PTSD, Paranoia, And Other Symptoms

Medically reviewed by Melissa Guarnaccia, LCSW
Updated October 16, 2024by BetterHelp Editorial Team

Post-traumatic stress disorder (PTSD) can have a wide range of symptoms. While paranoia is not listed in the diagnostic criteria of PTSD, it can overlap with some PTSD symptoms, and the two may be positively correlated. Below, we’ll look at the symptoms of PTSD, how paranoia is related, and possible treatments for this mental health condition.

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Paranoia and PTSD can be challenging to treat

What is post-traumatic stress disorder?

Post-traumatic stress disorder (PTSD) (sometimes spelled “posttraumatic stress disorder") is a mental disorder that can occur after a person experiences or witnesses traumatic events, such as sexual assault, a natural disaster, terrorism, combat, or childhood neglect.

Most people feel scared or afraid during and after a traumatic event occurred as a result of the body’s fight-or-flight response. Generally, people recover from this naturally, and the fear and stress fade as time passes. However, for people with PTSD, the fear and stress can linger long after the event is over or even start months later.

According to the National Institute of Mental Health, symptoms of PTSD typically start within three months of the event, but they can begin much later. For a PTSD diagnosis, people must experience symptoms for longer than a month and the symptoms must be significant enough to interfere with daily life.

Many people associate PTSD with veterans, but anyone can experience it. According to the National Center for PTSD, PTSD is “slightly more common among Veterans than civilians.” At some point in their lifetime, about 7% of veterans and about 6% of adults in the general population will experience PTSD.

Symptoms of PTSD

Symptoms of PTSD are generally categorized into four categories:

  • Arousal and reactivity symptoms: These symptoms, also sometimes called PTSD hypervigilance, include feeling tense or on edge, being easily startled, having angry outbursts, engaging in risky behavior, and having sleeping problems. The symptoms can lead to ongoing feelings of stress and anger that can interfere with everyday life.
  • Avoidance symptoms: Someone experiencing avoidance symptoms may go through great lengths to avoid reminders of the traumatic experience. People may change their entire routine to avoid reminders of the event. For example, if they were in a car accident, they may stop driving altogether or refuse to get into a car.
  • Cognition and mood symptoms: Cognition and mood symptoms can affect how someone with PTSD relates to their loved ones. These symptoms can include having negative thoughts about themselves or the world, having difficulty remembering details of the event, blaming themselves, losing interest in hobbies and other activities, and having a hard time feeling positive emotions.
  • Re-experiencing symptoms: Other PTSD symptoms may include flashbacks, dreams or memories of the event, and physical signs of stress. Re-experiencing symptoms through perceived threats can also include physical symptoms, such as a rapid heart rate, elevated blood pressure, or sweating.

Diagnosis depends on the type of symptoms that someone experiences. For a PTSD diagnosis, an adult must experience two arousal and reactivity symptoms, one avoidance symptom, two cognition and mood symptoms, and at least one re-experiencing symptom for at least one month.

Causes of PTSD

PTSD can develop after a traumatic, frightening, or stressful event, but only about 5.6% are officially diagnosed with PTSD. Researchers are unsure why some people develop PTSD and others do not, but there are a few theories. Some pre-existing conditions, like anxiety or depression, may predispose people to developing PTSD, and there may be genetic factors involved. 

Other possible causes have been suggested, too. For example, some research has shown that people with PTSD have altered levels of stress hormones, which may be the reason for the ongoing hyperarousal associated with the disorder.

What is paranoia?

Paranoia is a pattern of thinking where people have feelings of distrust or suspicion of others without reason. People with paranoia may believe that others are spying on them or trying to harm them. Anyone can experience mild paranoia, but it can also be a type of delusion, which can be a sign of a more serious mental health condition.

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Can paranoia occur in PTSD?

Paranoia is not listed as a symptom of PTSD in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), and it is not part of the diagnostic criteria. However, there are some similarities between the two. For example, both paranoia and PTSD may cause someone to be hypervigilant. A study published in Psychological Medicine that assessed PTSD and paranoia in survivors of assault found that although PTSD and paranoia were two separate experiences, they were positively correlated.

Paranoia symptoms and other mental health conditions

Although paranoia may coincide with PTSD, it may not mean that a person has the disorder. Paranoid ideation may be a symptom of a variety of mental disorders, including:

  • Bipolar disorder
  • Borderline personality disorder
  • Schizophrenia
  • Schizoaffective disorder

Medications for PTSD

Treatment for PTSD can be complex and may require medication. Medications used to treat PTSD include SSRIs (selective serotonin reuptake inhibitors) and SNRIs (serotonin-norepinephrine reuptake inhibitors), which are anti-depressant medications. It can take weeks to notice any changes when taking antidepressants. If you are taking these medications to treat PTSD, you might talk to your doctor about side effects and dosages. Never start, stop or change any medications without the advice of your doctor. 

Mental health care: Types of therapy to treat post-traumatic stress disorder (PTSD)

Psychotherapy is also a primary treatment for PTSD, paranoia, and other symptoms of hypervigilance. There are multiple approaches and treatment techniques for PTSD, but the overall goal may be to help people with this condition identify and change troubling thoughts and behaviors, identify triggers, and manage symptoms.

The American Psychological Association strongly recommends the following approaches to therapy to treat PTSD: 

Cognitive behavioral therapy (CBT)

CBT typically focuses on feelings, thoughts, and behaviors and how changing one of those factors can influence the others. For example, identifying and changing unhelpful thoughts may help change behaviors and feelings. 

Prolonged exposure therapy for post-traumatic stress disorder

This is a type of CBT that focuses on helping people confront their fears by teaching them to face the things that they’re avoiding. By learning how to gradually approach their memories and feelings about the traumatic situation, they can learn that the memories and feelings themselves are not dangerous.

Cognitive processing therapy (CPT)

CPT is another type of CBT that helps people learn to challenge and modify unhealthy beliefs related to a traumatic experience. This process may help people gain a better understanding of the event to reduce the negative effects on daily life.

Cognitive therapy

Cognitive therapy is derived from CBT and typically helps people stop having negative evaluations of the traumatic event. In this type of therapy, someone with PTSD often learns to interrupt negative thought patterns so they have less of an impact on their daily life.

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Paranoia and PTSD can be challenging to treat

Online therapy for PTSD

Online therapy can be a flexible alternative for people with PTSD. If driving to an appointment or meeting with a therapist in person causes you stress, or if you’re looking for a more convenient way to get treatment, consider online therapy.

With an online platform like BetterHelp, you can work with a licensed mental health professional from the comfort of your own home. There are more than 30,000 providers available, and you can change therapists at any time until you find one who is a good fit. 

Mental health research has found that online therapy can be an effective treatment approach to PTSD. One 2022 study of 196 people with mild to moderate PTSD looked at the differences between online therapy and in-person therapy and found that there was no difference in effectiveness after 16 weeks.

Takeaway

Paranoia is not a symptom of post-traumatic stress disorder and is not part of the diagnostic criteria for the disorder, but research has found that the two are positively correlated. If you’re experiencing symptoms of PTSD, paranoid thoughts, or psychotic symptoms, getting support from a therapist may help you learn to manage your symptoms and learn healthy coping mechanisms. To learn more about online psychological treatments for PTSD, connect with a mental health professional at BetterHelp.
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