11 Most Common Paranoia Treatment

By: Michael Puskar

Updated June 01, 2020

Medically Reviewed By: Laura Angers

While treatments exist for paranoia, it can be complicated to address. For most people, quality treatment can relieve symptoms, but they're likely to return at some point, so it's essential to learn how to manage them.

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The Encyclopedia of Mental Health suggests that paranoia disorder is the most difficult mental health condition to understand and treat. It's difficult to address specifically because the paranoia symptoms themselves block treatment. If the patient can't trust the therapies and medications required, he or she will refuse to cooperate and remain compliant. However, there are some treatments for paranoia that have shown promise. If a mental health professional can build trust with the patient, it becomes possible for treatments to have a lasting effect. Although these treatments usually allow the patient to cope with symptoms, it's important to know that it's rarely possible to eliminate them completely.

Nonetheless, many people have successfully treated paranoia with the help of a therapist and medication, so you can, too. If you're affected by paranoia, know that seeking help is the first and most essential step to getting better and improving your mental health.

Therapies to Treat Paranoia

Psychotherapy is the most effective treatment for paranoia, and there are many types of psychotherapy that a patient might try. The key, however, is to build trust with the therapist and others involved in the treatment process. That said, building and keeping the trust of a paranoia patient while still offering constructive advice can be a fine line for a therapist to walk.

Because of the nature of paranoia symptoms, therapy as a paranoia treatment relies heavily on the patient and typically does not last long. 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 treatment over the course of many years.

Cognitive Therapy

Cognitive therapy is a specific form of psychotherapy in which negative thoughts about the self and the world are challenged and reshaped, so the patient develops 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 strong foundation of trust between the therapist and the patient because the therapist must challenge the paranoid thoughts of the patient. If the patient does not completely trust the therapist, the patient could believe that the therapist is against them, siding with the forces they're paranoid about.

Group Therapy

Group therapy is a psychotherapy method where people with the same psychosis meet in a group session. Each member of the group shares their feelings and experiences with others, so these individuals know they're not alone. Also, it can be useful for learning coping skills that have helped others in the same situation.

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When it comes to paranoia treatment, the biggest problem with group therapy is that the members of the group are often 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 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

Milieu therapy is a type of psychotherapy in which the patient's environment is controlled to prevent self-destructive behavior. This is often used on an in-patient basis, but it can also be applied to out-patient treatment with some in-home visits. To help suppress or cope with symptoms of paranoia, the patient's environment at home, work, and during certain activities is controlled or manipulated. This could take many forms, but it's usually aimed toward making sure that the patient does not become self-destructive or violent when they're trying to function in their normal day-to-day life.

Self-Esteem Boosting

In 2011, one study researched the effects of negative beliefs about the self on paranoia symptoms. It found that subjects who had negative feelings about themselves had more negative symptoms. When these views became more positive, their symptoms decreased. Because of this research, many therapists focus on self-esteem boosting exercises during the first six weeks of psychiatric treatment for paranoia patients. Boosting self-esteem can reduce symptoms and help make other therapies more effective. It also helps to build trust between the therapist and the patient.

Supportive Psychotherapy

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 paranoid delusions, they instead focus on ways to cope with the situations that arise. This is a good way to start therapy sessions for paranoia treatment. It allows the therapist to build a rapport with the patient and also builds on trust. Once trust is established, it's easier for the therapist to try other methods.

Coping Skills

Therapy can also help people suffering from paranoia by teaching coping skills. These might include relaxation therapies, such as meditation or visualization, or ways to reduce stress and anxiety and ground oneself when paranoid thoughts arise.

The goal of learning coping skills is to be able to function in society despite the difficulties presented by the illness. In general, it's a good idea for a therapist to teach coping skills in addition to any other treatments that are used. Because there's no cure or effective long-term treatments for paranoia, coping skills can help people in this position to function as normally as possible.

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When it comes to paranoia treatment, medications have not been proven to be successful. Unfortunately, there's little research on this topic because many patients are convinced that the drugs will harm them, so they refuse to be compliant. However, there are medications that have shown promise. Some of these show improvement in multiple symptoms, while others simply help patients cope with their paranoia by reducing anxiety and certain behaviors.


Phenothiazines are a type of antipsychotic that's 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's assumed that they block dopamine in the brain. There are many different phenothiazines available on the U.S. market. These include prochlorperazine, chlorpromazine, fluphenazine, perphenazine, trifluoperazine, and thioridazine. Compazine, Compro, Procomp, Promapar, Thorazine, Permitil, Prolixin, Stelazine, and Mellaril are some of the brand names you might hear.

One study from 1981 showed some promising effects of phenothiazines in paranoia treatment. The results were found to be most effective in good premorbid paranoid schizophrenics, but the effects of the medications were found to be less effective with nonparanoid schizophrenics. Therefore, psychiatrists sometimes attempt to use these medications in cases of extreme paranoia.


Pimozide is an antipsychotic medication that's frequently used to treat Turrets syndrome. Research from 1993 suggests that this medication could also be used to treat paranoia. In the study, a patient was essentially cured of paranoia symptoms using low dose pimozide. This paranoia treatment may be an option when other treatments fail, but it's not common and has been disputed.

Anti-Anxiety Medications

Anti-anxiety medications will not treat paranoia directly, but they are often prescribed to paranoia patients to help control symptoms of extreme anxiety that occur as a result of the paranoia. These symptoms 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 these symptoms, so patients can find ways to function. They may allow them to hold a job, travel around the city, attend social events, or have functioning relationships.

Antipsychotic Medications

A wide range of antipsychotic medications are often used to treat paranoia. These medications do not treat the paranoia itself, but instead, they treat the 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. These medications are most frequently given to patients when their symptoms could cause harm to themselves or others. They're largely sedative in nature, which helps calm what could otherwise be harmful impulsive behaviors, and they're most frequently used as a form of behavior modification. However, many patients become convinced that the medication is harming them in some way and refuse to take it.

Hospital Admission

In severe cases of paranoia, the patient may need to be hospitalized. This becomes required when other treatments fail or when the patient refuses to cooperate with treatments. Hospitalization is usually used as a last resort. Unlike in times past, admissions today are usually 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. Luckily, this is very rare, but most paranoia patients will find themselves in and out of hospitals throughout their lives.

Moving Forward

If you're suffering from paranoia symptoms or if you know someone who is, it's important to seek psychiatric treatment right away. A licensed psychologist can help diagnose paranoia and determine if it's a stand-alone disorder or the sign of a more serious mental health condition.

As with any mental health disorder, seeking help is the first step toward getting better. Anyone who struggles with paranoia will greatly benefit from treatment in the form of therapy or medications. If you need help, contact a therapist at BetterHelp to get started on the path to better health today. In the next section, you can read some reviews to see how others have greatly benefited from using BetterHelp's services.

Counselor Reviews

"Loretta has undoubtedly changed my life. In my late attempt to deal with trauma she has shown me the light at the end of the tunnel. Through various strategies and methods she has provided me, I have become less paranoid, guilt-ridden, and anxious. I am so glad I decided to start using BetterHelp and was paired with Loretta."

"I've barely started my counseling through this website. Even though it has been 3 weeks, it has helped out. I'm able to tell her things that my paranoid delusions aren't able to use against me. I guess it is because she is at a distance. Either which way, her tools of coping are massive and highly appreciated. Adding more tools to the chest."


Paranoia is often a challenging disorder to treat, but it's possible to get help. If you're struggling with paranoia, things will get better when you start working with a qualified mental health professional. Take the first step today.

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