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What are Paranoid Delusions?

Tricia Christensen
Updated Mar 03, 2024
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To be paranoid is to have great fear or anxiety about something. Having delusions means believing something that is not true and is possibly far-fetched. Taken together, paranoid delusions create fearfulness or anxiety, amplified by feeling/believing things that are false. It’s often thought that these delusions are only present in illnesses like schizophrenia, but other conditions may feature them. The most common illnesses associated with this symptom are schizophrenia, paranoid personality disorder, delusional disorder, and bipolar I, which may show such symptoms during mood swings.

A few examples of paranoia include when people believe that others, including government agencies or extra-terrestrials, are attempting to harm them; that people are regularly saying bad things about them behind their backs; that other people are trying to cheat them; or that a specific person is deliberately hurting them by behaviors like infidelity. These delusional stances exist despite repeated demonstration of evidence to the contrary. Although there may be some chance that such behavior could be true — the person's spouse could be cheating, for example — the paranoid person's belief has no actual basis in reality.

Paranoid delusions can lead people to act in a number of self-damaging ways. Paranoid jealousy could destroy a relationship, for example, or someone who thinks that aliens have implanted a tracker in his mouth might pull out his teeth in an attempt to remove it. Other characteristics may be present with delusions, making life much more difficult. Depending on other conditions present, a person might hear voices, hallucinate, have additional phobias, or be quite unable to function at most times. Though often mocked because these beliefs can seem so outlandish, paranoia is no joke, and it can destroy a person's chance to live normally.

How these delusions are treated may depend on the underlying condition. In many instances, medicines called anti-psychotics are used to help tame them and other symptoms like hallucinations, which may or may not be present. Mood stabilizers are used in the treatment of bipolar disorder to prevent cycling moods that might produce paranoid states.

Additional support through counseling is also needed. Although there may be a biological component to paranoid delusions, they may also spring from traumatic experiences, that when processed, help to produce more normalized thinking. No single treatment or single medicine is appropriate for all cases and significant work in therapy requires the cooperation of the person suffering from these delusions.

People suffering from what they believe to be paranoid delusions may want to begin by speaking to a psychiatrist, who can prescribe medication and provide initial or ongoing therapy. Should a delusion be so severe that it suggests a person might die or commit self-harm, he or she should immediately contact emergency services or emergency psychiatric services in his or her community to get the help. Of course, people who are suffering from delusions greatly believe in them, and they may be unwilling to take this step. When danger is suspected, friends or family are advised to try to help by getting in touch with professionals for advice.

The Health Board is dedicated to providing accurate and trustworthy information. We carefully select reputable sources and employ a rigorous fact-checking process to maintain the highest standards. To learn more about our commitment to accuracy, read our editorial process.
Tricia Christensen
By Tricia Christensen , Writer
With a Literature degree from Sonoma State University and years of experience as a The Health Board contributor, Tricia Christensen is based in Northern California and brings a wealth of knowledge and passion to her writing. Her wide-ranging interests include reading, writing, medicine, art, film, history, politics, ethics, and religion, all of which she incorporates into her informative articles. Tricia is currently working on her first novel.

Discussion Comments

By anon297431 — On Oct 15, 2012

I developed a mood disorder, mostly depression after my parents split up when in early teens. It caused me to be more and more isolated and deeply desperate yet unable to express it. I coped reasonably well through college. At 26 after a spree of uncharacteristic self-destructive behaviors, and I had a "breakdown".

Later, antidepressants or sleep deprivation helped me out of the depression, but worsened my relapse rate. Lamictal helps. Paranoia set in and at times I've said mean, dumb things. Now maybe I've a reason for hyper-vigilance but am unable to discern why.

By everetra — On Jun 01, 2011

@hamje32 - There are different types of schizophrenia. One person may have delusions of grandeur where another may simply have mood swings. The real challenge for doctors is to determine not only what kind of medical condition a patient has, but if it’s an illness at all.

For example, some of the paranoid symptoms resemble the actions of a normal person who embraces conspiracy theories. Here the doctor must be careful with his diagnosis. I think it takes more than one visit to make an accurate determination.

By hamje32 — On May 29, 2011

@NathanG - The delusion definition has unfortunately become muddled because of its use in pop culture. What most of the people in the general public know about paranoid symptoms comes from movies. We see films where the protagonist is misdiagnosed as a schizophrenic when in fact he is “normal,” but having some contact with the unseen realm. Think of the movie The Sixth Sense for example.

Hollywood has made it harder for people to understand what the real medical condition is, and of course it doesn’t help that we use the term flippantly like calling people “paranoid” at the drop of a hat.

By NathanG — On May 27, 2011

@allenJo - I had a friend who suffered from wild mood swings and could never hold down a job. He went to a psychiatrist and they put him on the bipolar medicines. It almost destroyed him, making his condition worse. He began to have wild schizophrenia delusions, and years later the doctor admitted that they had made his condition worse, and finally pulled him off the medication.

I agree these people need medication but we have to be careful not to quickly diagnose something as paranoid schizophrenia and immediately write a prescription.

By allenJo — On May 25, 2011

Unfortunately many people that we classify as paranoid schizophrenic are homeless people. They may demonstrate some of the paranoid symptoms described here. I would see them out on the street when I worked downtown. When I engaged them in conversation some of them would talk to me about the CIA being out to get them and that they were actually undercover agents, and weird flaky ideas that couldn’t possibly be rooted in reality.

I felt for these people and often wondered what caused them to snap. But it’s important that people who are truly mentally ill be treated, and not be shunned aside or thrown out on the street. You have to have the right medicine for the illness. Shelter is important, but medical treatment is what’s needed.

Tricia Christensen

Tricia Christensen


With a Literature degree from Sonoma State University and years of experience as a The Health Board contributor, Tricia...
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