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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.

Mae'r dudalen hon hefyd ar gael yn Gymraeg. This link will take you to a Welsh translation of this page.

What is paranoia?

Paranoia is thinking and feeling like you are being threatened in some way, even if there is no evidence, or very little evidence, that you are. Paranoid thoughts can also be described as delusions. There are lots of different kinds of threat you might be scared and worried about.

Paranoid thoughts could also be exaggerated suspicions. For example, someone made a nasty comment about you once, and you believe that they are directing a hate campaign against you.

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In paranoia, your fears become amplified and everyone you meet becomes drawn into that web. You become the centre of a threatening universe.

What kind of things can you be paranoid about?

Everyone will have a different experience of paranoia. But here are some examples of common types of paranoid thoughts.

You might think that:

  • you are being talked about behind your back or watched by people or organisations (either on or offline)
  • other people are trying to make you look bad or exclude you
  • you are at risk of being physically harmed or killed
  • people are using hints and double meanings to secretly threaten you or make you feel bad
  • other people are deliberately trying to upset or irritate you
  • people are trying to take your money or possessions
  • your actions or thoughts are being interfered with by others
  • you are being controlled or that the government is targeting you

You might have these thoughts very strongly all the time, or just occasionally when you are in a stressful situation. They might cause you a lot of distress or you might not really mind them too much.

I find it really hard to trust people as my head tells me they're out to get me.

Most people have paranoid thoughts about threats or harm to themselves but you can also have paranoid thoughts about threats or harm to other people, to your culture or to society as a whole.

What counts as a paranoid thought?

Paranoid thoughts are usually to do with your ideas about other people and what they might do or think. It can be difficult to work out whether a suspicious thought is paranoid or not, especially if someone else says your thoughts are paranoid when you don't think they are. This could be a friend, family member or doctor, for example.

People may think about risks in different ways and believe different things are good or bad evidence for suspicious thoughts. People might also believe different things based on the same evidence. Ultimately you have to decide this for yourself.

Suspicious thoughts are more likely to be paranoid if:

  • no one else shares the suspicious thought
  • there's no definite evidence for the suspicious thought
  • there is evidence against the suspicious thought
  • it's unlikely you would be singled out
  • you still have the suspicious thought despite reassurance from others
  • your suspicions are based on feelings and ambiguous events

Another jogger looked across at me as he overtook me and my anxiety immediately crystallised around his glance. 'Are you following me?' I shouted. I had the thought he was an agent hired by my employer to track my movements.

What about justified suspicions?

Not all suspicious thoughts are paranoid. We all have good reason to be suspicious sometimes. Justified suspicions are suspicions that you have evidence for. For example, if lots of people have been mugged on your street, it is not paranoid to think that you might be mugged too and take care when walking through your area. Justified suspicions can help keep you safe.

Evidence and justification can be lots of different things. Your evidence might be an individual experience but it might be a history of persecution or discrimination. For example, if you are a young black man and you know that police target more young black men for stop and search, it's not paranoid to feel under greater threat of a stop and search yourself.

It can sometimes be difficult to work out whether your thoughts are paranoid or whether they are justified suspicions. Our information on what counts as a paranoid thought and helping yourself can help you decide.

Is paranoia a mental health problem?

Paranoia is a symptom of some mental health problems but not a diagnosis itself.

Paranoid thoughts can be anything from very mild to very severe and these experiences can be quite different for everybody. This depends on how much:

  • you believe the paranoid thoughts
  • you think about the paranoid thoughts
  • the paranoid thoughts upset you
  • the paranoid thoughts interfere with your everyday life

Lots of people experience mild paranoia at some point in their lives – maybe up to a third of us. This is usually called non-clinical paranoia. These kind of paranoid thoughts often change over time – so you might realise that they are not justified or just stop having those particular thoughts.

At the other end of the spectrum is very severe paranoia (also called clinical paranoia or persecutory delusions). If your paranoia is more severe then you are more likely to need treatment.

Paranoia can be one symptom of these mental health problems:

  • paranoid schizophrenia – a type of schizophrenia where you experience extreme paranoid thoughts
  • delusional disorder (persecutory type) – a type of psychosis where you have one main delusion related to being harmed by others
  • paranoid personality disorder

This information was published in July 2020. We will revise it in 2023.

References and bibliography available on request.

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