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Paranoia

Explains paranoia, including possible causes and how you can access treatment and support. Includes tips for helping yourself, and guidance for friends and family.

What is paranoia?

Everybody experiences suspicious or irrational thoughts from time to time. These fears are described as paranoid when they are exaggerated and there is no evidence that they are true.

There are three key features of paranoid thoughts. If you have paranoia, you may:

  • fear that something bad will happen
  • think that other people or external causes are responsible
  • have beliefs that are exaggerated or unfounded.

Generally speaking, if you are experiencing paranoia, you will feel a sense of threat and fear.

There are different types of threat or harm that you may feel paranoid about. You may feel you are at risk of:

  • psychological or emotional harm – thinking somebody is bullying you, spreading rumours about you, talking about you behind your back
  • physical harm – believing somebody trying to physically hurt or injure you, or even trying to kill you
  • financial harm – thinking another person is stealing from you, or is damaging your property or tricking you into giving away your money.

It could be one person you feel threatened by, or it may be a group of people, an organisation, an event or an object.

I have lived in fear for so many years. I always expect someone to knock on my door and when I open it, [that] they [will] attack me. And when I go out, I think I will be beaten up by people.

Many people experience mild paranoid thoughts at some point in their lives, for example, thinking that people are looking at them or talking about them behind their backs. These types of thought are relatively common and are closely related to anxiety.

I have a female friend who is often suspicious and untrusting of people... In her case, it seems as if the problem is based on heightened anxiety.

Our relative often assumed that the general conversation was aimed at him when it was about someone entirely different. [Or that] someone in a different room was talking about him when it was actually the neighbour’s TV.

More severe paranoid thoughts are not as common, but have a more significant impact on your day-to-day life. You are likely to feel alarmed, and possibly terrified, isolated and exhausted. Severe paranoid thoughts are sometimes called persecutory delusions, because the person experiencing them feels they are being persecuted.

I experienced paranoia as part of transient episodes of psychosis... These involved very cosmic thoughts, for example that the world was about to end, or that international war was imminent.

[My friend] says he is sometimes aware of the thoughts of some previous neighbours of his (some years ago and over three miles away) who have a continuing negative attitude to him. He won’t accept this is anything to do with his schizophrenia, a diagnosis he accepts, but believes [it] is controlled by his medication.

It is possible to recover fully from paranoia. This might mean that you no longer have any paranoid thoughts. Or it may mean that you still experience them, but learn coping strategies so they no longer disrupt your life or cause you distress.

I struggled with paranoia for a long time and it was very distressing. But with time and the help of my therapist, I have learned to deal with it and life is a lot brighter now.

What is a paranoid thought?

It is difficult to identify what a paranoid thought is. Sometimes your thoughts and beliefs may seem irrational, but that does not mean you have paranoia.

Many people have certain cultural or unusual beliefs, such as believing in witchcraft, aliens or conspiracy theories, that are not shared by the general population. However, unless such beliefs cause you to feel threatened and scared, they would not be considered to be paranoia.

Similarly, what may be a paranoid thought for one person may be a rational reaction for another. This largely depends on the context of the thought, and your own life experience. For example, if someone has a loving and supportive family, feeling that a family member wants to hurt them may be considered irrational and paranoid.

However, if someone has difficult relationships with their family and has been threatened by a relative in the past, feeling that a family member wants to hurt them may be a rational reaction to a difficult situation. Similarly, if someone feels that they are being spied on by the government, this may seem irrational and paranoid to the people around them. However, if that person is a political refugee who has come to this country after being persecuted by their government, it may be understandable that they feel they are being watched.

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