Why Am I So Paranoid? Learning to Cope

Author Tracy Smith
Updated on June 29, 2023

Paranoia is a thought process that involves an irrational distrust trust in others without justification or cause. It is fueled by intense thoughts that will not go away and is perpetuated by powerful anxiety and fear. Paranoia is often accompanied by illogical thoughts that one is being threatened or targeted by an outside entity, even when there is no evidence to support these claims. A person with paranoia sees random occurrences as purposeful instead of as arbitrary or coincidental. It impacts many areas of a person’s functioning, including occupational, social, and educational settings.

paranoid man staring out a window

Symptoms of Paranoia

Symptoms of paranoia can range in intensity, from mild to severe, and may include:

  • Mistrust of others
  • Stress
  • Being defensive and hostile
  • Hypervigilance 
  • Being argumentative

Causes of Paranoia

Paranoia can arise from environmental, psychological, or biological factors. Paranoia may evolve from inconsistent and unstable environments, from trauma and abuse, from mistrustful relationships with primary caregivers, or from situations of discrimination. Sleep deprivation, increased stress, and social anxiety can also impact one’s ability to think clearly, thus prompting further thoughts of paranoia.

Some mental health conditions include paranoia among their symptoms, including :

  • Paranoid personality disorder
  • Delusional (paranoid) disorder
  • Paranoid schizophrenia

Drug use, neurological issues, and memory loss are some other causes of paranoia.

Treating Paranoia

If paranoia is causing significant distress and impairment, there are several ways to address symptoms and dysfunction. Treatment can include psychotherapy and medication, although individuals with paranoia often have difficulty trusting physicians and mental health practitioners. Once a trusting relationship is formed, psychotherapy can assist individuals to understand and gain insight into their condition. Treatment can help an individual learn coping mechanisms to manage anxiety and to dispel irrational thinking.

Cognitive-behavioral therapy is a common form of treatment for paranoia. This treatment approach asserts that changing irrational thoughts will alter a person’s feelings and behaviors. Thus, challenging irrational thoughts will assist an individual to alleviate feelings of anxiety and fear. Treatment allows one to challenge irrational thoughts and to conduct reality testing to see if there is any truth to their claims.

If paranoia is linked to a more serious mental health disorder, such as schizophrenia or delusional disorder, a psychiatrist may prescribe an anti-psychotic medication to help an individual reduce paranoid thoughts. In less severe forms of paranoia, a psychiatrist may prescribe an antidepressant to help an individual to reduce anxiety or depression linked to the paranoia.

In Summary

Paranoia is the belief that one is being targeted or persecuted with no basis in reality. Paranoia causes significant amounts of distress and impairment and greatly impacts a person’s normal, everyday functioning. However, psychotherapy, medication, and dispelling irrational thoughts are all effective coping mechanisms to help a person to successfully combat symptoms of paranoia.


Author Tracy Smith

Tracy is a Licensed Professional Counselor and is a clinical supervisor for a Community YMCA. Tracy has over 12 years of experience working in many settings including partial care hospitalization and intensive outpatient programs, community agencies, group practice, and school-based programs. Tracy works with clients of all ages, but especially enjoys working with the adolescents.

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