A young man in an office peers through blindsParanoia is an unfounded belief that something bad is happening (or going to happen). Often, an individual experiencing paranoia will be suspicious of another person or group. The person may believe the other party is hostile and acting against them. Others tend to perceive the person’s sense of threat as exaggerated and “illogical.”

Paranoia tends to be a symptom of a mental health condition rather than a diagnosis in itself. Paranoia can also occur outside of any mental health issues. When paranoia interferes with daily life, a therapist can provide support

What Is Paranoia?

Paranoia is a belief that one is under threat despite a lack of evidence. A person may exaggerate the likelihood of certain risks and feel the need for increased caution. They may mistrust public figures, organizations, loved ones, or all strangers. Someone with paranoia will likely hold at least one of these common beliefs:

  • Others are deceiving or betraying them.
  • Others are subtly insulting or threatening them by using innuendos, hints, or code words.
  • An outside force is monitoring them.
  • An outside force is controlling them (mentally or physically).

When Does Paranoia Become A Concern?

Mild paranoia is fairly common. Around one third of people will experience non-clinical paranoia at some point in their lives. Someone with mild paranoia may realize their fears are unlikely to have much basis in reality. Yet they may still lend some credence to their suspicions. For example, a person who isn’t invited to a party may wonder if her friends are conspiring to exclude her, even though deep down she knows that scenario is unlikely.

Paranoia can grow more intense over time. The severity of paranoia is often measured by:

  • How much the person believes the paranoid thoughts. (When a person’s beliefs persist despite evidence to the contrary, they qualify as delusions.)
  • How often the person thinks about the paranoid beliefs.
  • How much the paranoid thoughts upset the person.
  • How much the paranoia interferes with the person’s day-to-day activities.

In general, paranoia becomes a concern when it affects one’s quality of life. If the person believes they are in danger, they can develop severe stress. Their paranoia may cause them to mistrust others, reducing their support network and preventing them from getting objective viewpoints. Without treatment, a person’s well-being may continue to decline.

What Causes Paranoia?

Paranoia often develops as a result of multiple factors rather than one single factor. Potential causes of paranoia include:

  • Trauma: Individuals who have endured prolonged periods of stress, such as military veterans, are more likely to develop paranoia. Childhood neglect and abuse can also increase one’s risk of paranoid thinking in adulthood.
  • Pre-existing mental health concerns: Anxiety or depression can worsen paranoid thinking. Someone with these conditions may be prone to interpreting events in a negative light.
  • Isolation: Paranoid thoughts seem to be more common among individuals who feel isolated from their community. This sort of isolation can occur in both urban and rural areas.
  • Lack of sleep: A 2008 study examined a group of 30 people with persecutory delusions (a type of high-level paranoia). Over half of participants experienced moderate or severe insomnia
  • Substance abuse: Certain drugs can cause paranoia, including cannabis, alcohol, cocaine, steroids, and amphetamines. Withdrawal from such drugs can also prompt paranoid thoughts. 
  • Neurological issues: Paranoia may be a symptom of neurological conditions such as dementia, Huntington's disease, or Parkinsonism. It can also occur after a stroke or brain injury. 
  • Genetics: A 2014 twin study found paranoia symptoms have a heritability of 50%. In other words, genetics may be responsible for 50% of the differences in paranoia levels across the population.

Am I Paranoid?

Not all suspicions are paranoia. For example, if a person is part of a persecuted minority group, then it is not unreasonable for them to assume others are discriminating against them. Likewise, someone in a war zone may very well be in danger from an unseen sniper. 

Context is often key in distinguishing between paranoia and justified suspicion. If you aren’t sure if your specific fear is paranoid, consider the facts. How much evidence is there for your belief being true? Statistically, how likely is your fear to occur? Is there any evidence against your belief that you may be ignoring? 

If you are having trouble getting an objective view or cannot trust the people around you to speak honestly, a therapist can serve as a third-party opinion. A therapist is legally bound to keep your communication confidential, so you do not have to worry about your fears being used against you. A therapist can listen to any and all thoughts without judgment.


  1. Foster, C. (2016). Understanding paranoia. Retrieved from https://www.mind.org.uk/media/5274193/paranoia.pdf
  2. Freeman, D. & Freeman, J. (2014, October 1). What causes paranoia, hallucinations, and grandiose ideas? The Guardian. Retrieved from https://www.theguardian.com/science/2014/oct/01/paranoia-hallucinations-grandiose-delusions-schizophrenia-environment-genes
  3. Paranoia and delusional disorders. (n.d.) Mental Health America. Retrieved from http://www.mentalhealthamerica.net/conditions/paranoia-and-delusional-disorders