Understanding Symptoms, Causes, And How To Treat Paranoia

While each of us is sometimes skeptical of other people and their motives for a variety of reasons, persistent and unfounded thoughts and feelings of paranoia can sometimes be indicative of a mental health or medical condition. Let’s dig deeper into how this mental health experience can manifest, what conditions it can be linked to, and which treatment options are available.

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What is paranoia?

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Exploring symptoms of paranoia

While each of us might find ourselves suspicious of another person’s motives or desires from time to time, there are certain symptoms to look out for that may indicate true clinical paranoia. 

Some common symptoms of paranoia may include:

• Defensiveness and hostility
• Difficulty relaxing around others
• A tendency to hold on to grudges
• An inability to trust others
• Overanalyzing the behaviors of others, particularly in search of ill will or conspiracy
• Inventing scenarios in which you are a victim or otherwise somehow scorned by others
• In severe cases, clinging to elaborate and conspiratorial thinking 

What causes paranoia?

As with many mental health symptoms, paranoia can be caused by genetic factors, environmental factors, or a combination of the two. For example, a person who experienced childhood trauma and has a genetic predisposition to schizophrenia may begin to experience paranoia as an early sign of schizophrenia. Or, a person with a genetic predisposition to psychosis who experiences a period of extreme stress may develop paranoia and delusions. As we’ll discuss below, there are various mental health conditions that can cause paranoia, each of which may be influenced by both nature and nurture.

In other cases, paranoia can be a symptom of a medical issue or a side effect of a medication or substance. 

Mental health conditions that can cause paranoid thoughts

There are several different conditions that can cause paranoia. Parkinson’s, dementia, and strokes are examples of medical conditions that often manifest as this symptom. Severe depression and some types of bipolar disorder can sometimes cause paranoia as well. However, when it comes to mental health conditions, some of the most commonly associated with paranoia include the following.

Paranoid personality disorder

Those with paranoid personality disorder don’t usually experience debilitating delusions that hinder their daily functioning. However, the persistent feelings of distrust and suspicion that characterize this personality disorder can often affect their ability to form lasting and meaningful relationships with others.

Delusional disorder

Individuals with delusional personality disorder often fixate on one more specific, false but unshakeable beliefs about themselves or others. For example, some with delusional disorder might become fixated on the idea that the government is watching them while they sleep, which could lead to distress and them going to great lengths to protect themselves from this perceived threat.

Schizophrenia

According to the Substance Abuse and Mental Health Services Administration (SAMHSA), schizophrenia is a serious mental illness that causes people to interpret reality abnormally. This psychotic disorder is often characterized by symptoms like hallucinations and delusions, among others. Delusions can be closely linked to paranoid feelings, since a person will often misinterpret benign occurrences as supporting their false belief, which can become a cycle that’s difficult to break. 

Paranoia and substance use

Paranoia and the misuse of substances such as drugs and alcohol are often linked. For example, alcohol, marijuana, hallucinogens, stimulants, and even certain prescription medications may all potentially cause symptoms of paranoia.Studies also suggest that substance misuse may trigger symptoms of schizophrenia to emerge in predisposed individuals.

The risks of untreated paranoia

Virtually any untreated mental health symptom has the potential to worsen and cause additional complications, and the same is true for paranoia. Since paranoia can cause anxiety and social issues, which may make a person engage in defensive or avoidant behaviors to cope, this symptom can significantly worsen over time when untreated. 

For example, a person experiencing paranoia related to perceived suspicious behaviors of their neighbor might feel anxious whenever they see them through the window. Without treatment, their resulting anxiety may cause them to take measures like blacking out their windows, only whispering even indoors so they can’t be overheard, and never leaving their own home so they can’t be seen—all of which could negatively impact their life and the lives of their family members. These behaviors may also result in further consequences like job loss and an inability to seek medical care.

In this way, ongoing paranoia can also strain relationships and make it difficult or impossible to form healthy new connections. Since research suggests that social connections are closely linked to overall well-being, this could be another serious side effect of untreated paranoia. If you notice this symptom in yourself or a loved one, it’s generally recommended that you seek the support of a licensed healthcare professional as soon as possible.

How to treat paranoid personality disorder and other causes of paranoia

In order to answer the question, “how to treat paranoia,” a doctor or psychiatrist must generally first uncover the underlying cause. If it’s substance misuse, for example, they may recommend substance use treatment as a key part of paranoia treatment. If it’s side effects from a prescribed medication, the provider may decide to change the individual’s prescription. For paranoia caused by Parkinson’s or dementia, certain medications and caregiver strategies may be recommended.

For an underlying mental health condition that causes paranoia, treatment often consists of some form of talk therapy in combination with medication. Schizophrenia is typically a lifelong condition that requires lifelong treatment, usually involving ongoing therapy and medications. If you’re experiencing paranoia, it’s recommended that you meet with your doctor or a mental health professional for evaluation and treatment advice. Don’t start, stop, or change any medication without checking with your doctor.

If paranoia is caused by an underlying or undiagnosed medical condition such as an infection or physical health problem, the symptoms will generally resolve or improve when the medical issue is treated. 

How therapy can help

Again, some form of psychotherapy will often be part of the treatment plan for those experiencing paranoia. There are various types of therapy that may help. One example is exposure therapy, which is guided by a trained professional and aims to help individuals experiencing paranoia become more comfortable with situations that might cause anxiety.

Cognitive behavioral therapy (CBT) is another option that may be recommended. Its purpose is to help an individual learn to recognize and shift distorted thoughts that may be causing distress. Meet with a mental health care professional for advice on which type might be right for you.

The effectiveness of cognitive behavioral therapy for paranoid thoughts

CBT is one of the most common types of therapy used today to treat a variety of mental health conditions and symptoms, and it may be recommended as a way of treating paranoia in cases where it’s mild or moderate as well. Cognitive behavioral therapy aims to help clients replace negative and distorted thoughts with more positive and productive ones in order to reduce distress and increase healthy behaviors.

Exploring the option of online therapy for mental health

People experiencing paranoia may find it hard to feel at ease speaking with a therapist in person. Others might have trouble finding a provider in their area or commuting to and from in-person appointments. In cases like these, online therapy can sometimes be a helpful alternative. Note that those experiencing severe paranoia or other severe symptoms of any mental health condition should typically seek in-person support. However, for those with mild to moderate symptoms or those who are also receiving on-site care, online therapy can be a helpful addition to their treatment plan in some cases. 

With online therapy, you can get matched with a licensed therapist in as little as 48 hours. You can then meet with them virtually from anywhere you have an internet connection. This flexibility can make the therapeutic process more comfortable and approachable for those experiencing paranoia, and it can also be more convenient for people who find it difficult to leave home. Research suggests that online therapy may help reduce paranoid symptoms in some cases.