Effective Strategies For Coping With Paranoia And Anxiety

Paranoia and anxiety are two complex mental health experiences that can impact a person’s everyday life and overall mental well-being. Individuals living with paranoid feelings may be overly suspicious and have a hard time trusting others. Anxiety, on the other hand, involves persistent and excessive worry, often accompanied by physical symptoms such as increased heart rate, sweating, and trembling. 

Understanding more about paranoia and anxiety may help people distinguish between these two symptoms, which can have similarities in some cases. Here, we’ll examine the causes, symptoms, and treatment options for individuals experiencing a mental illness that may involve paranoia and/or anxiety.

Understanding paranoia and anxiety

Although anxiety and paranoia can sometimes be connected or have similarities, they are not the same. A person with anxiety can develop paranoia and vice versa, but they do not always appear together. Understanding the difference between paranoia and anxiety may help a person understand what they’re experiencing and know when to seek help.

What is paranoia?

Paranoia may be caused by a personality disorder or delusional disorder, which may impact how a person sees and experiences the world around them. Certain medical conditions like Parkinson's disease and Alzheimer’s disease may also cause paranoia, as may sleep deprivation, social isolation, and certain substances. When paranoia is caused by a mental illness, treatment may consist of some form(s) of therapy, sometimes in combination with medication and lifestyle changes.

If you are struggling with substance use, contact the SAMHSA National Helpline at (800) 662-4357 to receive support and resources. Support is available 24/7.

What is anxiety? 

Anxiety is a natural response to a perceived threat, and it triggers the fight-or-flight response in the body. Anxiety may cause physical symptoms such as an increase in heart rate and blood pressure, sweating, muscle tension, and shaking. While feeling some anxiety from time to time is normal, chronic anxiety that interferes with daily activities may be a sign of an anxiety disorder. People with a diagnosable anxiety disorder may find it hard to quiet intrusive thoughts or manage worry.

Some examples of anxiety disorders include generalized anxiety disorder, social anxiety disorder, specific phobias, and others. They’re one of the most common types of mental illnesses today, and they are considered to be treatable—usually through talk therapy, sometimes in combination with medication and lifestyle changes.

Mental health conditions that can cause paranoid thoughts

Individuals living with psychiatric disorders such as paranoid personality disorder, bipolar disorder, or paranoid schizophrenia may experience paranoid thoughts as a symptom, which can impact interpersonal relationships as well as work and home life. Although these disorders can have a serious impact on a person’s daily functioning and well-being, they can typically be diagnosed and treated by a mental health professional. 

Paranoid personality disorder

Paranoid thoughts and anxiety may be related to or caused by a personality disorder. ​​A personality disorder is a type of mental health disorder characterized by long-lasting patterns of behavior, cognition, and inner experience that are significantly different from the expectations of an individual's culture or societal norms. These patterns may be pervasive, inflexible, and stable over time, leading to distress or impairment in an individual’s daily life and relationships.

A person with paranoid personality disorder (PPD) in particular may view others with intense suspicion and believe that they’re out to get them, even without evidence of this. Individuals with PPD may assume that the motives or intentions of those around them are harmful, which can make it challenging to trust and work with others. PPD may also cause a person to hold grudges over time and can create feelings of hypervigilance or being on guard for acts of betrayal. 

Bipolar disorder

Bipolar disorder is a mental health condition characterized by extreme mood swings that include emotional highs (mania or hypomania) and, in some cases, lows (depression) as well. Paranoia, while not a core feature of bipolar disorder, can occur during certain mood episodes for some people—particularly during manic or severe depressive phases.

Paranoid schizophrenia

Paranoid schizophrenia is a subtype of schizophrenia, a chronic and severe mental illness that affects how a person thinks, feels, and behaves. It’s typically characterized by prominent delusions and hallucinations where individuals often believe they are being persecuted or that others are plotting against them. This subtype, like others, can impair an individual's daily functioning and quality of life.

How are paranoid thoughts and anxiety connected?

Paranoia and anxiety can occur on their own, but they could also appear in the same individual and even be connected in some cases. For example, having paranoid thoughts about the intentions of those around you and whether they’re aiming to harm you may create feelings of anxiety or fear. As feelings of anxiety due to paranoia rise, you might also experience more intense or frequent paranoid thoughts. 

It’s also possible for symptoms of anxiety to sometimes feel similar to symptoms of paranoia. For instance, someone with social anxiety disorder will typically have an intense fear of being judged or ridiculed by others in social situations. As a result, they may be more sensitive to perceived slights or may assume negative intentions in others, which can look like paranoia. If a person has social anxiety disorder and a disorder that causes paranoia, these symptoms could exacerbate each other.

Since these two mental health experiences can seem similar in some cases, it can be helpful to understand how to distinguish between the two. A key difference is that, in general, people with anxiety are aware that their thoughts may be irrational—even as they may struggle to control them. In contrast, people experiencing paranoia are typically unwavering in their fixed belief that others are out to get them. If you’re experiencing either symptom, it may be helpful to seek the support of a mental health professional.

Seeking support for anxiety or paranoia

Mental health support from a qualified provider is often required to address paranoia, and it can be important to seek this kind of support for anxiety too. That said, for people experiencing either of these, leaving the house to commute to an office and meet with a therapist you don’t know can be difficult due to these symptoms. That’s why online therapy can sometimes be a preferable alternative. 

With a platform like BetterHelp, you can get matched with a licensed therapist and meet with them remotely from anywhere you have an internet connection. That way, you don’t have to worry about commuting or meeting with someone new face to face. Research suggests that online therapy and in-person therapy can offer comparable benefits in many cases, so you can typically feel confident in choosing either one.