What Is Paranoia A Symptom Of, And What Causes It?

According to the American Psychiatric Association (APA), the defining features of paranoia can include “pervasive and unwarranted mistrust and suspiciousness of others.” People with paranoia may see the world as perpetually threatening, and they may always be on the lookout for proof that people are out to get them. 

Some people may experience mild paranoid thoughts that come and go. For others, paranoia can be a sign of a serious mental health condition. Treatment can be challenging, as someone who is experiencing paranoia may have a difficult time trusting doctors and mental health professionals. However, treatment methods like therapy can often reduce and manage paranoia over time. 

Symptoms of paranoia

Symptoms of paranoia can vary depending on their cause and severity. An individual experiencing paranoia may display the following symptoms:

• Searching for proof of their own victimization
• Misinterpreting the comments, actions, and behaviors of others
• Being hypersensitive to both real and imagined slights
• Being hypervigilant
• Isolating from friends and family
• Being argumentative or defensive
• Having senses of suspicion and mistrust

Causes of paranoia

Many factors can contribute to paranoid thinking, from mental health conditions to substance use. Below are several possible causes of paranoia.

Personality disorders

People with personality disorders usually have lifelong maladaptive patterns of thinking, behaving, and relating to other people. There are a variety of personality disorders, but two in particular may have paranoia as a symptom: paranoid personality disorder and schizotypal personality disorder.

Paranoid personality disorder

Paranoid personality disorder (PPD) can be defined by a long-term pattern of suspicion and mistrust that leads to impairment in multiple areas. People with this condition may suspect people in their lives are taking advantage of or lying to them, and they may find it difficult to confide in others for fear that any information they share could be used against them.

People with PPD may respond to their paranoid thoughts with defensiveness or aggression. Paranoid personality disorder can be one of the strongest predictors of aggressive behaviors in clinical populations, although it can be important to note that not all people with PPD display aggressive behavior. 

Schizotypal personality disorder

People with schizotypal personality disorder may be seen as odd or eccentric, and they may struggle with social cues, potentially leading them to be perceived as distant or aloof. They may engage in magical thinking or have strange beliefs, like believing in aliens or ESP (extrasensory perception). 

People with this condition generally don’t understand how their behaviors affect their relationships with others, so they usually have few close relationships and may misinterpret the behaviors and motivations of the people around them.

Some of the paranoia-related symptoms of schizotypal personality disorder can include misinterpreting the meanings of common events and occurrences going on around them, having overly suspicious thoughts about the loyalty of people in their lives, and believing that others are talking about them behind their backs.

Schizophrenia

Schizophrenia is a complex mental illness that usually involves episodes of psychosis. Delusions can be a symptom of the condition, and paranoid delusions tend to be the most common. People with schizophrenia may believe that they are being followed or harmed when they are not, or they may perceive neutral gestures or comments made by people in their environment as threatening and believe they are directed at them.

What is paranoid schizophrenia?

You may have heard the term “paranoid schizophrenia” to describe schizophrenia with paranoid delusions. However, paranoid schizophrenia is no longer a diagnosable mental illness in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V). Instead, what was formerly referred to as paranoid schizophrenia now falls under the diagnosis of “schizophrenia spectrum disorder,” along with the other former subtypes of schizophrenia.

Bipolar disorder

Another mental health condition that can involve paranoia is bipolar disorder. Bipolar disorder is primarily characterized by mood episodes, usually alternating between periods of depression and mania or hypomania. 

Bipolar I disorder usually involves manic episodes, which can be accompanied by psychotic features, like delusions. One of the most common types of delusions is paranoid delusions, in which people may believe that they are being stalked or targeted by others.

Delusional disorder

Paranoia can also be a symptom of delusional disorder, which is typically characterized by firmly held false beliefs (delusions) lasting a month or more. Rather than being unrealistic, these delusions usually center around things that could conceivably happen in real life but for which the person has no evidence or proof. Other symptoms of psychosis, like hallucinations, are not usually present in delusional disorder. 

Multiple types of delusions can occur with this condition, including persecutory delusions, which generally involve someone thinking they’re being spied on or plotted against, perhaps by a coworker, and jealous delusions, in which someone may be convinced that their partner is being unfaithful. Sometimes, these delusions may contribute to paranoid thoughts.

Neurodegenerative disorders

Some forms of dementia and neurodegenerative disorders may also contribute to the development of paranoid thoughts. Research shows that people with Alzheimer’s disease, Lewy body dementia, Parkinson’s disease, and frontotemporal lobar degeneration may be at risk of experiencing paranoid delusions.

Environmental factors

Research also suggests that paranoia can result from social media use in some individuals who experience psychosis.

In addition, according to Mental Health America, paranoia can result from childhood neglect.

Substance use

Substance use is another environmental factor that can contribute to symptoms of paranoia. According to the Mental Health Services Administration, chronic methamphetamine use can lead to anxiety, confusion, paranoia, and aggression. 

Other substances that can cause psychotic symptoms like paranoia include cocaine, ecstasy, ketamine, LSD, cannabis, and magic mushrooms. 

Although updated evidence may be needed, some prescription medications, such as corticosteroids, may also cause psychotic symptoms like paranoia. Always inform your prescribing provider if you experience any adverse effects when taking any medication.

Mental health treatment for paranoia

Treatment for paranoia may depend on the underlying cause, and some causes may be more challenging to treat than others. For example, personality disorders tend to be some of the most challenging mental disorders to treat due to many individuals not realizing they could benefit from professional support. However, those who do seek help often experience significant improvements.

Treatment may be more straightforward for other causes of paranoia, like depression, anxiety, low self-esteem, insomnia, and substance use. In many cases, various types of therapy can be used to address and manage paranoid thoughts. For example, cognitive behavioral therapy may help many individuals identify inaccurate and unhelpful thought patterns and replace them with more constructive ones. It may also teach people experiencing paranoia how to question the validity of their paranoid thoughts.

Depending on the cause of paranoia, a doctor or psychiatrist may also prescribe medication to treat it. Never start, stop, or change the way you take medication without speaking to your doctor.

Online therapy for paranoia

If you are experiencing paranoid thoughts, online treatment may be a convenient and accessible way to get the support you deserve in an environment where you feel comfortable. With an online platform like BetterHelp, you can work with a licensed therapist from your home. If you’re not comfortable with video chats, you can also choose audio calls or online chat sessions with your therapist. 

Research suggests that online therapy may effectively address paranoia in individuals with schizophrenia. However, it can be important to note that people who are currently experiencing acute psychosis may need in-person care.