The Spectrum Of Paranoia Disorders

According to the Practitioner’s Guide to Evidence-Based Psychotherapy, paranoia is characterized by a “pervasive and unwarranted mistrust and suspiciousness of others.” People can experience isolated paranoia occasionally during periods of stress, and paranoia can also result from traumatic experiences, such as childhood emotional neglect. However, paranoia can also be a symptom of a serious mental disorder. Below, we’ll explore the differences between paranoia and anxiety and take a closer look at some of the mental health conditions that can cause paranoia.

Anxiety vs. paranoia

Research shows that worrying processes are involved in both paranoia and anxiety. While they may share some overlapping symptoms, there are important differences between the two. 

Anxiety is something that everyone can experience occasionally in response to stress. When anxiety is extreme or long-lasting, it may be a sign of an anxiety disorder, such as generalized anxiety disorder, panic disorder, or social anxiety disorder.

Paranoia typically causes an irrational distrust of other people and other symptoms, including feeling persecuted, victimized, or misunderstood. People with paranoia often experience beliefs about conspiracies, persecution, or threats.

Paranoia can arise from anxiety and vice versa. They can also have many overlapping symptoms, like feeling nervous, having an upset stomach, or experiencing a rapid heart rate. However, the processes behind each one tend to be different.

What are paranoia mental disorders?

There are a variety of mental disorders that can have paranoia as a symptom, though, according to Mental Health America, it is more common in psychotic disorders. The following are some mental health conditions that can cause paranoia.

Paranoid personality disorder

Paranoid personality disorder (PPD) is a mental disorder that typically causes a long-term pattern of suspicion and distrust of others without any reason to be paranoid. People with this condition generally don’t believe that their thoughts and behaviors are problematic.

Because people with this mental health condition may find it difficult to trust mental health professionals, you may wonder, how is paranoid personality disorder diagnosed, or how is paranoid personality disorder treated? Diagnosing and treating this disorder and all personality disorders can be challenging, and people with symptoms may not seek help on their own. When they do see a mental health care provider, it's often due to related conditions, like anxiety or depression, or because of a problem created by their personality disorder, like a relationship ending.

When assessing someone for PPD, a mental health professional will likely ask general questions that may be less likely to cause the person to be hostile or defensive to gain insight into the person’s view of reality, relationships, impulse control, and past history. They may arrive at a diagnosis by using the diagnostic criteria laid out in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).

Symptoms of paranoid personality disorder

People with PPD may not experience delusions or hallucinations that may be seen in other paranoid disorders, but the disorder can affect a person’s ability to function in everyday life. Symptoms of PPD may include the following:

• Doubting the trustworthiness or loyalty of others
• Believing that others are deceiving them
• Holding grudges
• Taking criticism poorly
• Believing there is hidden meaning in the innocent remarks of others
• Having persistent suspicions about their partner being unfaithful
• Being distant in their relationships
• Believing they are always right
• Being argumentative, hostile, or stubborn
• Having a hard time relaxing

Schizotypal personality disorder

People with Schizotypal personality disorder are often perceived as eccentric or odd. They generally do not know how to form relationships or understand how their behavior affects others, and they may misinterpret the motivations and behaviors of others.  

Symptoms of schizotypal personality disorder

People with schizotypal personality disorder may experience the following symptoms:

• Having a lack of friends or relationships outside of their immediate family
• Having flat emotions or inappropriate emotional responses
• Having ongoing and severe social anxiety
• Taking neutral things personally
• Having unusual mannerisms 
• Being paranoid or suspicious 
• Believing they have special powers
• Dressing in odd ways, such as wearing mismatching clothes
• Speaking in unusual ways

Delusional disorder

Delusional disorder is a type of psychotic disorder in which people have non-bizarre delusions, which are those that involve situations that can happen in real life, like being followed or lied to. These delusions are different from bizarre delusions, which generally center on things that could not happen in reality. Non-bizarre delusions can involve untrue or highly exaggerated misinterpretations of real-life experiences. 

People with delusional disorder can generally function well, and they do not typically exhibit an unusual manner. There are multiple types of delusional disorder. The type someone has depends on the theme of their delusion. 

Types of delusional disorder

• Erotomanic, when people believe that another person, often someone famous, is in love with them
• Grandiose, when people have an overinflated sense of their own knowledge, self-worth, power, or identity
• Jealous, when people believe their spouses or partners are being unfaithful without any evidence
• Persecutory, when people believe someone is spying on them, mistreating them, or attempting to harm them 
• Somatic, when people believe they have a medical problem or physical issue
• Mixed, when people have two or more of these delusions

Symptoms

Symptoms of delusional disorder can include the following: 

• Having delusions
• Lacking self-awareness that these delusions are problematic
• Being unable to accept that the delusions are irrational
• Exhibiting anger or violent behavior
• Experiencing anxiety or depression
• Being preoccupied with the trustworthiness or loyalty of their friends
• Reading threatening meanings into neutral occurrences or remarks
• Holding grudges

Schizophrenia

 is a serious mental illness that typically affects people’s feelings, behaviors, and thoughts. It usually has its onset in early adulthood. People with this condition may lose touch with reality and require lifelong treatment. 

Symptoms of schizophrenia

A person's symptoms with schizophrenia can be severe and may include the following:

• Delusions: Delusions occur when people believe things that aren’t real. For example, they may think they are being harmed or they are being targeted by certain gestures or actions when they are not. They may believe that they are famous or possess special talents, or they may be convinced that a major disaster is about to occur.
• Hallucinations: Hallucinations generally involve hearing or seeing things that other people don’t observe but that seem very real. Hearing voices is one of the most common hallucination types, but hallucinations can occur with any of the five senses. 
• Disordered thinking and speech: People with schizophrenia can have a difficult time talking to other people. If someone asks them a question, they may give an unrelated answer, or they may put together unrelated words in a way that other people cannot understand.
• Unusual or disorganized motor behavior: People with schizophrenia may become agitated easily or act in a giddy or childlike manner. Behavior often doesn’t focus on a goal, so doing tasks can be difficult for them. They may be unable to follow instructions or not move or respond to stimuli at all. 
• Negative symptoms: Negative symptoms refer to things that are lacking. For example, people with schizophrenia may not bathe often, feel pleasure, or have interest in everyday activities. They may withdraw from friends and family, talk in a monotone voice, or have a lack of facial expressions.

Getting treatment for paranoia-related mental disorders

If you are experiencing paranoia that is causing you distress and impairing your ability to enjoy your life, there are several ways to get help. Specific treatment approaches depend on the underlying cause and severity of your paranoia. You might consider seeking medical advice from a doctor to determine if medications are available to help with paranoid thoughts.

Online therapy as part of treatment for paranoia and anxiety

Psychotherapy can be helpful in improving symptoms of multiple mental health conditions. People who are experiencing paranoid thoughts may find it difficult to seek therapy, but working with a provider online can be a suitable option. When you sign up for an online therapy platform like BetterHelp, you can work with a licensed professional from the comfort of home at a time that works for your schedule. There are more than 30,000 providers available on the platform, and you can change therapists at any time until you find the right fit for you.

In addition to being convenient and flexible, research has found that online treatment is effective for treating a variety of mental health conditions. For example, one study found that digitally supported cognitive behavioral therapy was effective at improving paranoia for people with schizophrenia-spectrum psychosis.