or feelings that we are in danger or under threat, even though there is little to no evidence that this is the case. We can all experience these types of thoughts sometimes, but for some they become extreme, affecting everyday life.

While paranoia itself is not a mental health condition, it is often a symptom of underlying mental health conditions. If your paranoia is severe, treatment may be needed to help you feel better and less afraid.

Here we’ll look into the topic of paranoia in more detail, including how it can affect us, the different causes associated with paranoia and what treatments can help.

What is paranoia?

People can have paranoid thoughts about many different things, and everyone’s experience will be different. Common paranoid thoughts involve worrying that someone is out to hurt you or those close to you.

You may worry that people are talking about you behind your back or that you’re being watched. You may think organisations like the government or the police are monitoring you. There may be people in your life, such as friends and family, who you think are deliberately trying to upset you or bring harm to you.

You might think people are trying to steal from you, or even that your thoughts and actions are being interfered with. Something a stranger does or say might trigger you into thinking they’re out to hurt you, or that there’s a sinister reason for them crossing your path.

These types of thoughts may pop up occasionally and not worry you much. In more extreme cases, you may experience them very regularly and be distressed by them. Paranoia can affect how you interact with the world around you, and can have a huge effect on your quality of life.

It’s important to note here that we all feel suspicious sometimes, and indeed in some cases these suspicions are justified. The key is understanding the difference between a justified suspicious thought and a paranoid thought.

Here are some examples of when suspicion may be paranoia:

  • If there’s no concrete evidence to support your suspicion.
  • If no one else shares your suspicion.
  • If there’s evidence to suggest your suspicion is not warranted.
  • If other people’s reassurances don’t make you feel better.
  • If your suspicions are more based on feelings, hunches or ambiguous events.

Paranoia symptoms

If you’re experiencing paranoia, there are certain behaviours you may experience. These include safety behaviours, acting differently towards other people, isolating yourself and low mood.

Safety behaviours - There may be particular things you feel you need to do in order to be safe from whatever you are worried about. For example you may feel like you need to wear protective clothing, not speak on the phone or check your house for cameras. As it’s likely that nothing will happen to you while you perform your safety behaviours, which can then feed into your paranoia (as you believe it’s the safety behaviour keeping you safe).

Acting differently towards others - Paranoid thoughts can often lead you to worry that other people are out to cause you harm. This can lead you to change the way you behave with others; you may avoid certain people and cut yourself off from your social circles. These types of behaviours can in turn make other people act differently towards you, which can feed into your paranoia.  

Isolating yourself - When you have paranoid thoughts, you can feel like it’s better for you to be alone. You may push others away and isolate yourself, maybe even deciding not to leave the house. You might think that nobody else understands you or believes you, and this can be very frightening and upsetting.

Low mood and anxiety - Due to all of the above, it’s not unusual for your mood to be affected. You may start to struggle with low mood or even depression as a result. Anxiety is also common as you may feel very anxious about certain situations. Paranoid thoughts have also been found to be more distressing to those who struggle with anxiety and low mood.

What causes paranoia?

There is rarely one clear cause of paranoia. There are lots of different factors at play and it’s likely to be a combination of reasons. There are however certain things researchers have found make people more likely to experience paranoia. These include:

Childhood experiences. If you were brought up in a stressful environment where you felt vulnerable and unsafe, you may find it hard to trust people.

Other life experiences. Stressful and negative experiences later in life can also have an impact. If you’ve been bullied or if you’ve been mugged for example, you may be more likely to develop paranoia.

Your environment. Some research has found that those who live in an urban environment, and those who feel isolated from their community may be more likely to develop paranoia. Media portrayal of world events can also contribute to this.

Physical illness. In some instances paranoia is a result of a physical illness such as Alzheimer’s disease, Parkinson’s, Huntington’s and even strokes. For some, hearing loss can also lead to paranoid thoughts.

Lack of sleep. When we don’t sleep enough we may be more likely to experience hallucinations and unsettling feelings. You may find these thoughts get worse late at night.

Drugs and alcohol. Illegal drugs like cocaine, cannabis, LSD, ecstasy and amphetamines are known to trigger paranoia in some cases. Alcohol abuse, certain insecticides, fuel and even paint have also been linked to paranoia.

A side-effect of excessive cocaine use is paranoia, and some days it would grab hold of me so badly that I would be looking for people in the bushes, or would be convinced that someone was in my house. I sometimes even found myself scared of my own shadow.

- Read Edward's story.

Genetics. Research has found that genes also have a role to play in the development of paranoia, however it has not yet been discovered which genes increase our risk.

Mental health conditions. There are a number of mental health conditions that can increase your risk of developing paranoia. There are also some mental health conditions where paranoia is a direct symptom.  

Mental health conditions that can involve paranoia

Conditions like depression and anxiety can make you more likely to develop paranoia. The relationship between paranoia and anxiety in particular is a complicated one. Both involve reacting to a perceived threat. Paranoid thoughts can lead you to feel anxious and anxiety can lead to paranoid thoughts, therefore it’s not uncommon for both to exist alongside each other.

In other cases paranoid thoughts are a symptom of a mental health condition. These include:

  • Paranoid schizophrenia - This is a common type of schizophrenia which involves prominent hallucinations and extreme paranoia, to the point of them being considered delusions.
  • Paranoid personality disorder - This is characterised by an extreme distrust in others and severe paranoid thoughts.
  • Psychosis - This is when the line between fiction and reality get blurred for some people. They may see and hear things that aren’t there and this can lead to a sense of paranoia.

Treatments for paranoia

If you find your paranoid thoughts are having a big impact in your life, seeking treatment is advised. For most people, visiting their GP will be the first port of call. If you’re already seeing a mental health professional for another condition, be sure to tell them you’re worried about paranoid thoughts.

There are different therapies that can be used to help, including talking therapies.

Cognitive behavioural therapy (CBT) is the most common talking therapy to help with paranoia. CBT helps you look at the way your thoughts and behaviours affect one another, helping you to consider alternative interpretations. CBT can also be a big help in reducing any associated anxiety.

Other talking therapies that may be beneficial include family therapy, psychodynamic therapy and one-to-one counselling.

Arts therapies may also be recommended as an option. These use the power of the arts (whether that’s music, drama or art) to help you communicate your thoughts and feelings. This can be particularly helpful if you find it difficult articulating your experience.

Your doctor may also prescribe you medication. This may include antipsychotic drugs (if you have been diagnosed with paranoid schizophrenia for example) or antidepressants (if you’re struggling with low mood and/or anxiety).

One of the more challenging aspects of treatment for paranoia is finding a therapist you can trust. The very nature of paranoia can make it difficult for you to put your trust in others, making talk therapy more difficult. It’s therefore important for you to take time choosing a therapist you feel comfortable with and if possible, be open with them about your concerns.

Hopefully over time, you’ll build trust with your therapist and feel able to work together to lessen the impact of your paranoid thoughts.

Fighting the stigma

Paranoia is an area that people can struggle to understand. There are misconceptions of paranoia and this can lead to you being faced with stigma. Helping to educate people on what paranoia is can help.

You may want to print out this page for friends and family to read, share your experiences with others or search for support groups with others who experience paranoia.

You are not alone and you do not deserve to be treated badly.

Search for a counsellor
Would you like to provide feedback on our content?
Tell us what you think

Please note we are unable to provide any personal advice via this feedback form. If you do require further information or advice, please search for a professional to contact them directly.

You appear to have an ad blocker enabled. This can cause issues with our spam prevention tool. If you experience problems, please try disabling the ad blocker until you have submitted the form.

This site is protected by reCAPTCHA, the Google Privacy Policy and Terms of Service apply.

Find a therapist dealing with paranoia

All therapists are verified professionals

All therapists are verified professionals