How To Cope With Paranoia: Key Treatment Options
Paranoia is a symptom that involves interpreting that others are out to get you despite a lack of evidence that this is true. Paranoid perceptions are characteristic of certain mental health conditions, like paranoid personality disorder and delusional disorder, but these aren’t the only possible causes. Here, we’ll talk about how to cope with paranoia—a process that typically begins with getting to the root cause of this symptom.
What causes paranoia?
Mental health conditions like schizophrenia and certain personality disorders commonly include paranoia, and medical conditions like Parkinson's disease and brain tumors can as well. A person experiencing extreme sleep deprivation or substance misuse may also have paranoid thoughts. Treatment for paranoia usually depends on the underlying cause, so working with a healthcare provider to figure out the root cause is often key.
Seeking professional support as a first-line response to paranoia
If you're experiencing paranoia that is persistent and/or is interfering with your daily functioning or well-being, the first recommended step is to seek professional support. The symptom can sometimes indicate the presence of a serious underlying condition, so meeting with a doctor and a mental health professional is typically important. Talk therapy, substance use counseling, and medication are some of the possible treatments for paranoia, depending on what's causing it. Below, we'll cover some steps to consider taking if you’re living with paranoia, including seeking help, getting enough sleep, and managing stress.
Getting screened for paranoid personality disorder
In some cases, a person experiences paranoia because of an underlying mental health disorder. Paranoid personality disorder (PPD) is one most closely associated with paranoia because paranoid thoughts are the primary symptom. People with PPD experience paranoid thoughts long-term, as part of their personality. This may interfere with their ability to work or maintain relationships.
Research suggests that up to 4.4% of people may have paranoid personality disorder. If paranoia has been part of a person's way of thinking for many months or years, they may benefit from being screened for PPD. However, many people with PPD believe their paranoid thoughts to be true, so they see no reason for treatment. Those who do undergo treatment tend to improve.
Paranoid personality disorder treatment
Paranoid personality disorder doesn't have a single, official treatment. Also, there is currently no medication approved by the US Food and Drug Administration (FDA) for PPD specifically. Often, talk therapy is recommended as a top treatment for personality disorders in general. It often aims to help a person learn to recognize and counter distorted thoughts and develop healthy coping mechanisms for distress.
Getting screened for other mental health conditions
Paranoid personality disorder isn't the only mental illness that can feature paranoia as a symptom. Borderline personality disorder, schizophrenia, and delusional disorder all involve paranoia as possible symptoms, too. That said, the way paranoia presents itself and how severe paranoia symptoms are can vary widely depending on which disorder a person may have.
In addition, some mental health disorders that don't have paranoia as a core symptom have still been linked to paranoia, such as anxiety, depression, and bipolar disorder. If you’re experiencing this symptom, being screened for these other conditions by a mental health professional may be something to consider.
Treatments for paranoia and related mental health symptoms
When a person has both paranoia and a diagnosed mental illness, a mental health specialist generally treats them according to the standards for that illness. For all of the mental illnesses mentioned in this section, therapy, medication, or a combination of both are standard treatments. That said, the types of therapy or medications recommended vary depending on the specific mental health condition.
Getting screened for underlying medical problems
Sometimes people develop paranoia as a result of an underlying health problem, usually something affecting the brain. Dementia, an infection, a traumatic brain injury, a brain tumor, or epilepsy are examples of things that could all contribute to paranoia. If you have experienced paranoia as part of a sudden shift in personality and cognitive ability or your paranoia has appeared alongside other sudden symptoms, you should seek a medical evaluation from your doctor.
Physical health and paranoia
When a person has a physical health condition causing paranoia, treating that specific problem usually takes priority. If the underlying illness or injury is something that can be effectively treated, then the paranoia may go away once the underlying problem has been resolved. If the underlying issue is irreversible, like dementia, then treatment that involves reducing and coping with the paranoia may be advised.
Improving sleep to reduce paranoia
Both sleep deprivation and insomnia can increase the risk of or trigger paranoia, so improving sleep may have the reverse effect. Research suggests that when a person goes more than 48 hours without sleep, they often begin to hallucinate and develop delusions, which can include paranoid delusions. In studies, participants with no history of a mental health condition believed bizarre delusions, like that their fellow study participants wanted to kill them or that aliens were sending them messages, after total sleep deprivation.
Insomnia has also been linked to paranoia in other research. Insomnia appears to increase a person's risk of paranoia, and paranoia likely increases a person's risk of insomnia. Research suggests that treating this sleep problem could help reduce paranoid thinking.
If you're experiencing both paranoia and sleep problems, addressing the sleep problems may reduce the paranoia. A research study with 3,755 participants indicates that cognitive behavioral therapy for insomnia (CBT-I) may help reduce insomnia and paranoia. CBT-I helps people identify how their behaviors and patterns of thinking influence their sleep so they can make changes to improve the quality of their rest.
Managing stress to reduce paranoia
Along with improving sleep, reducing stress is another potential paranoia treatment that could help people with or without mental health conditions. Some researchers propose that having experienced a higher number of stressful life events is linked to higher levels of paranoia. Paranoia may stem from all types of stress, ranging from childhood trauma to chronic daily stress.
If you are experiencing trauma, support is available. Please see our Get Help Now page for more resources.
Some experts argue that paranoia is an evolutionary response that developed as a way of protecting people from threats. While more research is needed to understand why humans experience paranoia, this hypothesis would help explain why trauma and stress often increase the symptom. If a person is undergoing stress, gaining a heightened awareness of threats—which could look like paranoia—may provide protection that wouldn't be there if the person hadn't gained a heightened awareness.
Stress reduction can take many forms. Research has found evidence suggesting that relaxation techniques like deep breathing, biofeedback, and progressive muscle relaxation may all help reduce stress. Similarly, activities like mindfulness meditation, yoga, and tai chi may help some people relax. Journaling, exercising, and engaging in activities you enjoy could also help.
Discontinuing or limiting substance use to reduce paranoia
Substance use can cause or worsen symptoms of paranoia. Generally, when the cause of paranoia is substance use, the first-line treatment is to stop using the substance. When complete cessation isn't realistic for a person, experts often recommend receiving relevant treatments, like medication and therapy, and practicing harm reduction. Harm reduction involves trying to minimize the harm the use of a substance does to a person.
Specific substances and paranoia
A variety of substances have been linked to paranoia. Sometimes, when a person has been using multiple substances, they may not know which one triggered their paranoia symptoms. Discontinuing or reducing the use of all substances may help. Even after substance use is discontinued, paranoia symptoms may continue in some people, and other treatments may then be necessary.
The following are some of the substances that have been linked to paranoia:
Therapy for paranoia
Often, people aren't sure what’s causing their paranoia or if paranoia is the right term for what they're experiencing. Therapy provides a safe space in which you can discuss your thoughts and feelings, including those that you find uncomfortable. This process may be easier to do when you can meet with your provider virtually from the comfort at home, such as with online therapy.
While it may not be right for everyone in every situation—such as when a person is experiencing paranoia as part of acute psychosis and needs immediate in-person treatment—virtual therapy can be a helpful tool in many cases. With a platform like BetterHelp, you can get matched with a licensed therapist with whom who you can meet remotely. Research suggests that online therapy can often provide similar benefits to in-person sessions.
Anxiety-focused cognitive behavioral therapy for paranoia
Among people who have paranoid thoughts but not an underlying mental illness, therapy aimed at targeting anxiety may help. For example, findings from one randomized controlled trial suggest that those who underwent anxiety-focused cognitive behavioral therapy (CBT) experienced reduced paranoia and improved overall function compared to a control group. The study’s authors conclude that reducing anxiety may often be an effective way of also reducing paranoia.
Takeaway
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