How To Overcome Persecutory Delusions

Medically reviewed by Laura Angers Maddox, NCC, LPC
Updated May 14, 2024by BetterHelp Editorial Team
Please be advised, the below article might mention trauma-related topics that include suicide, substance use, or abuse which could be triggering to the reader.
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A delusion of persecution can be defined by many as a false belief that others might be threatening or conspiring against one.

This delusion can manifest itself when someone thinks misfortune is either happening or going to happen. Those living with this delusion might believe a "persecutor" is out to get them. 

As the name implies, this state of mind often starkly contrasts with reality and might breed undesirable consequences. In many cases, before persecutory delusions can be conquered, they must first be understood. In this article, we explore possible causes and treatments of this mental health condition, with the hope that it can empower those who are experiencing them (or who are living with someone who may be experiencing them) to seek support for a higher quality of life.

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Learn about persecutory delusions

An analysis of persecutory delusions

Previously referred to as paranoid disorders, persecutory delusions are considered by many to be one of the most common types of delusions. Ultimately, the afflicted individual might believe that everyone else is out to harm them in one form or another—regardless if this is true. 

This form of delusion can be encountered on a standalone basis, or it can be found in those who live with schizophrenia, obsessive-compulsive disorder (OCD) or related mental health conditions. It can also be common among those who use medications. 

Persecutory delusions may foster anger, frustration, resentment and even physical violence. Understanding what they are and what a chronic condition like this can entail can result in a more empathetic experience for those who are living with the condition, possibly elevating their quality of life. 

If you or a loved one is experiencing abuse, contact the Domestic Violence Hotline at 1-800-799-SAFE (7233). Support is available 24/7.

Approximately 10-15% experience persecutory delusions. Both men and women can be susceptible to this condition, and it can occur in both earlier and in later years of age. 

Individuals who have persecutory delusions may struggle to break free from them into reality—even when other people are able to support them in the moment. 

If you're experiencing similar symptoms, we want to let you know that you're not alone. It can be possible to get help for persecutory delusions. Many might start by finding support from a licensed therapist.

What causes persecutory delusions?

Due to the rarity of this disorder, investigating persecutory delusions can be somewhat challenging. A single concrete cause behind persecutory delusions has not been discovered yet at the time of this publication. However, it is believed by many to be a coping method that can develop over time as a result of high stress levels. 

An individual's genetics can also impact susceptibility to persecutory delusions. For instance: Someone who has relatives who have schizotypal personality disorder or schizophrenia may be more likely to experience persecutory delusions.

Are persecutory delusions an extension of paranoia?

Paranoia is considered by many to be the root of persecutory delusions in most cases, along with many other mental health and emotional disorders. Many individuals with paranoia have reported experiences of feeling nervous, depressed, frightened or suicidal.* However—this may not be the cause for every single person who lives with the disorder. Remaining open and ready to listen to the stories of people who live with the condition can empower many to take the steps needed to have a higher quality of life. 

Possible treatments for persecutory delusions 

There are many treatments for persecutory delusions and paranoia that can empower people who live with these challenges to live a healthy, fulfilling life. 

Possible options can take on many different forms and may include antipsychotic medication, antidepressants, or talk therapy. 

Please be advised that the information found in the article is not a substitute for professional medical advice. Always seek the advice of your physician or other qualified health providers with any questions you may have.

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Psychotherapy and psychopharmacology can be used to address various forms of delusion. These forms of treatment can help many to regain healthy social skills and improve their lifestyle. 

Psychotherapy and psychopharmacology are considered by many to be more gradual forms of treatment. They can often require time and trust between the patient and therapist to be as effective as possible. 

Sometimes rehabilitation can be difficult—but it can end up being worth the effort in the end. If someone with persecutory delusions is believed to be a danger to themselves or others, however, they may require admission to a hospital.

We do want to note: Antipsychotic drugs and psychopharmacology may not be the only potential forms of treatment for individuals who live with delusions. Cognitive therapy can also be an effective form of aid for some patients. 

Cognitive therapy strategies can use questions and behavioral experiments to assess individuals experiencing various delusions. After a trusting relationship is established, the therapist can then begin to work with their patients to help them combat their delusions and adopt more realistic critical thinking habits.

Gentle, supportive treatment options can be better than more direct ones in some. After all, individuals experiencing persecutory delusions might be more likely to view criticism as attack. A person who feels as though their therapist is attacking them may be much less likely to be receptive to treatment—which is why a gentle and approachable method might be best for many. 

No matter what option is chosen, many might find that the rehabilitative process for persecutory delusions can take time, effort, and patience.

The power of positive thinking

If you or someone you know is living with persecutory delusions, it can feel overwhelming to try and address or manage symptoms. As someone undergoes the process of therapy, they might find that gradually adopting positive thoughts and beliefs may help them as they work to overcome persecutory delusions.

Positive thinking (combined with professional support) can be an excellent way to see the world through a realistic and healthy lens. 

How can online therapy support those living with persecutory delusions?

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Learn about persecutory delusions

If you are experiencing persecutory delusions, it's not your fault. You might benefit from actively seeking professional assistance or guidance. 

Psychotherapy and cognitive therapy, whether with an in-person or online counselor, are forms of treatment that may help you feel better about yourself and the world around you.

Online therapy specifically can support people who live with persecutory delusions, as they may find it difficult to leave the home. Rather than experiencing stress or strain, those who experience these delusions can seek support from the comfort of their home or another safe space. This can offer them a more enriching experience and can possibly support a greater adherence to the treatment plan. 

Is online therapy effective? 

Cognitive behavioral therapy (CBT) has been scientifically suggested as an efficient way to treat persecutory delusions and other forms of psychosis.  

In a recent study, those who received CBT showed significantly less worry, fewer or no delusions and overall improvement based on the study’s self-reporting system. These effects were maintained and self-reported at a 24-week follow-up. It may be some time before VR CBT is available for everyone with persecutory delusions. Additionally, CBT has been shown to work just as well online as when it is delivered in person.


If you are experiencing persecutory delusions, it can be helpful to know that you are not alone. An experienced therapist can provide online support as you work through any troubling thoughts and delusions. Over time, you may find that you can see things in a different light so that you can start living a more fulfilling life. BetterHelp can connect you with a therapist in your area of need.
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