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Conditions: Paranoia

What is paranoia?

Paranoia refers to thinking and feeling like you are being under threat in some way. This usually occurs when there is no evidence, or very little evidence, that you are.

Paranoid thoughts can also be described as delusions or could constitute exaggerated suspicions. There are various types of threat you might be scared and worried about but usually fears are amplified, and it can feel like you are at the centre of a dangerous world. It is also common to experience paranoid thoughts about threats or harm to other people in your life or society.

It is important to note that not all suspicious thoughts are paranoid as we all have valid reasons, at times, to be suspicious and hypervigilant. It can be challenging at times to distinguish a paranoid thought from a justified suspicion. The latter usually is accompanied by evidence, and they can be adaptive as they can help us keep or feel safe. Paranoid thoughts also lie on a spectrum and can be very mild to very severe and these experiences can be quite different for different people.

Paranoid thoughts can be very intense and be ongoing or can occur in the context of a stressful situation and subside or go away after some time. They may cause a lot of distress or be ignored and not paid too much attention to. Many of us experience mild paranoia at some point in our lives and this usually is referred to as “non-clinical” paranoia which means that they change over time and usually dissipate as you may realise they are not justified. 

In more severe cases, the paranoia can develop into persecutory delusions and can also be part of other mental health problems such as schizophrenia, (persecutory type) delusional disorder – a type of psychosis where you have one main delusion related to being harmed by others or paranoid personality disorder. 

The most common paranoid thoughts relate to feeling that:

  • you are being talked about behind your back or watched by people or organisations (either on or offline)

  • other people are deliberately (directly or subtly) trying to make you look bad, threaten you or exclude you, irritate or upset you

  • you are at risk of being physically harmed or even killed

  • people are trying to take your money or possessions

  • your actions or thoughts are being intercepted or interfered with by others

  • you are being controlled or that the government is targeting you


It is likely that your thoughts are paranoid if:

  • you still have the suspicious thought despite evidence against it or reassurance from others

  • your suspicions are based on feelings and ambiguous events rather than evidence

  • no one else shares the suspicious thought


When to seek help?

  • you strongly believe the paranoid thoughts

  • you think about the paranoid thoughts a lot and are preoccupied with them

  • the paranoid thoughts upset you and cause you great deal of anxiety and distress

  • the paranoid thoughts interfere with your relationships and your everyday life

Treatment recommendations

Psychological therapy (such as CBT or psychodynamic) can help you understand your experiences and develop coping strategies to deal with them. Paranoid thoughts might make it more challenging to trust your therapist and therefore to talk about how you feel, and it is important that you engage with a therapist that you are most comfortable with. The selected treatment would be individually tailored to your needs following a comprehensive assessment process in our service

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