Exploring Possible Treatments For Paranoia: A guide

While treatments might exist for people experiencing paranoia, paranoia symptoms can be complicated to address. For most people, milieu therapy or other types of supportive strategies can help to relieve symptoms in some. However, some people may find that they are most successful in managing symptomatic experiences when multiple strategies are used. 

Below, we’ve compiled a list of possibly helpful treatment options for paranoia, empowering those who live with the condition to learn more about available options and reach a higher quality of life.

The medically reviewed Encyclopedia of Mental Health suggests that paranoid personality disorder (PPD) can be among the most challenging mental health conditions to understand and treat. Understanding the differences between paranoid personality disorder and paranoia which may be present among schizophrenia patients or other populations can be a strong place to start in validating the experiences of those who live with the condition. 

What is paranoia and how can it be treated?

Paranoia can be defined as the feeling of somebody or something that is pursuing you to cause you harm. It does not have to have a basis in reality and may not for some. While many people associate paranoia with schizophrenia, it is not limited to paranoid schizophrenia patients. For example, anxiety disorders, eating disorders, OCD, bipolar disorder, paranoid personality disorder, and dementia sometimes experience paranoia. Paranoid personality disorder is a bit more nuanced for many, possibly resulting in other symptoms such as: 

• Hypersensitivity 
• Possibly irrational suspicions, such as those that can occur with no underlying cause 
• Feelings of prolonged anger that can result in emotional or relational stability 
• Inability to relax

While people who live with PPD can experience other symptoms, the ones listed above are generally considered common for most. Searching for supportive strategies to treat the symptoms and experiences of those living with the disorder can result in a higher overall quality of life for many. 

Below, we’ve listed a range of supportive strategies that can support those currently living with paranoia or with PPD. 

Cognitive-based therapy

Cognitive therapy is considered by most to be a specific form of psychotherapy in which negative thoughts about oneself and the world might be challenged and reshaped, possibly empowering the patient to develop a more positive outlook. 

The theory behind this form of therapy is that with a conscious effort to change negative thoughts to positive ones, behavior patterns can be modified—and any residual mental health issues (such as stress) can be addressed. 

Cognitive therapy generally requires a strong foundation of trust between the therapist and the patient to be as effective as it can be, as the therapist may be required to challenge the patient’s paranoid thoughts over the course of treatment. If the patient does not completely trust the therapist, the patient could believe that the therapist is against them, possibly “siding” with the issues they're paranoid about. This could compromise the efficacy of the treatment. 

Group therapy

Many people attend group therapy, which can be defined as a psychotherapy method in which people with the same or similar symptoms of paranoia or related mental health conditions can meet in a group session. Group therapy can also be useful for learning coping skills that have helped others in the same situation create positive change.

A possible consideration to be aware of with group therapy for those living with paranoia or PPD is that group participants might be suspicious of one another and the leading therapist. While building trust with a therapist can happen over time, building trust with a group of other individuals experiencing symptoms of paranoia can be a bit more nuanced. Patience, empathy, and understanding are generally regarded as the top three key facets of a successful group therapy program, specifically for those who live with paranoia or related conditions. 

Milieu therapy

Milieu therapy is generally defined as a type of psychotherapy in which the patient's environment might be controlled to prevent self-destructive behavior. This can be used on an in-patient basis, but contemporary milieu therapy can also be applied in outpatient treatment environment with some in-home visits or scheduled therapy sessions. Though there is some controversy about milieu works as a therapy because of its clinical ambiguity, a 2016 cross-site ethnographic study interviewed therapists involved in milieu therapy, finding that the practice appears to be both common and unified in its implementation.

Generally, therapeutic milieu techniques might be aimed at making sure that the patient does not become self-destructive or elicit violent behavior when they're trying to function in their day-to-day life. These techniques can help the patient to practice positive change and learn new coping skills—possibly showing them that they do not need to be in the right environment (such as in the milieu therapist’s office) to take control of this behavioral condition. 

Self-esteem support

Supportive psychotherapy

It can be beneficial for patients to undergo simple, supportive psychotherapy. In this type of therapy, counselors can offer support to the patient— helping them work through their symptoms or problems. 

Instead of challenging paranoid delusions, the sessions can instead be focused on strategies to cope with situations that arise. This could be a good way to start receiving therapy if you’re actively experiencing paranoia symptoms, as it can allow the therapist to build a rapport with the patient. Once trust is established, it may be easier for the therapist to try other methods of support through proven psychotherapeutic techniques.

Coping skill support

For over a century, therapy (including Milieu therapy), has been generally thought to have helped people living with paranoia. This effect can be gained from the range of coping skills that those living with paranoia or PPD may gain from sessions or intervention. These skills might include relaxation routines, such as meditation or visualization, or ways to reduce stress or nervousness when paranoid thoughts arise.

The goal of learning coping and social skills for many is to function in society despite the difficulties presented by the illness. Generally, it might be a good idea for a therapist to teach coping skills in addition to any other treatments that are used. 

Medications

When it comes to treatment, medications have not been proven to successfully treat PPD. Unfortunately, there's little research on this topic, reportedly because many patients are convinced that the drugs will harm them. However, some medications have shown the ability to treat multiple symptoms, while others may simply help patients cope with their symptoms by reducing conflicts, anxiety and certain behaviors. However, medications are not an appropriate course of treatment for children, which is important to note if a younger person you know is struggling. Please consult with your doctor or primary care physician about your diagnosis before considering any medication management options.

The potential of hospital admission

In many cases, outpatient clinics are sufficient for treatment. However, in more severe cases of PPD, the patient may benefit from the support that can come from hospitalization. This can be indicated when other treatments, like milieu therapy, may be deemed as ineffective or if the patient doesn’t wish to cooperate with needed treatments developed by their doctors. 

Generally, hospitalization may be used as a last resort for many. Unlike in times past, hospital admissions today might be temporary and generally only last as long as the worst of the symptoms do. 

Once the disorder stabilizes to a non-harmful point, the nurses might choose to release the client. However, there are some acute cases in which symptoms of paranoia may not subside. In these cases, people might benefit from admission into long-term care facilities with mental health nursing units.

Moving forward: Living well with paranoia or PPD 

If you're living with paranoia symptoms or if you know someone who is, it can be helpful to seek psychiatric treatment right away. Licensed mental health professionals can help diagnose paranoia (which may lead to a dual diagnosis), possibly determining the best course of treatment for your specific health needs. Additionally, some people with paranoia may benefit from employment programs and occupational training, which can promote recovery and boost self-esteem.

How can online therapy support those living with paranoia? 

If you need help with psychosis or mental health issues such as stress, PPD, anxiety disorders or paranoia, you may consider engaging in online therapy. This form of therapy can support you in reaching a higher quality of life. 

Is online therapy effective? 

As with any mental health disorder, seeking help can be a helpful first step toward improving your mental health and your quality of life. Many who struggle with paranoia may benefit from treatment in the form of online therapy.  However, stigma can make people with paranoia less likely to ask for help, according to a quantitative and qualitative study review. As a result, online therapy may be a more appealing option.

Studies currently suggest that online counseling can improve your mental health, offering comparable results to traditional face-to-face therapy. One such study from Palo Alto University suggested that video-based cognitive behavior therapy can effectively treat depression and anxiety disorders, which are two comorbid disorders that may be associated with PPD or paranoia. According to the findings, approximately 73% of study participants self-reported that they saw an improvement in symptoms after six weeks, and the information concluded that there would be an expected “decelerated decrease in symptoms over time”.