What is paranoia?

Paranoia is a mental state where you are suspicious without reason. You may feel that people are trying to harm you in some way or that something dreadful is about to happen. Everyone can be suspicious at times, or feel fearful about the future, but if you are experiencing paranoia you may lose insight into the fact that perhaps your fears are groundless, and in extreme forms you may be unable to distinguish between reality and fantasy. Paranoia is a psychiatric condition which often occurs as a feature of a more serious mental illness such as schizophrenia or manic depression, or as a result of using street drugs.

What are the symptoms?

Paranoia can take many forms, and is often seen as a response to the particular life stresses of an individual. You may feel isolated and unable to depend upon or trust anyone else. You might feel suspicious of other people's actions and motivations, that everyone has a hidden agenda concerning you. You may become irrationally jealous of a partner, or suspect that a relative is trying to poison you. Feelings of being watched or followed are common, and in extreme cases you might think that your thoughts are being monitored or that your home is bugged.

Who experiences it?

Anyone can experience mild feelings of paranoia as a result of things going wrong in their life, however, extreme paranoia is usually seen in people with mental health problems, or users of street drugs. People may develop paranoia at any age, but young people tend to have the most spectacular delusions, for example, that aliens are controlling my thoughts". Young men are affected slightly more than young women.

What causes it?

Paranoia can be caused by a number of factors such as stressful life events, but it is most commonly seen in people with mental health problems and people using street drugs. Drugs such as amphetamine, cannabis, cocaine, ecstasy and LSD often cause bad trips, where users feel paranoid for a time, but long-term or heavy drug users can experience more serious problems with paranoia that are not easily shaken off.

People experiencing severe anxiety or depression can develop problems with paranoid feelings, but the most extreme forms of paranoia are usually seen in people diagnosed with schizophrenia or manic depression. These illnesses can cause people to lose touch with reality, a feature known as psychosis, so that when people develop paranoia they frequently lose the insight to recognise that their fears are not grounded in reality.

What can be done?

The first step towards recovery is usually to recognise that there is a problem and to seek help. However, people experiencing paranoia often fail to recognise that they have a problem that can be treated. If this is the case, friends or family may have a role in encouraging the person to seek help. The first point of contact would usually be a GP who may be able to prescribe drug treatment, or refer the person to a psychiatrist or psychologist for more intensive treatment. Paranoia is usually treated with antipsychotic drugs which have a tranquillising effect and aim to reduce paranoid feelings. Other forms of treatment are known as talking treatments; these include counselling, cognitive behaviour therapy (CBT) and psychotherapy. If a person is very distressed, they may be admitted to hospital for treatment. People are usually encouraged to go to hospital as voluntary patients, but sometimes if someone's behaviour is very disturbed, they can be admitted to hospital against their will under the Mental Health Act 1983.

Who can help?

Friends and family can help by encouraging the person to seek treatment and support. They can also support a paranoid person by trying to help them sort out what are facts and what are paranoid assumptions. It is important to ensure that you don't say anything that might collude with delusional beliefs or feed their paranoia. It can be quite distressing living with a paranoid person, so friends and family might wish to seek some support for themselves too. Many organisations can provide advice, information and either practical or emotional support. These include mental health and drug charities, helplines, counselling and therapy services, social services, GPs and the health service.

Updated: 02/06/2011