11 Most Common Paranoia Treatment
Updated December 14, 2018
Reviewer Laura Angers
While treatments do exist for paranoia, it is very difficult to treat, and the prognosis is not a good one. For most people with paranoia, symptoms may come and go with quality treatment, but will likely return again and again.
The Encyclopedia of Mental Health relates paranoia disorder as the most difficult mental health condition to understand and treat. The biggest reason that it is so difficult to treat is that the paranoia symptoms themselves block treatment. The patient tends to mistrust the therapies and medications and therefore will refuse to cooperate and remain compliant.
However, there are some treatments of paranoia that have shown promise. If trust can be built between the professionals and the patient, it becomes possible for treatments to have some lasting effect. However, these treatments are mostly able to allow the patient to cope with symptoms, rather than to eliminate the symptoms.
Different forms of psychotherapy are the most effective treatment for paranoia. The key to making therapies work for the patient to treat paranoia symptoms is to build trust with the therapist and those involved in the therapy. Building and keeping the trust of paranoia patients while still being able to offer constructive advice can be a fine line to walk for the therapist.
Because of the nature of the symptoms of paranoia, therapy as a paranoia treatment relies heavily on the patient and is typically not a long-lived treatment. The therapist must build trust and keep it. As soon as the patient feels that they cannot trust the therapist, they will stop going to therapy and treatment will end. For this reason, many people with paranoia go in and out of therapy over the course of many years.
Cognitive therapy is a specific form of psychotherapy in which negative thoughts of self and the world are challenged and hopefully altered to a more positive outlook. The idea is that with conscious effort to change negative thoughts to positive ones, behavior can be modified.
Cognitive therapy requires a very trustworthy relationship between the therapist and the patient. The therapist must challenge the paranoid thoughts of the patient. If the patient does not completely trust the therapist, the patient could gain the delusion that the therapist is against them and siding with the forces that they are paranoid about.
Group therapy is psychotherapy where some people with the same psychosis are placed in a group session. Each member of the group shares with others. This is designed to give some support to each other in the form of knowing that they are not alone. Also, it can be helpful for learning coping skills that others in the same situation have found helpful.
The biggest problem with group therapy for paranoia treatment is that the members of the group are all suspicious of one another and the leading therapist. While trust can be built over time with a therapist, building trust with a group of other paranoid patients can prove difficult. This is especially true because many patients do not stick to therapy, so the group dynamic is constantly changing.
Milieu therapy is psychotherapy in which the patient's environment is controlled to prevent the self-destructive behavior. This is often used on an in-patient basis, but it can also be applied to out-patient with some in-home visits.
The patient's environment at home, work, and during certain activities is controlled or manipulated to help suppress or cope with symptoms of the paranoia. This could take many forms but is aimed toward making sure that the patient does not become self-destructive or violent in trying to function in normal day to day life.
One study done in 2011 researched the effects of negative beliefs about the self about paranoia symptoms. They found that subjects who had negative beliefs about themselves had more negative symptoms. When beliefs were turned around to be positive, symptoms decreased.
Because of this research, it is suggested that in the first six weeks of psychiatric treatment for paranoia patients are focused on self-esteem boosting exercises and therapy. Boosting self-esteem can reduce symptoms and help make other therapies more effective. It also helps build trust between the therapist and the patient.
It can be very helpful for patients to have simple supportive psychotherapy. In this type of therapy, the therapist is simply supportive of the patient and helps them work through their paranoia. Instead of challenging the delusions, they instead focus on ways to cope with the situations that arise from them.
This is a good way to start therapy sessions for paranoia treatment. It allows the therapist to build a rapport with the patient and builds on trust. Once trust is established, and the patient sees the therapist as a means of support, other therapies can be attempted.
Another way that therapy can help in paranoia treatment is by teaching coping skills. These might include relaxation therapies such as meditation or visualization. It may also include ways to reduce stress and anxiety and ground oneself when paranoid thoughts abound.
The goal of coping skills is to be able to function in society in spite of the difficulties presented by the illness. It is a good idea for a therapist to teach coping skills in addition to any other treatments that are used. Because there is no cure or effective long-term treatments for paranoia, coping skills can help people in this position to function as normally as possible.
Medications have not been proven to be successful in treating paranoia in and of itself. Part of the reason that no good research exists about the effects of medication as a paranoia treatment is that many patients are convinced that the medications will cause them harm and refuse to be compliant.
However, some medications have shown promise. Some of these medications show improvement in multiple symptoms, while others are used to simply help patients cope with their paranoia by reducing anxiety and certain behaviors.
Phenothiazines are a certain type of anti-psychotic that is typically used when other antipsychotics are ineffective. The exact mechanism of how these medications work is not well understood by the scientific community, but it is assumed that they block dopamine in the brain.
There are many different phenothiazines available on the market in the US. These include prochlorperazine, chlorpromazine, fluphenazine, perphenazine, trifluoperazine, and thioridazine. The brand names of some of these medications include Compazine, Compro, Procomp, Promapar, Thorazine, Permitil, Prolixin, Stelazine, and Mellaril.
One study done in 1981 showed some promising effects of phenothiazines in paranoia treatment. The effects were found to be most effective in good premorbid paranoid schizophrenics. However, the effects of the medications were found to be less effective with nonparanoid schizophrenics. This leads psychiatrists to attempt use of these medications in cases of extreme paranoia.
Pimozide is an antipsychotic medication that is frequently used to treat Turrets syndrome. Some research done in 1993 suggests that this medication could be used to treat paranoia. In the study, a patient was essentially cured of paranoia symptoms using low dose pimozide. However, this paranoia treatment is not common and has been disputed. It may be an option when other treatments fail.
Anti-anxiety medications will not treat paranoia directly. However, they are often prescribed to paranoia patients to help control the symptoms of extreme anxiety that occur as a result of the paranoia. Paranoid delusions often cause symptoms of extreme anxiety that can make it very difficult for the patient to function in or out of society.
Anti-anxiety medications in high enough doses can help control the side effects of the paranoia so that patients can function more fully in society. It may allow them to be able to hold a job, travel around the city, or be able to have functioning relationships or attend social settings.
A wide range of antipsychotic medications are often used as a paranoia treatment. These medications also do not treat the paranoia itself, but rather symptoms that come along with the paranoid delusions. Antipsychotics can often help relieve some of the more severe symptoms that keep a patient from being able to function.
Antipsychotic medications are most frequently given to patients when their symptoms could cause harm to themselves or others. These medications are largely sedative in nature, which helps calm what could otherwise be harmful impulsive behaviors. They are most frequently used as a form of behavior modification. However, many patients become convinced that the medication is harming them in some way and will refuse to take it.
In severe cases of paranoia, the patient may need to be hospitalized. This becomes required when other treatments are failing, or when the patient is refusing to cooperate with treatments. Hospitalization is usually used as a last resort. Unlike in times past, more recently hospitalizations are temporary and only last as long as the worst of the symptoms. Once the disorder stabilizes to a non-harmful point, the hospitalization ends.
However, there are some severe cases where the paranoia never subsides. In these cases, people may find themselves in long-term care facilities. This is very rare, however. Most paranoia patients will find themselves in and out of hospitals throughout their lives.
Where To Get Help
If you or a loved one are suffering from paranoia symptoms, it is important to seek psychiatric treatment right away. A licensed psychologist can help diagnose paranoia and determine if it is a stand-alone disorder or a symptom of a more serious mental health condition.
As with any mental health disorder, seeking help is the first step toward getting better. If you or a loved one are having trouble coping in society because of paranoia, you could greatly benefit from treatment in the form of therapy or medications. Contact a therapist today to get started on the path to better health.