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Paranoia

7-minute read

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Key facts

  • Paranoia is when a person believes others are trying to harm them.
  • Many people feel mildly paranoid at times.
  • Paranoid symptoms can include feelings of distrust and suspicion.
  • Drug use, mental illness or health conditions can cause paranoia.
  • Treatment for paranoia depends on the underlying cause.

What is paranoia?

Paranoia is a state of mind in which a person believes that others are trying to harm or deceive them. It can include a feeling of being watched, listened to, followed or monitored. It might be a belief that there is a conspiracy working against them or that someone is treating them unfairly.

People with paranoia sometimes have an increased sense of self-importance and believe that other people are taking notice of them when this is not the case.

Mild paranoid thoughts are quite common in the general population and usually go away naturally. Long-term paranoia can be a symptom of a mental illness or be caused by medicines, substance use, dementia or another health condition.

Paranoia can lead to delusional thoughts. A delusion is a fixed, false belief that someone continues to hold even when there is no evidence that the belief is true.

What causes paranoia?

There are many causes of paranoia such as:

Paranoia can also be caused by mental health disorders including:

What are the symptoms of paranoia?

Paranoid symptoms can include:

Being paranoid can make people:

CHECK YOUR SYMPTOMS — Use the Symptom Checker and find out if you need to seek medical help.

When should I see my doctor?

It is important to seek help if you are experiencing paranoia that is causing you distress. You can speak with:

If you know someone who frequently has paranoid thoughts and feelings and it is causing them distress in their lives, encourage them to seek professional help.

If you are worried about someone else’s paranoia, it’s best not to criticise them or tell them they are imagining things. Remember that their thoughts are real to them. Understanding and support are the best way of encouraging them to seek help from a professional.

ASK YOUR DOCTOR — Preparing for an appointment? Use the Question Builder for general tips on what to ask your GP or specialist.

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How is paranoia diagnosed?

Paranoia can be difficult to diagnose. People with paranoia may not be able to recognise that they have a problem and may avoid doctors or hospitals due to a fear of being harmed.

A mental health assessment by a doctor can help assess the level of paranoia and rule out other medical issues. An assessment involves detailed questions about the current problems, family history, general medical history and any medicines or drug and alcohol use.

A physical examination, blood tests or scans can also help identify the cause of your symptoms.

If your doctor suspects a diagnosis of mental illness or personality disorder, they may refer you to a psychiatrist (mental health specialist).

How is paranoia treated?

Treatment for paranoia depends on the underlying cause. Treatment may include:

People with paranoid thoughts may find it hard to trust a doctor or mental health professional and may have difficulty accepting treatment. Developing a positive relationship with a health provider may take time but can be an important step on the road to recovery.

Resources and support

Talking to your doctor is a good place to start if you need help. If you’d like to find out more or talk to someone else, here are some organisations that can help:

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