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Paranoia
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.
This page is also available in Welsh.
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.
This page covers:
- What kind of things can you be paranoid about?
- What counts as a paranoid thought?
- Is paranoia a mental health problem?
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:
How could paranoia affect me?
You might do or feel specific things as a result of your paranoid thoughts. These things can feel helpful at the time – but in the long term they could make your paranoia worse.
- Safety behaviours
- Isolation
- Worry and sadness
- Paranoia and stigma
Behaviour towards other people
If you think someone is threatening you or wants to harm you in some way, you may behave suspiciously or aggressively towards them. You might push them away or decide that you are better off without them.
But this means that people might start to treat you differently. They might try to avoid you too. It might become harder to make or keep friends. This can make you feel as if your beliefs were justified in the first place.
Safety behaviours can sometimes start to act as evidence for your paranoid thoughts. You might think that you are safe because you do those things and then do them even more. But this means you don’t have a chance to try different ways of coping with scary situations or to test your beliefs and see if they are justified or not.
Talking therapies can help you test your thoughts and practise dealing with scary situations and people. This can be very uncomfortable at first but the therapist should offer you a lot of support and take things at a pace that you can manage.
“Paranoia can appear to make people very selfish, and self-absorbed.”
Isolation
Paranoid thoughts can make you feel alone. You might feel as if no one understands you, and it can be hard when other people don’t believe what feels very real to you. If you avoid people or stay indoors a lot, you may feel even more isolated. You might find it helpful to read our information on talking to someone you trust.
“Paranoia is a very lonely and very frightening illness – it strips people of their confidence.”
Worry and sadness
You might feel anxious and worried about your paranoid thoughts or feel low and sad about what they mean and how they affect your life.
Anxiety and low mood might make you more vulnerable to paranoid thoughts. Research has also shown that people who are more anxious or have low mood are more distressed by paranoid thoughts. It might help to read our information on anxiety and depression.
“What really disturbed me was the strength of the panic that felt like being stabbed. I realised this thought was paranoid but it was the idea that I could think something as bizarre as this that was terrifying to me.”
Hearing voices, paranoia and schizophrenia
Watch Miles talking about his experiences of paranoia and hearing voices.
Paranoia and stigma
There are a lot of misunderstandings about what it means to experience paranoia. It’s important to remember that you aren’t alone and you don’t have to put up with people treating you badly. Here are some options for you to think about:
- Show people this information to help them understand more about paranoia.
- Talk to other people who experience paranoia by going to a peer support group – or setting one up for yourself.
- Share your experience with others. Mind publishes blogs and video blogs from people with experience of mental health problems, including paranoia. See our pages of mental health stories, including information on how to contribute your story with a blog or vlog.
- Know your rights. Our pages on legal rights provide more information.
- Take action with Mind. See our campaigning page for details of the different ways you can get involved with helping us challenge stigma.
Why do I experience paranoia?
No one knows exactly what causes paranoia. There are lots of theories and different people will have different explanations for their own experiences. It’s likely to be a combination of things.
Researchers have identified some general risk factors – these are things that could make paranoid thoughts more likely:
- Having confusing or unsettling experiences or feelings that you can’t easily explain.
- The way you feel – if you are anxious or worried a lot or have low self-esteem and expect others to criticise or reject you.
- The way you think – if you tend to come to conclusions quickly, believe things very strongly and don’t easily change your mind.
- If you are isolated.
- If you have experienced trauma in the past.
There are lots of more specific things that may play a role in causing paranoid thoughts. Sometimes this could be because they make you more likely to experience the risk factors above. These are some examples of things that may contribute to paranoid thoughts:
- Life experiences. You are more likely to experience paranoid thoughts when you are in vulnerable, isolated or stressful situations that could lead to you feeling negative about yourself. If you are bullied at work, or your home is burgled, this could give you suspicious thoughts which could develop into paranoia.
- Experiences in your childhood may lead you to believe that the world is unsafe or make you mistrustful and suspicious of others. These experiences may also affect your self-esteem and the way you think as an adult. For example, this could include being abused by someone in your family, or being bullied at school. See National Association for People Abused in Childhood (NAPAC) if you need support for dealing with childhood abuse.
- External environment. Some research has suggested that paranoid thoughts are more common if you live in an urban environment or community where you feel isolated from the people around you rather than connected to them. Media reports of crime, terrorism and violence may also play a role in triggering paranoid feelings.
- Mental health. If you experience anxiety, depression or low self-esteem, you may be more likely to experience paranoid thoughts – or be more upset by them. This may be because you are more on edge, worry a lot or are more likely to interpret things in a negative way. Paranoia is a symptom of some mental health problems. Many people experience paranoid delusions as part of an episode of psychosis.
- Physical illness. Paranoia is sometimes a symptom of certain physical illnesses such as Huntington’s disease, Parkinson’s disease, strokes, Alzheimer’s disease and other forms of dementia. Hearing loss can also trigger paranoid thoughts in some people.
- Lack of sleep. Lack of sleep can trigger feelings of insecurity and even unsettling feelings and hallucinations. Fears and worries may develop late at night.
- The effects of recreational drugs and alcohol. Some types of recreational drug may trigger paranoia, such as cocaine, cannabis, alcohol, ecstasy, LSD and amphetamines. This may happen particularly if you’re already feeling low, anxious or experiencing other mental health problems. However, researchers still aren’t sure whether recreational drugs directly cause paranoia, or if people who experience paranoia are also more likely to use recreational drugs. Certain steroids taken by athletes, and some insecticides, fuel and paint, have also been associated with paranoia. Drinking alcohol and smoking may also stop medication from effectively treating your symptoms. See our pages on recreational drugs and alcohol for more information.
- Genetics. Research has suggested that genes may affect whether you are more likely to develop paranoia – but we don’t know exactly which ones.
What is the relationship between paranoia and anxiety?
The relationship between paranoia and anxiety is complicated. A paranoid thought could be described as a particular type of anxious thought. Both are to do with reacting to the possibility of some kind of threat.
Anxiety can be a cause of paranoia. Research suggests that it can affect what you are paranoid about, how long it lasts and how distressed it makes you feel. Paranoid thoughts can also make you feel anxious.
How can I help myself?
If you are experiencing paranoid thoughts – or think that you might be – there are things you can do to help yourself cope. You may choose to try them on their own or alongside treatment.
Keep a diary
You may find it helpful to keep a diary recording, for example:
- what your paranoid thoughts are
- how you feel about them
- how often you think about them
- your sleep
- other life events
You could do this in a notebook or use an app or online tool like MoodPanda. You might find it helpful to give the thoughts a number from 1–10 to show how strongly you believe them and how distressing you find them.
This may help you:
- identify what might be triggering your paranoia and when you are most likely to have paranoid thoughts
- recognize paranoid thoughts when they occur and help you question and challenge them
- think about what has been helpful in the past
Once you have a better understanding of your triggers, you can try to take steps to avoid them.
Question and challenge paranoid thoughts
Challenging yourself about your suspicious thoughts can help you work out whether these thoughts are paranoid or justified.
Here are some questions you could ask yourself:
- Would other people think my suspicions are realistic?
- What would my best friend say?
- Have I talked to other people about my worries?
- Is it possible I have exaggerated the threat?
- Is there any evidence for my suspicions that can’t be questioned?
- Are my worries based on events that could be viewed in different ways?
- Are my worries based on my feelings rather than definite evidence?
- Is it likely that I would be singled out above everyone else?
- Is there any evidence against my beliefs?
- Do I still feel suspicious even though other people have reassured me that there is no reason to be?
Look for support around you
Talk about your thoughts with someone you trust
You may find that talking about your thoughts with a trusted friend or family member can reduce stress and help you to question and challenge paranoid thoughts. You could share this information with them, particularly the information for friends and family. If you don’t have someone you feel you can trust, the Samaritans are there for anyone in distress 24 hours a day.
“I’ve found it becomes easier and less straining on yourself once you share your thoughts with someone else.”
Maintain relationships
Feeling connected to other people is an important part of staying well. It can help you to feel valued, confident and more able to face difficult times.
Feeling lonely or isolated could make your symptoms worse. If you don’t feel like you have strong connections with people or you’d like to make more, it could help to explore support services and peer support.
Try peer support
Peer support brings together people who have had similar experiences. Some people find this very helpful.
There are lots of ways to find peer support. You could:
- see our list of useful contacts
- see our peer support directory
- ask your local Mind about peer support
- try an online peer support community like Side by Side (also see our information about staying safe online)
You can also find peer support groups for paranoia through The National Paranoia Network or Rethink.
Learn to relax
Try mindfulness
There is some evidence that mindfulness can help reduce mild paranoia. Our pages on mindfulness have more information.
Manage your stress
Our pages on managing stress have information and tips to help you cope with stressful situations or events.
Try some relaxation techniques
Relaxation can help you look after your wellbeing when you are feeling stressed, anxious or busy. See our pages on relaxation for tips and exercises to help you relax.
Look after yourself
Try to get enough sleep
Sleep can give you the energy to cope with difficult feelings and experiences. See our pages on sleep problems for more information, including tips to improve your sleep.
Think about your diet
Eating regularly and keeping your blood sugar stable can make a difference to your mood and energy levels. See our pages on food and mood for more information.
If you have a difficult relationship with food and eating, our pages on eating problems have information and tips which may help.
Try to keep active
Exercise can be really helpful for your mental wellbeing. Even doing something small can make a big difference. Our pages on physical activity and your mental health have ideas for most ages and abilities, including things you can do at home.
Spend time in nature
Spending time in nature can help improve your mood and feel more in touch with your surroundings. This could be going to a local park or forest, doing gardening or bringing nature into your home. Our information on nature and mental health has more about the benefits, and lots of ideas you could try.
Try doing something creative
Doing something creative, like doodling, playing a musical instrument or baking, can help distract you from difficult thoughts or feelings, or help you to process them. It can also be rewarding. Try not to worry about the finished product. Just focus on enjoying yourself.
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.
What can friends and family do to help?
This section is for friends and family who want to support someone they know with paranoia.
If you have a relative or friend who may be experiencing paranoid thoughts, it can be difficult to know how to help. You might feel unsure of how to react, particularly if you don’t agree with the beliefs they are expressing.
Consider if their beliefs might be justified
It’s easy to dismiss thoughts as paranoid if you don’t agree with them or they don’t match your experience. It’s even easier if your loved one has experienced other paranoid thoughts or delusions in the past. But it’s important to try to check that you’re not making assumptions.
Consider if there is a basis for their beliefs
Even if you feel that their thoughts aren’t justified, it’s worth remembering that many paranoid thoughts will have developed from anxieties about a real situation. Try to explore whether there is a basis for their fears. This can help both of you understand how the thoughts have developed.
“The most helpful thing for me is to be taken seriously. On some level I know my beliefs can’t be real, yet to me they are utterly terrifying. Treating the fear as very real, even if you can’t go along with my reasons for the fear, is so important.”
Talk openly
Paranoid beliefs can make people feel isolated but talking about them can help reduce stress. You might find that your point of view reassures them and gives them a different perspective.
Don’t dismiss their fears
Even if you don’t agree that they are under threat or at risk, try to understand how they are feeling. It’s important to recognise that their feelings are very real, even if you feel the beliefs they are based on are unfounded.
Focus on their feelings
Focus on the level of distress they are feeling and offer comfort. It’s possible to recognise their alarm and acknowledge their feelings without agreeing with the reason they feel that way.
“[It helps to] deal with the agitation by focusing on the feelings… [and] giving general comforting phrases such as ‘All is well, there is nothing to worry about, you are safe.’ Providing distraction activities can also help to break the cycle of paranoia.”
Support them to seek help
You can’t force anyone to get help if they don’t want it, so it’s important to reassure your loved one that it’s ok to ask for help, and that there is help out there. See our pages on how to support someone else to seek help for their mental health for more information.
Respect their wishes
Even if you feel that you know what’s best, it’s important to respect their wishes and don’t try and take over or make decisions without them.
Know how to get help in an emergency
If your loved one hasn’t been able to talk to you about their experiences, they may become very unwell before you realise they need help. If you are worried that your family member or friend is becoming very unwell or experiencing a mental health crisis, you could suggest that they use their crisis plan (if they have one). Our information on crisis services explains more about the help available to support someone in crisis.
Look after yourself too
Seeing someone you care about experiencing paranoia can be distressing or even frightening. You may feel as if you have no time for yourself, but looking after your own wellbeing is important for you and for them. You may find it helpful to get support through talking therapy or peer support. This may be available at a local Mind or a carer’s group, such as Carers UK.
See our pages on looking after yourself when supporting someone else and how to improve your mental wellbeing for more information.
“Looking after someone with paranoia is incredibly draining… having the same conversations day in day out. I learnt to be very clear and concise in my conversations with my father, to be very boundaried and always do what I said I was going to do, leaving no room for misinterpretation.”
Useful Contacts
Mind’s services
- Mind’s helplines provide information and support by phone and email.
- Local Minds offer face-to-face services across England and Wales. These services include talking therapies, peer support and advocacy.
- Side by Side is our supportive online community for anyone experiencing a mental health problem.
Other organisations
British Association for Behavioural and Cognitive Psychotherapies (BABCP)
babcp.com
Information about cognitive behavioural therapy and related treatments, including details of accredited therapists.
British Association for Counselling and Psychotherapy (BACP)
bacp.co.uk
Professional body for talking therapy and counselling. Provides information and a list of accredited therapists.
Carers UK
0808 808 7777
029 2081 1370 (Carers Wales)
advice@carersuk.org
carersuk.org
Advice and support for anyone who provides care.
Mood Diaries
medhelp.org/land/mood-tracker
moodscope.com
moodchart.org
moodpanda.com
Some examples of mood diaries – many more are available. Mind doesn’t endorse any particular one.
The National Association for People Abused in Childhood (NAPAC)
0808 801 0331
support@napac.org.uk
napac.org.uk
Supports adult survivors of any form of childhood abuse. Offers a helpline, email support and local services.
National Paranoia Network
nationalparanoianetwork.org
Information and support for people who experience paranoid thoughts.
Rethink Mental Illness
0808 801 0525
rethink.org
Provides support and information for anyone affected by mental health problems, including local support groups.
Samaritans
116 123 (freephone)
jo@samaritans.org
Freepost SAMARITANS LETTERS
samaritans.org
Samaritans are open 24/7 for anyone who needs to talk. You can visit some Samaritans branches in person. Samaritans also have a Welsh Language Line on 0808 164 0123 (7pm–11pm every day).