PTSD And Paranoia: Are They Linked?

Medically reviewed by Paige Henry, LMSW, J.D.
Updated July 12, 2023by BetterHelp Editorial Team
Content Warning: Please be advised, the below article might mention trauma-related topics that include abuse which could be triggering to the reader. If you or someone you love is experiencing abuse, contact the Domestic Violence Hotline at 1-800-799-SAFE (7233). Free, private support is available 24/7. Please also see our Get Help Now page for more immediate resources.

Post-traumatic stress disorder (PTSD) can lead to a wide range of symptoms that can vary from person to person. Some of the potential effects include feelings that are commonly related to paranoia, such as the belief that you can’t trust others or that people are seeking to harm you in some way. Experiencing paranoia with PTSD can make it challenging to seek help, but there are effective treatments available. 

Below, we’ll explore the connection between PTSD and paranoia, how both can affect you, and how to alleviate symptoms of these mental health challenges.

What Is PTSD?

Post-traumatic stress disorder is a mental health condition that typically develops as a result of experiencing or witnessing a traumatic event. Many people instinctively associate PTSD with veterans who have served in war. According to the American Psychiatric Association, "PTSD has been known by many names in the past, such as ‘shell shock’ during the years of World War I and ‘combat fatigue’ after World War II, but PTSD does not just happen to combat veterans." The condition can be caused by a variety of traumatic events. The American Psychiatric Association estimates that one in 11 people will be diagnosed with PTSD at some point in their lives.

PTSD Can Make It Hard For You To Trust Others

Someone can experience symptoms of PTSD after almost any type of event or situation that was traumatic for them. In some cases, it doesn't even need to be something they experienced personally; witnessing or receiving news of something traumatic can also sometimes lead to PTSD. PTSD can develop in people who have experienced or witnessed war, accidents, sexual assault, natural disasters, terrorist attacks, domestic violence, and a variety of other situations.

Symptoms Of PTSD

The symptoms of PTSD can vary from one person to the next, depending on the traumatic event they experienced, their mental health history, and other factors. The symptoms typically begin to show within a few months, but it could be years before a person shows signs. Symptoms need to be present for at least a month before a PTSD diagnosis can be made. However, that doesn't mean that you need to wait for a month to seek help and treatment if you have the symptoms described below.

The symptoms of PTSD can be divided into four categories:

  • Negative thoughts and feelings
  • A tendency to reexperience an event
  • Avoidance
  • Reactivity

Negative Thoughts And Feelings

After traumatic events, some people start believing that there is no one they can trust, or they may feel guilt and shame about the situation they experienced. They may lose interest in things they used to enjoy or experience consistent feelings of fear.


When someone has PTSD, they may experience frequent unwanted memories of a traumatic event. They may also experience nightmares in which they relive the event over and over. Some people experience flashbacks that make them feel that the situation is actually happening and that they are in the middle of it again.


Avoidance behaviors are those that limit exposure to certain stimuli because they remind a person of the traumatic event that they don't want to relive. Stimuli that could be triggering include people, conversations, locations, and objects.


A person with reactive symptoms may experience increased irritability, angry outbursts, or self-destructive behaviors. These symptoms can make it difficult for them to sleep or concentrate.

What Is Paranoia?

Paranoia is a state of mind characterized by distrust of others and high levels of fear and anxiety. A person with paranoia is typically suspicious of other people and may think that others are seeking to harm them in some way. They may believe in conspiracies or feel that others are threatening them. When left untreated, paranoia can seriously impact an individual’s ability to function.

Symptoms Of Paranoia

The symptoms of paranoia may vary from person to person, but the following are some common symptoms:

  • Suspicion and mistrust: An individual may feel that family, friends, acquaintances, or strangers have ulterior motives or are planning to harm them.
  • A tendency to read too much into someone else's behavior: An individual with paranoia may try hard to pick up on looks or a tone of voice that may signal deceit or malicious intent.
  • Defensive and argumentative behavior. Someone experiencing paranoia may seem defensive during conversations. 
  • A tendency to look for hidden messages. When a person experiences paranoia, they may search for hidden messages in things like newspapers or billboards.

PTSD And Paranoia

There are many similarities between paranoia and PTSD, particularly hypervigilance, which is an increased alertness to potential danger.

While paranoia is generally not considered a symptom of PTSD, it can be a common result of the feelings that trauma can produce. Paranoia can be particularly common in PTSD caused by an individual, such as in cases of assault.

One study examined the link between paranoia and PTSD in people who had experienced assault. The researchers found that 80% of people experienced heightened fear of others—a primary characteristic of paranoia. The study found that "paranoia after an assault may be common and distinguishable from PTSD but predicted by a strikingly similar range of factors."

Hypervigilance can mimic paranoia in many ways. You may notice elevated blood pressure, increased jumpiness, and an extreme focus on your environment, which can intensify feelings of panic or fear. Because PTSD often causes exaggerated fears, behavior associated with paranoia may be common at times. If paranoia is not managed properly, though, it can lead to worsening feelings of fear and anxiety.

Treatments Options For PTSD And Paranoia

Because of the potential negative effects of trauma, including paranoia, it may be important to get professional help. Left untreated, PTSD can worsen and continue to affect your mental health.

There are many different forms of treatment for PTSD and paranoia. Some of the most common include the following:

Cognitive Behavioral Therapy

Cognitive behavioral therapy, or CBT, aims to help you better understand how your thoughts may be leading to maladaptive feelings and actions. There are different types of CBT that may be used for PTSD, including cognitive processing therapy, eye movement desensitization and reprocessing, and prolonged exposure therapy. 

Prolonged exposure therapy may be used to help reduce the type of response that you have when you experience triggers. It works by gradually exposing you to stimuli that are associated with a traumatic event. This may help you manage avoidance and reactivity symptoms that may be causing hypervigilance and leading to other behaviors associated with paranoia.


There are several types of medication that could be prescribed based on your symptoms. As with many anxiety disorders, antidepressants can be helpful for PTSD. Antipsychotics and mood stabilizers may be prescribed to help with symptoms of paranoia.

Please consult with your doctor or primary care physician before taking any medication.

PTSD Can Make It Hard For You To Trust Others

Working Through Trauma And Paranoia In Online Therapy

If you’re experiencing paranoia or PTSD, you may benefit from speaking with a licensed counselor who has experience helping people in similar situations. If your symptoms make it difficult to leave home, you might consider trying online therapy, which has been shown to be effective for PTSD. A study involving 126 participants receiving either online or in-person therapy for their PTSD symptoms showed that both groups saw a significant reduction in their symptoms. The study concluded that the outcomes of online therapy were comparable to those of traditional therapy. 

With an online therapy platform like BetterHelp, you can choose how you’d like to communicate with a therapist—via phone, live chat, or videoconference. You can also contact your therapist at any time via in-app messaging, and they’ll respond as soon as they can. This may be especially useful if you experience paranoia or symptoms of PTSD in between sessions. 

Read below for reviews of BetterHelp therapists from those who have sought help for similar challenges in the past.

Counselor Reviews

“Paula is wonderful. She has been here for me since day one, and I feel like she truly is in my corner. She is patient, kind, and is excellent in dealing with chronic trauma and PTSD. She teaches me how my brain works, how I can deal with my emotions (and that it's okay to have them!), and she is helping me process the things that happened to me. She had good insights, and levels with me very well.”

“Robyn was able to give me gracious doses of support, help and advice when I was going through a rough period of anxiety, stress, relationship and family issues, as well as emotional trauma and PTSD. She’s insightful and gave me tools to better understand myself and my situation. She is easy to talk to and helped me put things into perspective in a way I didn’t think about before. Thank you, Robyn!!!”


Post-traumatic stress disorder is a mental health condition that can be further complicated by the existence of paranoia. If you’re living with PTSD, paranoia, or another concern, you don’t have to face it alone. If paranoia or symptoms of PTSD make you feel hesitant to go to a therapist’s office, you can connect with a licensed therapist from home through online therapy. With BetterHelp, you can be matched with a therapist who has experience helping people with paranoia and PTSD. Take the first step toward healing and reach out to BetterHelp today.

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