Is Paranoia A Symptom Of Anxiety?

Medically reviewed by Nikki Ciletti, M.Ed, LPC
Updated October 9, 2024by BetterHelp Editorial Team

Paranoia can cause persistent fear and distrust, which may feel similar to anxiety. Due to the similarity of the two mental health concerns, people may wonder whether paranoia is a symptom of anxiety or anxiety disorders. Exploring the connection can offer insight into mental health and indicate potential areas to seek support. 

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Experiencing anxiety-related paranoia?

What is anxiety?

According to the Anxiety & Depression Association of America (ADAA), 6.8 million adults in the United States experience generalized anxiety disorder, six million experience panic disorder, and 15 million experience social anxiety disorder. While each of these psychiatric disorders can present with unique symptoms, one common symptom that these individuals may experience is paranoia. However, to answer the question “Is paranoia a symptom of anxiety,” first, understanding the definition of anxiety and its various forms may be helpful.

The word “anxiety” can describe a feeling of uneasiness or discomfort that any individual can experience. Anxiety disorders are a set of mental health conditions involving anxiety that can cause individuals to experience this symptom persistently and in such a way that negatively impacts daily functioning. These conditions include but are not limited to generalized anxiety disorder (GAD), panic disorder, and social anxiety disorder. 

What is generalized anxiety disorder? 

Generalized anxiety disorder is a mental illness that can cause individuals to be frequently nervous or worried about various elements of everyday life, even if there is no tangible reason to have feelings of anxiety. Individuals with GAD can struggle with sleep disturbances, muscle tension, headaches, difficulty concentrating, and fatigue. These feelings can persist without treatment for weeks, months, or years. 

What is panic disorder?

Panic disorder can cause a person to experience panic attacks, episodes that can lead to increased heart rate, overwhelming anxiety, a sense of impending doom, and difficulty breathing. These episodes can happen in response to certain stimuli, but in some cases, a panic attack may occur for no discernible reason. Individuals with panic disorder can also feel anxiety when thinking about when their next panic attack will happen, which may cause them to avoid situations or places where panic attacks have previously occurred. 

What is social anxiety disorder? 

Individuals with social anxiety disorder may experience significant discomfort in everyday social situations. These anxious thought patterns could make maintaining relationships, attending school, or performing in the workplace difficult. Social anxiety disorder can cause someone to have the sense that they are being constantly judged by everyone around them, which can lead to low self-esteem and avoidance of social situations. Individuals with this condition can also struggle to make eye contact and experience physical symptoms, such as rapid heart rate, trembling, upset stomach, sweating, nausea, and lightheadedness. 

Can individuals with social anxiety disorders and other types of anxiety experience paranoia?  

While anxiety can lead to paranoia and paranoid thoughts, both anxiety and paranoia can feature distinct differences. For example, although a person with anxiety can be worried about what other people think, they may not believe that other individuals are monitoring them or mean to do them harm. Paranoia and anxiety can also differ in their focus, with paranoia often focusing on a specific person or group. Anxiety and anxious thoughts, on the other hand, can be more general, with individuals worrying about a wide variety of situations. 

What is paranoia?

The term “paranoia” can describe the belief that someone or an external force means to do you harm, even if there is little evidence to support it. For example, a person may pass by a group of laughing people and think they are laughing at them, even if they have no reason to do so. Paranoid feelings can also lead a person to believe a single person, a group of individuals, or larger entities such as a government organization are monitoring them. Even if they do not believe they are being monitored, those with paranoia may think that someone wants to take their possessions, whether that be from their home, vehicle, or what they have on their person. 

While individuals without a mental health disorder can experience paranoid thought patterns, paranoia can also be a symptom of a mental health condition. However, the way that paranoia manifests can vary depending on what mental health condition a person is experiencing. For example, paranoia caused by anxiety can look unique to paranoia as part of psychosis in a condition like schizophrenia. 

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Is paranoia a part of other mental health conditions?

Paranoia can be a symptom of various mental health conditions, including those that involve psychosis. Psychosis is a group of symptoms that can affect how an individual thinks and perceives the world around them. Mental health conditions that can involve paranoia or psychosis may include the following. 

Schizophrenia 

Schizophrenia can cause symptoms like hallucinations, impaired emotional expression, difficulty communicating, and trouble thinking logically. Those with schizophrenia may also experience paranoid delusions. These irrational thoughts can have various impacts; for example, a person with delusions may believe that someone close to them (even a loved one) intends to do them harm.

Bipolar disorder 

Bipolar disorder is typically characterized by manic and depressive episodes. Individuals with this disorder may alternate between the high energy and rapid thoughts of manic episodes and the fatigued and isolating lows of depressive episodes. Paranoia can also be an element of bipolar disorder, particularly during periods of mania for those with the bipolar I disorder subtype. Individuals may have the sense that they are being watched and believe they must remain hypervigilant, which could lead to anxiety and emotional outbursts. 

Schizoaffective disorder 

Schizoaffective disorder can involve elements of both schizophrenia and bipolar disorder, with some individuals experiencing hallucinations, paranoid delusions, and periods of mania or depression. Those with schizoaffective disorder may alternate between these manic or depressive episodes and periods of psychotic symptoms, which could significantly impact their ability to function. 

Other conditions 

Paranoia can also be a part of disorders that do not necessarily involve psychosis, including personality disorders. One example of a personality disorder that may feature paranoia is paranoid personality disorder (PPD). People with borderline personality disorder (BPD) may also sometimes experience paranoia. 

What is paranoid personality disorder?

Those with paranoid personality disorder (PPD) can struggle with trust, often becoming suspicious of individuals around them while remaining unaware of their own behavior. Individuals experiencing PPD may struggle to maintain social relationships, as their suspicious nature and difficulty with bonding could drive away potential friends and partners. 

Paranoid personality disorder symptoms

Individuals with PPD can present with various symptoms that may impact their thought patterns and behavior. These symptoms can include:

  • Perceiving innocuous comments as personal attacks
  • A persistent sense of suspiciousness
  • Holding long-term grudges
  • Hostility and aggression
  • Controlling or jealous behavior
  • Trouble relaxing
  • Difficulty trusting others with personal information

These symptoms can be challenging to experience. However, they may be alleviated by certain treatments. These treatments typically include different therapeutic approaches, such as cognitive-behavioral therapy (CBT). CBT may be helpful for paranoid personality disorder but is also effective for other conditions, such as paranoia caused by anxiety. 

Are there treatments for paranoia caused by anxiety? 

According to the Victoria Department of Health, treatments for paranoia (or paranoia caused by anxiety) may include various types of medication and therapy. These medications can include anti-anxiety or antipsychotic medications, while therapies such as cognitive-behavioral therapy could be effective. 

Cognitive-behavioral therapy (CBT) can help individuals identify the thought patterns that may be contributing to their paranoia or anxiety. A mental health care provider specializing in CBT can lead clients through exercises that allow them to express how they feel or respond to certain situations. From there, clients can find how these patterns connect to their behavior. As individuals gain a better understanding of these connections, they can work to restructure their thought patterns to promote more positive and beneficial outcomes.

The BetterHelp platform is not intended for any information regarding which drugs, medication, or medical treatment may be appropriate for you. The content provides generalized information that is not specific to one individual. You should not take any action without consulting a qualified medical professional.

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Experiencing anxiety-related paranoia?

Can everyone access in-person mental health treatments? 

While CBT and other types of therapy can be beneficial for individuals experiencing anxiety and paranoia, in-person forms of therapy may not be available or comfortable for everyone. Some individuals with anxiety may find it difficult to discuss mental health topics in person, preferring instead to talk to a therapist through phone calls, texts, or video chats. Others could live in a remote region or an area without mental health services, which could make finding a mental health professional difficult. 

In these and other situations, online therapy through a platform like BetterHelp may be an effective alternative to in-person therapy. Through an online platform, clients can access therapy from home, which might be helpful for those with social anxiety. In addition, they can choose between phone, video, or live chat sessions, giving them control over the method of support they receive. 

Research shows that online therapy can be equally as effective as in-person therapy for mental health treatment. In a 2021 meta-analysis, researchers compared data from over 100 studies (totaling 5000 participants) involving in-person or video-delivered psychotherapy (VDP). They found that not only did individuals see substantial improvement after video-delivered psychotherapy, but VDP was clinically no less effective than in-person therapy. 

Takeaway

Anxiety disorders can have a variety of symptoms, including paranoia. These anxiety disorders can vary and may include generalized anxiety disorder, panic disorder, and social anxiety disorder, among others. Paranoia, or the sense that someone or some force means to do you harm, can also be a feature of other mental health disorders. 

Conditions that may incite paranoia could include those that involve psychosis, such as schizophrenia, bipolar disorder, and schizoaffective disorder, and those that typically do not, such as paranoid personality disorder. Treatments for paranoia and anxiety may be beneficial for those experiencing a mental health disorder. These may include certain medications and therapy, such as cognitive-behavioral therapy. Consider reaching out to a therapist online or in your area to get tailored support with your symptoms.

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