Paranoia Explained

Paranoia is thinking and feeling like you are being intimidated in some way, even if there is no evidence, or very little evidence, that you are. Paranoid thoughts can also be described as delusions. There are lots of different kinds of threats you might be scared and worried about.

Paranoid thoughts could also be fabricated suspicions. For example, someone made a nasty comment about you once, and you believe that they are directing a hate campaign against you. Everyone will have a different experience of paranoia. But here are some examples of common types of paranoid thoughts.

You might think that:

  • you are being talked about behind your back or watched by people or organizations

  • other people are trying to make you look bad or exclude you

  • you are at risk of being physically harmed or killed

  • people are using hints/double meanings to secretly threaten you or make you feel bad

  • other people are deliberately trying to upset or irritate you

  • people are trying to take your money or possessions

  • your actions or thoughts are being interfered with by others

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

You might have these thoughts very strongly all the time, or just occasionally when you are in a stressful situation. They might create a lot of distress or you might not really mind them too much.


No one knows exactly what causes paranoia. There are lots of theories and different people will have different explanations for their own experiences. It's likely to be a mixture of things.

Researchers have identified some general risk factors – these are things that could make paranoid thoughts more likely:

  • having confusing or unsettling experiences or feelings that you can't easily explain.

  • the way you feel – if you are anxious or worried a lot or have low self-esteem and expect others to criticize or reject you.

  • the way you think – if you tend to come to conclusions quickly, believe things very strongly and don't easily change your mind.

  • if you are isolated.

  • if you have experienced trauma in the past.

There are lots of more specific things that may play a role in causing paranoid thoughts. Sometimes this could be because they make you more likely to experience the risk factors above. These are some examples of things that may contribute to paranoid thoughts:

  • Life experiences: You are more likely to experience paranoid thoughts when you are invulnerable, isolated, or in stressful situations that could lead to you feeling negative about yourself. If you are bullied at work, or your home is burgled, this could give you suspicious thoughts which could develop into paranoia.

  • External environment: Some research has suggested that paranoid thoughts are more common if you live in an urban environment or community where you feel isolated from the people around you rather than connected to them. Media reports of crime, terrorism, and violence may also play a role in triggering paranoid feelings.

  • Physical illness: Paranoia is sometimes a symptom of certain physical illnesses such as Huntington's disease, Parkinson's disease, strokes, Alzheimer's disease, and other forms of dementia. Hearing loss can also trigger paranoid thoughts in some people.

  • Lack of sleep: Lack of sleep can trigger feelings of insecurity and even unsettling feelings and hallucinations. Fears and worries may develop late at night.

  • Genetics: Research has suggested that genes may affect whether you are more likely to develop paranoia – but we don't know exactly which ones.


If your paranoid thoughts are causing you to distress then you may want to seek treatment. You may also be offered treatment for paranoia as part of your treatment for a mental health problem.

Talking therapy

Talking therapies can help you understand your experiences and develop coping strategies to deal with them.

Cognitive-behavioral therapy

The most common form of talking therapy for paranoia is cognitive-behavioral therapy. During CBT, you will examine the way you think and the evidence for your beliefs and look for different possible interpretations. CBT can also help reduce worry and anxiety that may influence and increase feelings of paranoia.

Arts and creative therapies

Arts and creative therapies use arts-based activities to help you express how you are feeling, in a therapeutic environment. These types of treatment can be helpful if you are having trouble talking about your experience.


If you have a diagnosis of paranoid schizophrenia or delusional disorder, you are likely to be offered an antipsychotic drug to reduce your symptoms. Antipsychotics may reduce paranoid thoughts or make you feel less threatened by them.

If you have anxiety or depression, your GP may offer you antidepressents or minor tranquilizers. These can help you feel less worried about the thoughts and may stop them from getting worse. See our pages on medication for more general information.


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