Potential solutions for coping with paranoia

For some people, paranoia is a frightening symptom of a mental health condition that may interfere with work, relationships, and daily life. For others, it may be a temporary sense of unease. Paranoia can also be brought on by substance use. 

If you're experiencing paranoia for any reason, you're not alone. It can be helpful to find research-backed coping mechanisms to cope with these symptoms and, in some cases, to reach out for professional guidance. 

What is paranoia?

Paranoia can involve intense, anxious, or fearful feelings and thoughts about a perceived threat or conspiracy. It can also involve mistrust and suspicion that is difficult to cope with or reduce. Severe paranoia can occur as a symptom of a mental illness, such as a psychotic disorder from the DSM-5. However, people without a mental illness can also experience paranoia. 

Symptoms associated with paranoia may include:

• Deep mistrust toward others
• Holding grudges or feeling unforgiving
• Hypersensitivity
• Difficulty compromising or accepting criticism
• Feeling "targeted" by others
• Hostility 
• Controlling and jealous behaviors in relationships
• Stress or anxiety related to beliefs about others
• Feeling misunderstood
• Feeling persecuted without a present threat 
• Isolation

Causes of paranoia

Mental Health America cites that paranoia is often the result of a breakdown of various mental and emotional functions involving reasoning and assigned meanings. They note that the reasons for these breakdowns are varied and uncertain. At times, the symptoms of paranoia are tied to repressed, denied, or projected feelings. Other times they are related to events and relationships in a person's life, thereby increasing isolation and difficulty getting help.

Causes of paranoia vary in intensity and may include chronic sleep deprivation, stress, anxiety disorders, and depressive disorders. It can also be a symptom of mental illnesses like schizophrenia, schizoaffective personality disorder, bipolar disorder, and dementia, among others. Substance use and memory loss may also contribute to feelings of paranoia. 

Paranoid personality disorder

Another potential underlying cause of paranoia is paranoid personality disorder (PPD). PPD involves relentless mistrust and suspicion of others without a known cause. While the condition is rare, research has found that up to 4.4% of adults in the US may have PPD. This condition may be more common in men than women and is often diagnosed in early adulthood. Psychological and environmental factors like childhood trauma can impact a person's development of PPD later in life, and it may be linked to schizophrenia, suggesting biological factors could play a part. 

If you are experiencing trauma, support is available. Please see our Get Help Now page for more resources.

Some instances of paranoia may be easier to treat or not require treatment at all. If your paranoia is caused by temporary situational stress, it may subside when the stressor is no longer present or as you adapt to your new situation. If it is due to substance use, the paranoia may subside once the substance is no longer in the bloodstream. 

Many people experiencing paranoia cognitively understand that their feelings may not reflect the moment's reality, but emotionally and mentally, they can have difficulty moving past it. For instance, if a person is robbed on the street, they may feel paranoid about walking alone after the occurrence. While fear is understandable, it might be associated with a mental health condition if it is persistent long-term and impacts your functioning.

Treating paranoia

Treatments for paranoia can vary depending on the cause of your symptoms. Coping with paranoia may mean addressing the root. Psychotherapy or medication may be recommended, depending on the cause. However, consult a medical doctor before starting, changing, or stopping a medication. 

Some people with this condition may feel hesitant to seek treatment due to a mistrust of others. If they don't feel safe connecting with a therapist, getting to the root of the paranoia can be challenging. Because of its nature, some people with advanced cases of paranoia may decline medication or treatment programs because they feel suspicious. Building a safe and long-term relationship with a therapist might be beneficial in these cases. 

Regardless of its cause, psychotherapy can be valuable in treating paranoia.  Research suggests that cognitive-behavioral therapy (CBT) is particularly effective for treating paranoia. CBT provides clients a framework for recognizing paranoid thoughts and tools for coping with them safely and productively. 

Cases of extreme paranoia, such as those associated with schizophrenia, bipolar disorder, delusional disorder, or dementia, may require medical treatment with a psychiatrist. Talk to your doctor about options for your symptoms. You're not alone, and support is available.

Alternative counseling options 

Paranoia can be challenging for those who think their feelings are based on actuality. It may take time to establish trust with a professional, but success is possible by adhering to a treatment plan. It can also be helpful to note that licensed therapists have years of experience treating these symptoms and are compassionate experts in their field. 

Paranoia can be challenging for those who think their feelings are based on actuality. It may take time to establish trust with a professional, but success is possible by adhering to a treatment plan. It can also be helpful to note that licensed therapists have years of experience treating these symptoms and are compassionate experts in their field. 

If you face barriers to treatment beyond your symptoms, you may find it uncomfortable to commute to an office and speak with a therapist. In these cases, online therapy could be beneficial and has become a viable solution to barriers for those who struggle to obtain face-to-face counseling. With the rise in popularity of online psychotherapy, platforms like BetterHelp have contracted thousands of therapists to support clients from home through video, phone, or live chat sessions. 

If you're unsure whether online therapy is safe or effective, knowing that studies support its effectiveness can be helpful. One study found that internet cognitive-behavioral therapy (ICBT) effectively improved reasoning and reduced paranoia in people living with psychosis, paranoia, or schizophrenia. In addition, clients reported positive experiences using therapy online.

Counselor reviews

Read below for some reviews of BetterHelp counselors from people experiencing similar issues with paranoia.

"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 way, her tools of coping are massive and highly appreciated. Adding more tools to the chest."

"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."