How to Deal With Your Paranoia

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?

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.

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?

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.

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.

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.

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.

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

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”)

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

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]