Paranoia is the feeling that you’re being threatened in some way, such as people watching you or acting against you, even though there’s no proof that it’s true. It happens to a lot of people at some point. Even when you know that your concerns aren’t based in reality, they can be troubling if they happen too often.
Paranoia is thinking and feeling like you are being threatened 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 threat you might be scared and worried about.
Paranoid thoughts could also be exaggerated suspicions. For example, someone made a nasty comment about you once, and you believe that they are directing a hate campaign against you.
“In paranoia, your fears become amplified and everyone you meet becomes drawn into that web. You become the centre of a threatening universe.”
Everyone will have a different experience of paranoia. But here are some examples of common types of paranoid thoughts.
You might think that:
You might have these thoughts very strongly all the time, or just occasionally when you are in a stressful situation. They might cause you a lot of distress or you might not really mind them too much.
“I find it really hard to trust people as my head tells me they’re out to get me.”
Most people have paranoid thoughts about threats or harm to themselves but you can also have paranoid thoughts about threats or harm to other people, to your culture or to society as a whole.
Paranoid thoughts are usually to do with your ideas about other people and what they might do or think. It can be difficult to work out whether a suspicious thought is paranoid or not, especially if someone else says your thoughts are paranoid when you don’t think they are. This could be a friend, family member or doctor, for example.
People may think about risks in different ways and believe different things are good or bad evidence for suspicious thoughts. People might also believe different things based on the same evidence. Ultimately you have to decide this for yourself.
Suspicious thoughts are more likely to be paranoid if:
“Another jogger looked across at me as he overtook me and my anxiety immediately crystallised around his glance. ‘Are you following me?’ I shouted. I had the thought he was an agent hired by my employer to track my movements.”
Paranoia is a symptom of some mental health problems but not a diagnosis itself.
Paranoid thoughts can be anything from very mild to very severe and these experiences can be quite different for everybody. This depends on how much:
Lots of people experience mild paranoia at some point in their lives – maybe up to a third of us. This is usually called non-clinical paranoia. These kind of paranoid thoughts often change over time – so you might realise that they are not justified or just stop having those particular thoughts.
At the other end of the spectrum is very severe paranoia (also called clinical paranoia or persecutory delusions). If your paranoia is more severe then you are more likely to need treatment.
Paranoia can be one symptom of these mental health problems:
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 combination of things.
Researchers have identified some general risk factors – these are things that could make paranoid thoughts more likely:
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 in vulnerable, isolated or 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.
Experiences in your childhood may lead you to believe that the world is unsafe or make you mistrustful and suspicious of others. These experiences may also affect your self-esteem and the way you think as an adult. For example, this could include being abused by someone in your family, or being bullied at school. See National Association for People Abused in Childhood (NAPAC) if you need support for dealing with childhood abuse.
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.
Mental health. If you experience anxiety, depression or low self-esteem, you may be more likely to experience paranoid thoughts – or be more upset by them. This may be because you are more on edge, worry a lot or are more likely to interpret things in a negative way. Paranoia is a symptom of some mental health problems. Many people experience paranoid delusions as part of an episode of psychosis.
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.
The effects of recreational drugs and alcohol. Some types of recreational drug may trigger paranoia, such as cocaine, cannabis, alcohol, ecstasy, LSD and amphetamines. This may happen particularly if you’re already feeling low, anxious or experiencing other mental health problems.
However, researchers still aren’t sure whether recreational drugs directly cause paranoia, or if people who experience paranoia are also more likely to use recreational drugs. Certain steroids taken by athletes, and some insecticides, fuel and paint, have also been associated with paranoia. Drinking alcohol and smoking may also stop medication from effectively treating your symptoms.
Genetics. Research has suggested that genes may affect whether you are more likely to develop paranoia – but we don’t know exactly which ones
The relationship between paranoia and anxiety is complicated. A paranoid thought could be described as a particular type of anxious thought. Both are to do with reacting to the possibility of some kind of threat.
Anxiety can be a cause of paranoia. Research suggests that it can affect what you are paranoid about, how long it lasts and how distressed it makes you feel. Paranoid thoughts can also make you feel anxious.
If you are experiencing paranoid thoughts – or think that you might be – there are things you can do to help yourself cope. You may choose to try them on their own or alongside treatment.
You may find it helpful to keep a diary recording, for example:
You could do this in a notebook or use an app or online tool like MoodPanda. You might find it helpful to give the thoughts a number from 1–10 to show how strongly you believe them and how distressing you find them.
This may help you:
Once you have a better understanding of your triggers, you can try to take steps to avoid them.
There is some evidence that mindfulness can help reduce mild paranoia. Our pages on mindfulness have more information.
Our pages on managing stress have information and tips to help you cope with stressful situations or events.
Relaxation can help you look after your wellbeing when you are feeling stressed, anxious or busy. See our pages on relaxation for tips and exercises to help you relax.
Sleep can give you the energy to cope with difficult feelings and experiences. See our pages on sleep problems for more information, including tips to improve your sleep.
Eating regularly and keeping your blood sugar stable can make a difference to your mood and energy levels. See our pages on food and mood for more information.
If you have a difficult relationship with food and eating, our pages on eating problems have information and tips which may help.
Exercise can be really helpful for your mental wellbeing. Even doing something small can make a big difference. Our pages on physical activity and your mental health have ideas for most ages and abilities, including things you can do at home.
Spending time in nature can help improve your mood and feel more in touch with your surroundings. This could be going to a local park or forest, doing gardening or bringing nature into your home. Our information on nature and mental health has more about the benefits, and lots of ideas you could try.
Doing something creative, like doodling, playing a musical instrument or baking, can help distract you from difficult thoughts or feelings, or help you to process them. It can also be rewarding. Try not to worry about the finished product. Just focus on enjoying yourself.
You may find that talking about your thoughts with a trusted friend or family member can reduce stress and help you to question and challenge paranoid thoughts. You could share this information with them, particularly the information for friends and family. If you don’t have someone you feel you can trust, the Samaritans are there for anyone in distress 24 hours a day.
“I’ve found it becomes easier and less straining on yourself once you share your thoughts with someone else.”
Feeling connected to other people is an important part of staying well. It can help you to feel valued, confident and more able to face difficult times.
Feeling lonely or isolated could make your symptoms worse. If you don’t feel like you have strong connections with people or you’d like to make more, it could help to explore support services and peer support.
Peer support brings together people who have had similar experiences. Some people find this very helpful.
There are lots of ways to find peer support. You could:
You can also find peer support groups for paranoia through The National Paranoia Network or Rethink.