What is paranoia?
Paranoid thoughts can take many forms. In some cases, strongly held paranoid beliefs may be described as persecutory delusions. Everyone’s experience with paranoia is different. Common paranoid thoughts may involve worrying someone is out to hurt you or those close to you, or that they are spreading nasty rumours about you.
These types of thoughts may pop up occasionally and not worry you much. In more extreme cases, you may experience them 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 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.
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.
What's the difference between suspicion and paranoia?
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 based more on feelings, hunches, or ambiguous events.
Counsellor Ian Stockbridge, BSc. (CBT), PGCert (Clinical Supervision), BACP (Accred) explains how counselling can help support people with paranoia.
Signs and symptoms of paranoia
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. Some signs and symptoms can include:
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.
Safety behaviours can sometimes reinforce paranoid thoughts. If nothing happens while you are using them, you may feel that the safety behaviour prevented something bad from happening.
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. You may also feel the need to find hidden motives in what others are doing.
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 or believes you, which 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.
Other signs can include:
- becoming more argumentative, irritable, or aggressive;
- finding it difficult to question or consider alternative explanations for strongly held beliefs;
- holding grudges for perceived slights ;
- different recollections of events from what others remember happening;
- seeming defensive, hypervigilant, or unable to relate;
- the consistent belief that your partner is being unfaithful;
- repeatedly pursuing legal action for the belief that your rights have been violated.
What causes paranoia?
Experts aren’t sure what exactly causes paranoia. There are lots of different theories and explanations. Currently, researchers think it is likely a combination of factors.
General risk factors that can make paranoid thoughts more likely include:
- childhood experiences
- other life experiences
- your environment
- physical illness
- lack of sleep
- drugs and alcohol
- genetics.
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.
Mental health conditions
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:
- Schizophrenia – Paranoid or persecutory delusions can be experienced by some people with schizophrenia.
- Paranoid personality disorder – This is characterised by an extreme distrust of others and severe paranoid thoughts.
- Psychosis – Psychosis can involve experiences such as hallucinations, delusions and confused or disturbed thoughts. Paranoid or persecutory beliefs can be part of psychosis.
When should I seek help for paranoia?
If you are able to recognise that your thoughts and worries don’t make sense, it can be a positive sign that you are aware that something is wrong and may need help. If feelings of paranoia begin to happen most or all of the time, start to get in the way of your home or work life or affect your day-to-day activities, it can be a cause for concern. Speak with your GP or mental health practitioner.
If you’re unsure whether your thoughts, worries, or concerns may be paranoia, speaking with an outside, impartial person can be a big help. Your GP or therapist can listen in confidence and without judgment, offering further guidance and suggestions for the best course of action to find the right support for you.
Many people experience mild paranoia at some point in their lives.
According to the mental health charity Mind, up to a third of us experience non-clinical paranoia at some point. Typically, these paranoid thoughts change over time, leading you to realise they aren’t justified or that they stop on their own.
More severe or persistent paranoid thoughts may require professional support or treatment.
Support for paranoia
If you find your paranoid thoughts are having a significant impact on 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.
Ways to manage paranoid thoughts
If you think you might be experiencing paranoid thoughts, there are a number of different things you can do to try and help yourself cope. These can include:
- Speak with friends and family – Talking about any worrying thoughts or feelings can help you to find support from someone you know and trust.
- Keep a diary – Writing down your thoughts, how frequently you think about them, how they make you feel, and how they affect your sleep can be helpful. Over time, this can help you to identify possible triggers, recognise paranoid thoughts, challenge them, and discover helpful coping strategies.
- Challenge paranoid thoughts – Question if your thoughts are justified or if they may be paranoia.
- Look after yourself – Reducing stress levels, practising mindfulness, and exploring relaxation techniques can help. Ensuring you get enough sleep, eat regularly, and stay active can boost your mood and energy, helping you feel better able to cope with triggers and challenges.
Can counselling help with paranoia?
There are various therapies that can help, including talking therapies.
The support offered for paranoid thoughts will depend on what is causing them and how they are affecting you. Talking therapies, including cognitive behavioural therapy (CBT), may form part of treatment for some people.
Cognitive behavioural therapy (CBT) is a common talking therapy to be offered to help with paranoia. CBT helps you look at how your thoughts and behaviours affect one another, helping you consider alternative interpretations. CBT can also be a big help in reducing any associated anxiety.
Other forms of therapeutic support may also be considered, depending on your needs and circumstances. These may include family therapy, psychodynamic therapy and one-to-one counselling. The speed and type of therapy you may be offered can vary depending on local NHS wait times and services provided.
Arts and creative therapies may also be recommended. 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 to articulate your experience.
Your doctor may also prescribe medication. This may include antipsychotic drugs, for example, if you have been diagnosed with schizophrenia or another condition involving psychosis, or antidepressants if you’re struggling with low mood 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.
How to support someone experiencing paranoia
It can be difficult to know how to support a friend, family member, or loved one who may be experiencing paranoia. It’s important to let them know that you are there for them.
It can be helpful to:
- Consider if their beliefs may have a basis or be justified – it’s easy to dismiss thoughts or beliefs as paranoia if they don’t match your experiences, or if they have previously had delusions. Paranoid thoughts often develop from anxieties about real situations. Try to find out if there may be a basis for their fears, so you can both better understand how these thoughts may have developed.
- Talk with them – open communication can help reduce feelings of stress and isolation.
- Listen and focus on their feelings – try not to dismiss or minimise their fears. You can listen to their feelings without agreeing with their interpretation of events.
- Encourage them to get help – reassure them that it’s OK to ask for help.
Finding a counsellor
If paranoid thoughts are affecting your wellbeing or day-to-day life, speaking to a professional can help you explore what you're experiencing and find appropriate support.
