Addressing Paranoid Thoughts: How To Get Rid of Paranoia In Five Steps

It can be normal to feel scared or have a mild sense of worry sometimes. However, paranoia may be a symptom of a more significant mental health concern. Paranoia is an unfounded distrust or fear of being persecuted or harmed. It may involve fears of being followed, betrayed, or exploited. For many people, these fears feel real and may accompany delusions like believing a stranger in the grocery store poses a threat to you. If you're experiencing paranoia, you're not alone, and there are a few steps you can take to overcome it. Learning how to get rid of paranoia starts with understanding what exactly this condition is and how it can affect your well-being.

What is paranoia?

Paranoia is a common form of thinking that can range from mild suspicion to persecutory delusions. When you are experiencing paranoia, you might feel overly suspicious of others and fear that they are out to get you. Paranoia is often associated with mental disorders like schizophrenia, bipolar disorder, and paranoid personality disorder. However, it can be experienced by people from various backgrounds, including those without a mental health diagnosis. Paranoia can interfere with cognitive functioning, relationships, and work without support, leading to issues with a person’s mental well-being.

If you're experiencing paranoia, you might feel like you’re under a constant threat of something bad happening. For example, you might fear that you're ill with a terminal disease, even without the facts to back it up. When you hold these false beliefs, you might become fearful each time you feel a minor symptom, thinking that it is proof of your fear being true. For many, seeing a therapist can help them process paranoid and suspicious thoughts and the uncomfortable feelings that can accompany them.

Types and severity of paranoia

Paranoia can manifest in different ways based on its cause, how long the paranoid thinking has been happening, and if the individual has sought any form of treatment. 

Mild and short-term paranoia

It’s common to experience mild and short-term paranoia from time to time. It may be caused by factors that are easier to change, such as sleep deprivation, substance use, or chronic stress. For example, if you stayed up late several nights in a row to study for a big exam, you may be more prone to believe a close friend is angry with you when they don’t respond to a few text messages, even though you know they have a busy schedule. Once you address whatever is causing the paranoia, it often resolves within days. 

Severe paranoia and delusional thinking

Severe paranoia and other forms of delusional thinking often cause more intense fears and anxieties. Individuals with severe paranoia may see common situations as real threats, which can cause them to avoid going in public spaces or cut off relationships with loved ones. Extreme paranoia is often caused by mental health conditions or chronic trauma. 

What causes paranoia?

Researchers are still trying to discern the cause of paranoia, but they believe it comes from a combination of different factors that can include:

• genetics
• brain chemistry
• psychological factors like low self-esteem or interpersonal sensitivity
• traumatic life events, such as job loss or the death of a loved one
• environmental factors 
• chronic stress
• substance abuse
• mental health conditions, such as personality or anxiety disorders
• a lack of sleep
• certain drugs

Paranoia and mental health conditions

In many cases, paranoia is a symptom caused by a mental illness. The conditions that most frequently involve paranoia include:

• Paranoid schizophrenia
• Delusional disorder
• Paranoid personality disorder
• Bipolar disorder

Paranoid thinking can be a symptom of other mental illnesses as well, such as postnatal psychosis, post-traumatic stress disorder, or substance-induced psychotic disorder. 

How paranoid thoughts develop

Paranoid thoughts rarely appear out of nowhere. They often develop slowly, shaped by a combination of life experiences, thinking patterns, stress, and biology. 

For many people, paranoid thinking starts after they experience a threat, whether it’s real or perceived. This could include something like a past betrayal, bullying, or other interpersonal trauma. Once someone experiences this kind of threat, their brain becomes overly sensitive to potential future threats. They may repeatedly assign negative meanings to other people’s remarks, even strangers, and assume others’ intentions without knowing why they behave a certain way.

Certain thought patterns can also cultivate paranoia. With confirmation bias, a person only notices evidence that supports their way of thinking. People who catastrophize frequently jump to the worst-case scenario. As someone begins to withdraw and avoid others in order to feel safer, social isolation can further encourage rumination and paranoid thinking.

Five steps to reduce paranoid thinking

People often avoid choosing confrontation for fear that their suspicions may be confirmed. It can be embarrassing to admit you hold certain suspicions or paranoid thoughts. However, avoiding the issue may only cause suspicions to grow, allowing paranoia to overtake your thoughts and actions. Below are a few steps any person experiencing paranoia could take: 

Step 1: Identify triggers and patterns

Paranoid and irrational thoughts usually follow specific situations and emotional states. Identifying triggers is often the first step in reducing these negative thoughts. Start by asking yourself:

• When did these thoughts show up?
• Whom did the thoughts often involve?
• What happened before you started experiencing paranoia?
• What kind of physical and emotional state were you in?

Step 2: Stay grounded in the present moment

Paranoid thinking can pull you into imagined future harm or hidden meanings behind past events. Stay in the present moment by practicing mindfulness in order to keep yourself focused on what is actually happening and reduce feelings of paranoia. You might use grounding techniques such as:

• 5-4-3-2-1
• Mindful eating
• Breathing techniques like box breathing

Step 3: Challenge false beliefs

Once you feel calm enough, you can start to look at paranoid thoughts through a more objective lens. Many of the techniques used in cognitive behavior therapy are designed to address irrational beliefs. For example, reality testing encourages you to look at a thought and determine if there is supporting or contradicting evidence. In a lot of cases, you’ll find no evidence for your false beliefs. Another technique, cognitive restructuring, teaches you to reframe negative things you believe in a more positive light. 

Step 4: Talk openly and build support

Paranoia thrives in isolation. When your thoughts stay private, it’s easier for them to become more convincing. Talking to trusted friends and family can help ground you in reality and reduce paranoia. For example, if you believe a friend is upset with you because they didn’t answer the last few times you called, reach out to them with how you’re feeling: “I am worried you’re mad at me because you haven’t answered my calls. What’s going on?”

It can also help to attend peer support groups, where you can talk openly about your paranoia and find encouragement and solidarity from others going through the same experience. 

Step 5: Know when to seek professional help

When paranoia is caused by mental illness, it can be difficult to address on your own. Left untreated, paranoia can lead to a mental health crisis that may even involve legal authorities. A mental health professional can help you address the cause of your paranoia and learn how to reshape the way you view the world. 

Treatment options for paranoia

Paranoia treatment often includes a combination of psychological therapy and medication. 

Psychological therapy

In talk therapy, patients can learn how to address the false beliefs that are contributing to their paranoid thoughts. Cognitive behavioral therapy (CBT) is the most common treatment approach. In CBT, you often practice reality testing and cognitive restructuring. Creative therapies may be helpful for individuals who don’t feel comfortable expressing their thoughts verbally. 

Medication options

Antipsychotic drugs, mood stabilizers, and selective serotonin reuptake inhibitors may be used to treat mental health conditions that can cause paranoid thinking and other symptoms. Medications should be taken under the supervision of a licensed healthcare provider. 

Supporting someone with paranoia

Supporting someone with paranoia can be challenging, but paranoia doesn’t have to destroy a relationship with someone you love. Paranoid thoughts usually come from a place of fear, so the goal is to help the person feel safe and supported, not judged. 

When someone is having paranoid thoughts, their fears feel very real to them, even if they don’t seem rational to you. If you just ignore or dismiss their paranoia, they may feel misunderstood or attacked. It can help to say things like, “I can see this situation is really worrying you.” This kind of validation acknowledges their thoughts without supporting the thoughts themselves. 

Although it may be tempting, it probably won’t help to try to prove the person wrong. Instead, talk openly about the facts surrounding their thoughts. You can ask questions to learn why they feel the way they do and encourage reality testing on their own. If the person seems open to getting help, you may gently encourage them to visit peer support groups or see a mental health care professional. If their paranoia is negatively impacting your life, you may benefit from speaking with a therapist as well. 

Getting support through BetterHelp

If you're experiencing paranoia and want to learn to cope with this mental health condition, you may benefit fromthe professional help a therapist can offer. As leaving home may increase feelings of paranoia, many clients appreciate the benefits and convenience of online therapy options. 

Consider cognitive-behavioral therapy (CBT) for treating paranoia

Research shows that internet-based therapy effectively treats paranoia and similar mental health concerns. In a double-blind study published by the NIHR Journals Library, research pointed to cognitive-behavioral therapy (CBT) as a successful way of treating paranoia and psychosis. The report discusses online tools for administering CBT, which can lead more people experiencing symptoms to seek care. CBT works by giving clients the tools to manage their paranoid symptoms and reframe unhelpful thoughts. According to the study, online therapy provides flexibility in treating mental health conditions that can cause paranoia, narrowing the psychological treatment gap.

Try online therapy for your paranoid thoughts

Internet-based psychological therapy can be a flexible, practical choice for managing paranoia symptoms. If you are having trouble coping with paranoid thoughts, the stigma associated with therapy may prevent you from seeking help. Online therapy through a platform like BetterHelp can allow you to reach out to your therapist outside of scheduled sessions. If you are experiencing unwanted thoughts, message your therapist anytime using the asynchronous unlimited message feature. You can also choose between live video, phone, or chat sessions each week.