How to Deal With Your Paranoia

The world can be a risky place. When you feel like people are constantly out to trick or harm you, going about the day-to-day is plain exhausting. It's even worse when you know you're your worst enemy. How do you grab your paranoia and wrestle it into submission? How do you take control of how you see the world?

Method 1
Method 1 of 3:

Examining Your Situation

  1. Step 1 Distinguish between paranoia and anxiety.
    Anxiety is not the same thing as paranoia, but these conditions have some similarities. People with anxiety are serious worriers. They might think "My parents will die in a car crash." People who are paranoid might think, "Someone will kill my parents to hurt me." If you think anxiety might be your issue, consider reading wikiHow's How to Deal With Anxiety article to start.[1]
    • There is also a difference between occasional anxiety about a specific event, such as stressing out over an exam, and persistent anxiety that follows you around. Anxiety disorders are the most common mental health disorders. If your anxiety seems generalized or “all the time” rather than located around a specific event or situation, you should see a mental health professional. You may have an anxiety disorder.[2]
    • Anxiety is much more common than clinical paranoia. The average age of onset for anxiety disorders is 31, though it can occur at any age. The symptoms of anxiety, or GAD (generalized anxiety disorder), mainly involve the inability to relax, startling easily, and having difficulty concentrating, amongst a plethora of physical symptoms. The good news is that it's highly treatable.[3]
  2. Step 2 Get a jury.
    It may be hard to believe, but a certain level of paranoia is pretty common. All of us have insecurities and all of us know what embarrassment feels like. About a third of people have paranoid thoughts at some point.[4] Before you jump to conclusions and assume you're paranoid, get 4 or 5 friends together and ask them if your thought processes are understandable or, well, delusional. It's a good way to determine if you are really paranoid or not.
    • There are 5 levels to paranoia. Most of us have general feelings of vulnerability and suspicious thoughts ("I could get murdered down this dark alley!" or "They're talking about me behind my back, aren't they?"). But when you hit mild ("They're tapping their foot to annoy me"), moderate ("My phone calls are being tracked"), or severe ("The FBI is in my TV, watching me") personal threat, it's a sign you may be paranoid.[5]
    • Look at how your thoughts impact your life. You may have the occasional paranoid thought, but if your life is not significantly impacted by them, you are probably not clinically paranoid.
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  3. Step 3 Decide whether you’re actually paranoid or just listening to previous life experience.
    Sometimes, your friends or loved ones may label thoughts as “paranoid” if you are suspicious of something, but suspicion is not always a bad trait. Sometimes, your life experiences may have taught you to view a certain way of behaving as suspicious. Being suspicious, for example that someone could hurt you, isn’t necessarily paranoia. It could just be that you have difficulty trusting people. This is particularly common after you’ve experienced a trauma or a very negative experience.[6]
    • For example, you may be suspicious of a new romantic interest who seems “too good to be true.” If you have a history of heartbreak in your relationships, you may well just be listening to what your previous experiences have taught you.
    • On the other hand, if you suspect your new romantic interest is a secret assassin who has been sent to kill you, this is probably paranoia talking.
    • As another example, you may be picking up on something that doesn’t seem “right” about a situation or person that causes suspicion. These reactions are not always paranoid. While you should examine your reactions, you don’t have to immediately discredit them.
    • Take time to evaluate your reactions and suspicions. You may react with immediate responses, such as fear or anxiety. Slow down and attempt to determine where these responses are coming from. Do you have a basis, such as a past experience or traumatic event, that would possibly provoke these reactions?[7]
    • Do a little fact-checking. No, this doesn’t mean running a background check on your new boyfriend or girlfriend. Sit down with a piece of paper and write out what’s going on. Say what the situation is, what you feel about it, how strong those feelings are, what you believe about the situation, whether those beliefs are rational and have facts that support them, and whether you can change your beliefs based on those facts.[8]
  4. Step 4 Consider your use of alcohol, drugs, and other substances.
    Paranoia is a common side effect of substance abuse. Alcohol can cause hallucinations and paranoia in chronic heavy drinkers.[9] Stimulants, including caffeine (yes, caffeine!), Adderall, or Ritalin, can cause paranoia and trouble sleeping. Combining stimulants with antidepressants or over-the-counter decongestant cold medicines can increase these side effects.[10]
    • Hallucinogens, such as LSD, PCP (angel dust), and other mind-altering drugs can cause hallucinations, aggression, and paranoia.
    • Most other illegal drugs, including cocaine and meth, can also cause paranoia. Up to 84% of cocaine users have cocaine-induced paranoia.[11] Even marijuana may induce paranoia in some users.[12]
    • Most prescription drugs will not cause paranoia if taken as prescribed. However, some prescriptions to treat Parkinson’s disease by stimulating the production of dopamine may cause hallucinations and paranoia.[13] If you're on prescription drugs and you think they might be causing your paranoia, talk to your doctor about possible alternatives. Do not stop taking your medications without talking to your doctor first.
  5. Step 5 Think about your situation.
    A recent traumatic event or loss can also cause some people to become paranoid. If you've lost someone recently or you're going through a particularly stressful situation, the paranoia could be your mind's way of coping.[14]
    • If your paranoia seems to stem from a fairly recent situation (at least within the past 6 months), it's probably not chronic. It still deserves your attention and you should still deal with it, but it may be easier to deal with if it is recent.
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Method 2
Method 2 of 3:

Dealing with Paranoid Thoughts

  1. Step 1 Start a journal to track your thoughts and feelings.
    Journaling can help you to understand what may have caused you to feel paranoid and it is also a great way to relieve stress. It can also help you identify your triggers, or people, places, and situations that seem to inspire your paranoia. To get started with journaling, choose a comfortable place and plan to devote about 20 minutes per day to writing. Think about situations in which you feel paranoid. For example:[15]
    • When do you feel the most paranoid? At night? Early in the morning? What is it about that time of day that makes you feel paranoid?
    • Who do you feel paranoid around? Is there a person or group of people who make you feel more paranoid? Why do you think those people make you feel more paranoid than usual?
    • Where do you feel the most paranoid? Is there a place where your paranoia peaks? What is it about that place that makes you feel paranoid?
    • In what situations do you experience paranoia? Social situations? Is there something about your surroundings?
    • What memories come to you when you experience these feelings?
  2. Step 2 Make a plan to avoid or reduce exposure to your triggers.
    Once you have identified the situations and people that seem to be contributing to your paranoia, you can make a plan to reduce your exposure to these triggers. While some people, places, and situations may be unavoidable, such as work or school, being aware of what triggers your paranoia may help you to minimize your exposure to other things that you can avoid.[16]
    • For example, if a certain route home from school makes you feel paranoid, take a different route, or ask a friend to accompany you.
  3. Step 3 Learn how to question your thought process.
    In the case of triggers that you cannot avoid, learning to question the rationality of your paranoid thoughts may help you to reduce or eliminate the way that you feel about these people and situations.[17] The next time that you find yourself thinking paranoid thoughts about a person, place, or situation, ask yourself the following questions.
    • What is the thought? When did I have it? Who was there? When was it? What happened?
    • Am I having a thought that is based on fact or opinion? How can I tell?
    • What am I assuming or believing about the thought? Is my assumption or belief realistic? Why or why not? What would it mean if the thought were real?
    • How do I feel—physically and emotionally?
    • What did/could I do to deal with the thought in a positive way?
  4. Step 4 Distract yourself from the paranoid thoughts.
    If you cannot defuse your paranoia by examining its content, try to distract yourself. Call up a friend, go for a walk, or watch a movie. Find a way to get your mind off of the paranoid thoughts so that you do not begin to dwell on them.[18]
    • Distraction can help you avoid rumination, the obsessive pattern of thinking where you think about the same thing over and over again, like a broken record. Rumination is associated with higher levels of anxiety and depression.
    • However, distraction on its own is usually not enough to fully address these thoughts. Distraction is a type of avoidance, which means you will need to take other steps to work on your paranoia too.
  5. Step 5 Avoid punishing yourself.
    You may feel embarrassed by your thoughts, and this could lead to you feeling guilty or judging yourself harshly for them.[19] Studies have shown that this type of technique, or “punishment,” is not effective at addressing paranoid thoughts.
    • Instead, try reappraisal (examining your thought process), social control (seeking advice from others), or distraction, as described elsewhere in this article.
  6. Step 6 Determine if you might need professional help.
    Mild paranoia may be manageable on your own, but you will likely need professional help if your paranoia is moderate to severe. If you are frequently having paranoid thoughts, consider the following questions:[20]
    • Are you considering acting on potentially harmful thoughts?
    • Are you considering hurting yourself or others?
    • Are you thinking and planning on how to go about hurting someone with the intent of doing it?
    • Are you hearing voices telling you to hurt yourself or others?
    • Are your obsessive thoughts or behaviors affecting your home or work life?
    • Are you reliving a traumatic experience over and over again?
      • If you answered yes to any of these questions, you should seek help from a mental health care professional as soon as possible.
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Method 3
Method 3 of 3:

Understanding Paranoia

  1. Step 1 Define “paranoia” properly.
    A lot of us use the term "paranoia" quite loosely. However, clinical paranoia involves persistent feelings of persecution and an inflated sense of self-importance.[21] Unlike everyday suspicion, paranoia does not have a rational basis. There are several medical or mental health conditions that can cause paranoia, but they are not common. You cannot and should not attempt to diagnose yourself with any of these conditions. If you display any of their symptoms, see your physician or a mental health professional such as a psychiatrist or clinical psychologist. Only a trained medical professional can diagnose mental illnesses.
  2. Step 2 Look for characteristic symptoms of Paranoid Personality Disorder (PPD).
    PPD affects somewhere between 0.5% and 2.5% of the population. People with PPD are so suspicious of others that it causes dysfunction in their daily lives, such as extreme social withdrawal. Its symptoms include:[22]
    • Suspicion, without grounds, of others, especially that you may be harmed, exploited, or deceived by them
    • Suspicion of others’ trustworthiness, even friends and family
    • Difficulty confiding in or working with others
    • Reading hidden or threatening meanings into harmless remarks or events
    • Grudge-bearing
    • Social withdrawal or hostility
    • Rapid anger reactions
  3. Step 3 Watch for signs of paranoid schizophrenia.
    People with paranoid schizophrenia are usually convinced that others are out to harm them or their loved ones. They may also believe that they are extremely important (delusions of grandeur). Only about 1% of people have schizophrenia.[23] Other common signs of paranoid schizophrenia include:
    • Social isolation or withdrawal
    • Suspicion of others
    • Guarded or reserved behavior
    • Delusional jealousy
    • Auditory hallucinations (“hearing things”)
  4. Step 4 Look for signs of Delusional Disorder.
    Delusional Disorder is the belief in one or more very specific paranoias (e.g., "The FBI is in my TV watching my every move"). It's pinpointed and not necessarily global, and the person is otherwise able to function without any obviously bizarre behavior. This disorder is extremely rare; only about 0.02% of people have delusional disorder.[24] Common symptoms of Delusional Disorder include:
    • High levels of self-reference. This means that the person sees references to themselves in everything, even when this could not possibly be true (e.g., believing that an actor in a movie is talking directly to them).
    • Irritability
    • Depressive mood
    • Aggressiveness
  5. Step 5 Consider whether you may have PTSD.
    Paranoia may accompany post-traumatic stress disorder (PTSD), a mental health condition that may develop after a person has experienced a trauma. Traumatic experiences can even cause hallucinations as well as paranoia. If you have experienced trauma in the past, such as abuse, it is possible that you have developed what is known as “persecutory ideation,” or the belief that others are out to harm you. This belief can cause you to suspect others or worry about being harmed, even in situations that most people would not see as suspicious or harmful. Unlike most other paranoias, this type of fear has a basis in that it is a reaction to the trauma. Working with a mental health professional who is experienced in handling trauma can help you overcome PTSD and this type of paranoia.[25]
    • The most common treatment for PTSD is cognitive-behavioral therapy (CBT), which focuses on learning how your trauma has affected your thinking and behavior. You can learn new ways to think about yourself and the world that will help reduce your symptoms.[26]
    • Other treatments include exposure therapy and EMDR (eye movement desensitization and reprocessing).[27]
  6. Step 6 Consider talking to a therapist about how you have been feeling.
    Without help, it may be hard to figure out why you feel paranoid and determine the best way to deal with those feelings. A licensed mental health professional can help you begin to understand these feelings and help you work through them.[28]
    • Keep in mind that feeling paranoid may be part of an underlying mental health condition that requires treatment. Talking to a therapist can help you understand what is going on and decide on the best course of action.
    • Seeing a therapist is very common. People do it all the time to get better and improve their lives. You can feel good about your decision to seek help: it’s brave and shows that you care about yourself.
    • Feel free to switch therapists! Many people feel stuck with whichever one they start with. If you're not jiving, find a new one. Find one that makes you feel comfortable and that you can see yourself trusting. It'll be the quickest path to progress.
    • Know that your therapist is required by law to keep the information you share confidential. People with paranoia tend to be afraid to share their problems, but therapists are legally and ethically bound to keep your secrets safe. The only exceptions to this rule is if you share plans to harm yourself or others, abuse or neglect is involved in your situation, or if a court orders your therapist to reveal information because you are on trial.[29]
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Warnings

  • Do not harm others because of what you suspect them of doing.
    Thanks
  • Share your thoughts and feelings with someone else. If you bottle up your feelings, eventually they will all come out at once, and repressing them is bad for your health. Talk to someone you trust.
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References

  1. ↑ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2830058/
  2. ↑ http://www.nimh.nih.gov/health/topics/anxiety-disorders/index.shtml
  3. ↑ https://www.nhs.uk/mental-health/conditions/generalised-anxiety-disorder/overview/
  4. ↑ http://bjp.rcpsych.org/content/186/5/427
  5. ↑ https://www.cambridge.org/core/journals/advances-in-psychiatric-treatment/article/helping-patients-with-paranoid-and-suspicious-thoughts-a-cognitivebehavioural-approach/2249747A0A5E647E1F8BFF3D6FABBB4C
  6. ↑ https://www.mind.org.uk/information-support/types-of-mental-health-problems/paranoia/about-paranoia/
  7. ↑ https://pubmed.ncbi.nlm.nih.gov/27619196/
  8. ↑ https://www.mind.org.uk/information-support/types-of-mental-health-problems/paranoia/helping-yourself/
  9. ↑ https://pubmed.ncbi.nlm.nih.gov/23157139/
  1. ↑ https://pubmed.ncbi.nlm.nih.gov/2650503/
  2. ↑ http://www.ncbi.nlm.nih.gov/pmc/articles/PMC181074/
  3. ↑ https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/paranoia
  4. ↑ http://jnnp.bmj.com/content/75/suppl_3/iii2.full
  5. ↑ https://mhanational.org/conditions/paranoia-and-delusional-disorders
  6. ↑ https://www.cci.health.wa.gov.au/~/media/CCI/Mental-Health-Professionals/Social-Anxiety/Social-Anxiety---Worksheets/Social-Anxiety-Worksheet---09---Thought-Diary-3.pdf
  7. ↑ https://my.clevelandclinic.org/health/diseases/9784-paranoid-personality-disorder
  8. ↑ https://www.cambridge.org/core/journals/advances-in-psychiatric-treatment/article/helping-patients-with-paranoid-and-suspicious-thoughts-a-cognitivebehavioural-approach/2249747A0A5E647E1F8BFF3D6FABBB4C
  9. ↑ https://www.tandfonline.com/doi/abs/10.1080/00207411.2017.1304075
  10. ↑ https://pubmed.ncbi.nlm.nih.gov/18056109/
  11. ↑ https://www.helpguide.org/articles/mental-disorders/paranoid-personality-disorder.htm
  12. ↑ https://my.clevelandclinic.org/health/diseases/9784-paranoid-personality-disorder
  13. ↑ https://medlineplus.gov/ency/article/000938.htm
  14. ↑ https://www.nimh.nih.gov/health/topics/schizophrenia
  15. ↑ https://mhanational.org/conditions/paranoia-and-delusional-disorders
  16. ↑ https://www.med.upenn.edu/ctsa/ptsd_symptoms.html#symptoms
  17. ↑ https://www.ptsd.va.gov/understand_tx/cognitive_processing.asp
  18. ↑ https://www.ptsd.va.gov/understand_tx/tx_basics.asp
  19. ↑ https://www.helpguide.org/articles/mental-disorders/paranoid-personality-disorder.htm
  20. ↑ http://www.apa.org/helpcenter/confidentiality.aspx

About this article

Trudi Griffin, LPC, MS
Co-authored by:
Trudi Griffin, LPC, MS
Professional Counselor
This article was co-authored by Trudi Griffin, LPC, MS. Trudi Griffin is a Licensed Professional Counselor in Wisconsin specializing in Addictions and Mental Health. She provides therapy to people who struggle with addictions, mental health, and trauma in community health settings and private practice. She received her MS in Clinical Mental Health Counseling from Marquette University in 2011. This article has been viewed 512,738 times.
3 votes - 67%
Co-authors: 47
Updated: April 10, 2023
Views: 512,738
Article SummaryX

Living with paranoia can be challenging, but there are ways to take control of your world. Think about what causes you to feel paranoid and reduce your exposure to these triggers. For example, if seeing certain people or being in specific places cause you to feel paranoid, then avoid these situations. Try distracting yourself whenever you start to feel paranoid. You can watch a movie, call a friend, or do anything else that keeps your mind busy. If you're obsessing to the point that it interferes with your daily life or are having thoughts about harming yourself or others, talk to a mental health professional so they can help you figure out what's going on and recommend the best treatment for you. To learn how to identify the source of your paranoia, keep reading.

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