for better mental health

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 treatment is available?

If your paranoid thoughts are causing you distress then you may want to seek treatment. You may also be offered treatment for paranoia as part of your treatment for a mental health problem.

The first step is usually to visit your GP. Our information on seeking help for a mental health problem can help you speak to your doctor about your mental health.

Talking therapy

Talking therapies can help you understand your experiences and develop coping strategies to deal with them.

Cognitive behavioural therapy

The most common form of talking therapy for paranoia is cognitive behavioural therapy (CBT). During CBT, you will examine the way you think and the evidence for your beliefs and look for different possible interpretations. CBT can also help reduce worry and anxiety that may influence and increase feelings of paranoia.

"I did a lot of CBT, examining negative thoughts and trying to compare them with evidence to the contrary. It helped to talk through this process with others who were more able to see alternative 'evidence' or ways of looking at things."

Other talking therapies

Many other forms of talking therapy are available, including:

  • psychodynamic therapy
  • counselling
  • family (or systemic) therapy

Talking therapies are free on the NHS, but waiting times may vary and can be long. You may choose to see a therapist privately if you can afford it. The British Association of Behavioural and Cognitive Psychotherapies (BABCP) and the British Association for Counselling and Psychotherapy (BACP) have a list of trained and registered therapists.

Finding a therapist you trust

Paranoid thoughts might make it more difficult to trust your therapist or to talk about how you feel. This can sometimes make therapy more difficult. It's important to try to find a therapist who you feel comfortable with. Our information on finding a therapist might help. It can also help if you feel able to tell them about your concerns.

You may also find it useful to agree with your therapist what you will do if your paranoia gets worse. For example, you may decide to pause sessions until you feel able to start again.

Arts and creative therapies

Arts and creative therapies use arts-based activities to help you express how you are feeling, in a therapeutic environment. These types of therapy can be helpful if you are having difficulty talking about your experience.

Medication

If you have a diagnosis of paranoid schizophrenia or delusional disorder, you are likely to be offered an antipsychotic drug to reduce your symptoms. Antipsychotics may reduce paranoid thoughts or make you feel less threatened by them.

If you have anxiety or depression, your GP may offer you antidepressants or minor tranquillisers. These can help you feel less worried about the thoughts and may stop them getting worse. See our pages on medication for more general information.

Paranoia and treatment using virtual reality

If you feel paranoid, you may avoid places or people that make you feel threatened – or use techniques to help you feel safe. New research is investigating whether virtual reality can be combined with cognitive therapy to help you to practise entering situations you are scared about and find out what happens if you don't use your usual techniques to help you feel safe.

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

References are available on request. If you would like to reproduce any of this information, see our page on permissions and licensing.

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