Table of ContentsView AllTable of ContentsWhat Is Paranoia?SymptomsTypesCausesDiagnosisTreatment
Table of ContentsView All
View All
Table of Contents
What Is Paranoia?
Symptoms
Types
Causes
Diagnosis
Treatment
Paranoia is the feeling of being threatened or persecuted in the absence of proof showing that’s the case. It is not a standalone diagnosis, but a symptom that warrants evaluation.
People who experience paranoia believe they are being lied to, stolen from, or cheated on without evidence. In extreme cases, they may think they are being poisoned or had a tracking device implanted.
Paranoia can be part of a psychiatric condition, such as paranoid personality disorder, persecutory delusional disorder, orschizophrenia. It can also be related to dementia, socioeconomic factors, physical factors, drug use, and cultural beliefs.
This article discusses paranoia. It explains the different types of paranoia, common symptoms, and how paranoia is diagnosed and treated.
Joerg Steffens / Getty Images
The term “paranoia” is often associated with being dramatic, but there are actually two essential elements that define paranoia: a belief that harm will occur paired with the attribution bias that others intend to do harm.
Paranoia vs. Phobia
Types of Paranoid Disorders
Paranoia is not a stand-alone psychiatric condition, but rather a feature of other mental disorders. The following conditions have paranoia as a central aspect of their presentation.
Paranoid Personality Disorder
Onset is linked to biological, genetic, and environmental factors, including physical and emotional trauma.
Delusional Disorder, Persecutory Type
People may experience relatedhallucinationsand even go as far as calling the police for help. Along with biological and genetic factors, stress can be a trigger.
According to the diagnostic criteria, persecutory delusions must be non-bizarre (could take place in reality), not have the characteristic symptoms ofother psychotic disorders, such as schizophrenia, and must be present for a month or longer.
Schizophrenia
Paranoia is sometimes a component of schizophrenia, a condition that makes it difficult to tell the difference between what is real and not real. Hallucinations, delusions, irritability, and trouble concentrating or sleeping are key features of the mental illness.
In earlier versions of the DSM, schizophrenia was divided into subtypes, including paranoid schizophrenia. The DSM-5 rolled these all under the main diagnosis of schizophrenia.
According to the diagnostic criteria, schizophrenia involves delusions, hallucinations, disorganized speech, and grossly disorganized or catatonic behavior that interferes with a person’s ability to work, have relationships, and take care of themself.
Other Types of Paranoia
Specific paranoia symptoms can vary based on underlying beliefs. Scientists have grouped these beliefs into common subtypes or themes. Common paranoia subtypes include the following:
Types of Delusions
While the exact causes of paranoia are unknown, environmental triggers can include exposure to trauma, insomnia, social isolation, and medication changes. It is often associated with the effects of substance use and mental disorders. There can be genetic contributions, particularly when it occurs as part of a mental disorder.
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Mental Health Conditions
In addition to personality disorders, delusional disorders, and schizophrenia, other psychiatric diagnoses can increase the risk of paranoia. These include:
Social and Environmental Factors
Being of a lower socioeconomic class is a known contributing factor to cultural paranoia.These beliefs are not self-directed but a product of growing up in a society where socioeconomic status directly influences the number of daily struggles and feelings of security.
The psychology of surveillance is another risk factor of cultural paranoia. It refers to the common belief that people’s personal information is being used for malevolent purposes.
Dementia
Paranoia is a common feature of dementia and other conditions that affect one’s cognitive abilities or result in cognitive decline:
Montreal Cognitive Assessment (MoCA) Test for Dementia
Medications and Drugs
Drug-induced paranoia can occur from prescription medication as well as street drugs and may be a sign of drug toxicity, overdose, or withdrawal.
Drugs associated with substance-induced paranoia include:
Paranoia is a symptom and not a stand-alone diagnosis. Healthcare providers will assess paranoia to find the underlying cause. This will typically include:
Your healthcare provider may also order tests to rule out other causes of paranoia. Blood and urine tests will check for an infection or other underlying illness along with a drug screening. Brain scans, such as CT or MRI, are also sometimes used.
If a mental disorder is the suspected cause of paranoia, you will likely be referred for a psychiatric evaluation. This involves an interview where the psychiatrist will ask about the following:
If you or a loved one is struggling with paranoia or substance abuse, contact theSubstance Abuse and Mental Health Services Administration (SAMHSA) National Helplineat1-800-662-4357for information on support and treatment facilities in your area.
Treatment for paranoia will depend on the underlying cause. When due to a psychiatric condition, paranoia is usually treated with a combination of medication and cognitive behavioral therapy.
Building a trusting relationship with your therapist is an important element of treatment. This goal is to reduce the impact of irrational, fearful thoughts and improve social skills.
The treatment process can be difficult at first and people with paranoia often experience irritability, are emotionally guarded, and can display hostility. Progress can be slow, but recovery is possible.
Summary
Paranoia is an irrational suspicion or mistrust of others that causes severe anxiety but is not rooted in reality. It is not a stand-alone diagnosis but a symptom of paranoid personality disorder, persecutory delusional disorder, schizophrenia, and other psychiatric conditions.
People who experience paranoia have intense and persistent feelings of fear, anger, and unfounded betrayal. Signs of paranoia include argumentativeness, defensiveness, hypervigilance, and preoccupation with the belief that people are out to get you.
12 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Raihani NJ, Bell V.An evolutionary perspective on paranoia.Nat Hum Behav. 2019;3(2):114-121. doi:10.1038/s41562-018-0495-0.xMental Health America.Paranoia and delusional disorders.American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders.5th ed. Washington, DC; 2013.U.S. National Library of Medicine: MedlinePlus.Paranoid personality disorder.U.S. National Library of Medicine: MedlinePlus.Schizophrenia.Substance Abuse and Mental Health Services Administration.Table 3.22, DSM-IV to DSM-5 schizophrenia comparison. In:Impact of the DSM-IV to DSM-5 changes on the National Survey on Drug Use and Health[Internet]. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2016.Kendler KS.The clinical features of paranoia in the 20th century and their representation in diagnostic criteria from DSM-III through DSM-5.Schizophrenia Bulletin. 2017;43(2):332-343. doi:10.1093/schbul/sbw161Anderson F, Freeman D.Socioeconomic status and paranoia: the role of life hassles, self-mastery, and striving to avoid inferiority.J Nerv Ment Dis. 2013;201(8):698-702. doi:10.1097/NMD.0b013e31829c5047The British Psychological Society.Are we all paranoid?National Institute on Aging.Alzheimer’s and hallucinations, delusions, and paranoia.Alzheimer’s Association.Vascular dementia.Fiorentini A, Cantù F, Crisanti C, Cereda G, Oldani L, Brambilla P.Substance-induced psychoses: an updated literature review.Front Psychiatry. 2021;12:694863. doi:10.3389/fpsyt.2021.694863
12 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Raihani NJ, Bell V.An evolutionary perspective on paranoia.Nat Hum Behav. 2019;3(2):114-121. doi:10.1038/s41562-018-0495-0.xMental Health America.Paranoia and delusional disorders.American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders.5th ed. Washington, DC; 2013.U.S. National Library of Medicine: MedlinePlus.Paranoid personality disorder.U.S. National Library of Medicine: MedlinePlus.Schizophrenia.Substance Abuse and Mental Health Services Administration.Table 3.22, DSM-IV to DSM-5 schizophrenia comparison. In:Impact of the DSM-IV to DSM-5 changes on the National Survey on Drug Use and Health[Internet]. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2016.Kendler KS.The clinical features of paranoia in the 20th century and their representation in diagnostic criteria from DSM-III through DSM-5.Schizophrenia Bulletin. 2017;43(2):332-343. doi:10.1093/schbul/sbw161Anderson F, Freeman D.Socioeconomic status and paranoia: the role of life hassles, self-mastery, and striving to avoid inferiority.J Nerv Ment Dis. 2013;201(8):698-702. doi:10.1097/NMD.0b013e31829c5047The British Psychological Society.Are we all paranoid?National Institute on Aging.Alzheimer’s and hallucinations, delusions, and paranoia.Alzheimer’s Association.Vascular dementia.Fiorentini A, Cantù F, Crisanti C, Cereda G, Oldani L, Brambilla P.Substance-induced psychoses: an updated literature review.Front Psychiatry. 2021;12:694863. doi:10.3389/fpsyt.2021.694863
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Raihani NJ, Bell V.An evolutionary perspective on paranoia.Nat Hum Behav. 2019;3(2):114-121. doi:10.1038/s41562-018-0495-0.xMental Health America.Paranoia and delusional disorders.American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders.5th ed. Washington, DC; 2013.U.S. National Library of Medicine: MedlinePlus.Paranoid personality disorder.U.S. National Library of Medicine: MedlinePlus.Schizophrenia.Substance Abuse and Mental Health Services Administration.Table 3.22, DSM-IV to DSM-5 schizophrenia comparison. In:Impact of the DSM-IV to DSM-5 changes on the National Survey on Drug Use and Health[Internet]. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2016.Kendler KS.The clinical features of paranoia in the 20th century and their representation in diagnostic criteria from DSM-III through DSM-5.Schizophrenia Bulletin. 2017;43(2):332-343. doi:10.1093/schbul/sbw161Anderson F, Freeman D.Socioeconomic status and paranoia: the role of life hassles, self-mastery, and striving to avoid inferiority.J Nerv Ment Dis. 2013;201(8):698-702. doi:10.1097/NMD.0b013e31829c5047The British Psychological Society.Are we all paranoid?National Institute on Aging.Alzheimer’s and hallucinations, delusions, and paranoia.Alzheimer’s Association.Vascular dementia.Fiorentini A, Cantù F, Crisanti C, Cereda G, Oldani L, Brambilla P.Substance-induced psychoses: an updated literature review.Front Psychiatry. 2021;12:694863. doi:10.3389/fpsyt.2021.694863
Raihani NJ, Bell V.An evolutionary perspective on paranoia.Nat Hum Behav. 2019;3(2):114-121. doi:10.1038/s41562-018-0495-0.x
Mental Health America.Paranoia and delusional disorders.
American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders.5th ed. Washington, DC; 2013.
U.S. National Library of Medicine: MedlinePlus.Paranoid personality disorder.
U.S. National Library of Medicine: MedlinePlus.Schizophrenia.
Substance Abuse and Mental Health Services Administration.Table 3.22, DSM-IV to DSM-5 schizophrenia comparison. In:Impact of the DSM-IV to DSM-5 changes on the National Survey on Drug Use and Health[Internet]. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2016.
Kendler KS.The clinical features of paranoia in the 20th century and their representation in diagnostic criteria from DSM-III through DSM-5.Schizophrenia Bulletin. 2017;43(2):332-343. doi:10.1093/schbul/sbw161
Anderson F, Freeman D.Socioeconomic status and paranoia: the role of life hassles, self-mastery, and striving to avoid inferiority.J Nerv Ment Dis. 2013;201(8):698-702. doi:10.1097/NMD.0b013e31829c5047
The British Psychological Society.Are we all paranoid?
National Institute on Aging.Alzheimer’s and hallucinations, delusions, and paranoia.
Alzheimer’s Association.Vascular dementia.
Fiorentini A, Cantù F, Crisanti C, Cereda G, Oldani L, Brambilla P.Substance-induced psychoses: an updated literature review.Front Psychiatry. 2021;12:694863. doi:10.3389/fpsyt.2021.694863
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