Paranoia: Definition, Symptoms, Characteristics, Criteria, Causes and Treatment

While there is no evidence to support their beliefs, people with the disorder believe they will be exploited, harmed, or deceived by others.

People with personality disorders, such as paranoia, are generally suspicious of others.

They are almost always suspicious of other people’s intentions, sometimes even thinking that their motives are evil.

It is usual for people to have a certain amount of paranoia in some life situations, such as worries about being fired from work.

However, people with the disorder are very concerned, causing it to permeate all areas of their lives, including their professional and personal relationships.

People with the disorder are generally difficult to understand and have trouble with close relationships.

Their extreme distrust, as well as resentment and hatred towards other people, can result in repeated arguments and complaints of hostile indifference towards others.


They are overly vigilant for potential threats, causing them to act cautious, covert, or seemingly dishonest.

This makes them appear cold and without any warm feeling.

Their expressions will generally show hostility, inflexibility, and bitterness.

The way they relate: belligerent and suspicious, usually elicits a hostile reaction from other people and validates their original expectations of others.

Paranoia is diagnosed more often in men than in women.

Paranoia can develop in anyone like other mental illnesses: rich or poor, educated or not, and famous or unknown.

Paranoia is a persistent and irrational feeling that people are “about to catch you” or are constantly being watched or listened to.

The three main types of paranoia are paranoid personality disorder, delusional (paranoid) disorder, and paranoid schizophrenia.

The goal of treatment is to reduce paranoid symptoms and improve the ability to function.

Mild paranoid thoughts can be pretty common in the general population and are usually short-lived and harmless.

In clinical paranoia, people believe that others are trying to harm them or are willing to get it.

Symptoms and characteristics

There are three critical characteristics of paranoid thoughts.

When the patient has paranoia, they may fear that something terrible will happen, think that other people or external causes are responsible for how they feel, or have beliefs that are exaggerated or unfounded.

These thoughts are persistent and completely irrational.

Paranoid people also sometimes have a high sense of self-importance and feel that people pay attention to them.

This distrust of others can make it difficult for people with paranoia to function socially or have close relationships.

Paranoia can be a symptom of several conditions, including paranoid personality disorder, delusional disorder (paranoia), and schizophrenia.

Criteria of the Diagnostic and Statistical Manual of Mental Disorders

When patients are concerned about their paranoia symptoms and seek medical help, the doctor will first assess their physical condition.

Paranoid symptoms can be caused by dementia; for example, if the medical evaluation does not identify a physical source for the signs and the patient is not using illicit drugs, a psychiatrist conducts a mental health evaluation.

The psychiatrist will use specially designed interview and assessment tools to evaluate the patient for a personality disorder.

A paranoid personality disorder is part of a group of mental health disorders called Group A personality disorders, which are characterized by abnormal and distorted thinking, and include Schizoid Personality Disorder and Schizotypal Personality Disorder.

People suffering from paranoia exhibit relentless, albeit unwarranted or irrational, mistrust and suspicion of others.

Typical expressions for a paranoid include:

According to the DSM-5, which is published by the American Psychiatric Association, four characteristics of the following criteria must be present to diagnose an individual with paranoia.

  • You think other people are using you, lying to you, or hurting you, but there is no proof.
  • You have doubts about the faithfulness and trustworthiness of other people.
  • Do not disclose any information to others due to the belief that the trust will be betrayed.
  • Please read the comments of others, even when they are pronounced in a friendly way, as hurtful or threatening.
  • Hold a grudge.
  • Without any evidence, you believe that your reputation is being attacked by others and will turn against them somehow.
  • You feel jealous and suspect that your partner is unfaithful to you for no reason.
  • Hypervigilance to physical, verbal, or social attacks.
  • Few, if any, close or intimate relationships.
  • It is shown as cold, distant, and argumentative.
  • Complains frequently.
  • It seems reserved.
  • He seems rational, logical, and unemotional but will be sarcastic, uncompromising, and unfriendly at times.
  • Has difficulty getting along with others.
  • It does poorly in group setups and team projects.
  • Very critical of others.
  • The response to criticism is found with hostility and opposition.
  • Extreme need to take care of yourself due to mistrust of others; very independent due to suspicion.

Causes of paranoia

While the cause of paranoia is unknown, researchers believe that a combination of biological and environmental factors can lead to it.

The disorder is most often found in families with a history of schizophrenia and delusional disorders.

The characteristics of paranoia can be seen in childhood and adolescence.

Trauma in early childhood can contribute to the development of paranoia.

Children can behave strangely, resulting in teasing from others.

According to the American Psychiatric Association, questions arise about a premorbid condition.

For example, a child who acts abnormally and is later rejected by his peers may learn to distrust others and be suspicious of their intentions.

It can be a contributing factor to the development of a paranoid personality.

Some causes are:

Delirium (10%)

This is a prevalent condition of “worse than normal” mental function, often brought on by the stress of serious illness, surgery, or hospitalization.

Drugs, alcohol, and other toxins (11%)

Medication side effects can cause delusions, hallucinations, or other forms of psychosis.

Particular attention should be paid to medications known to affect memory and thinking.

Abuse or withdrawal from alcohol or other substances can also cause symptoms of psychosis.

Disease (10%)

Many physical health problems can interfere with brain function.

These include electrolyte problems such as abnormal sodium, potassium, calcium, or magnesium in the blood, low levels of vitamin B12 or folate, thyroid problems, severe liver or kidney dysfunction, infections, and neurological diseases.

Brain damage from minor strokes can also cause symptoms of psychosis.

Depression (33%) and other ‘mood disorders’, including bipolar illness (5%)

About 15% of people with major depression may experience psychotic symptoms.

Delusions of guilt or deserved punishment are widespread.

Dementia (40%), including Alzheimer’s disease, Lewy body dementia, and others

Delusions are widespread in dementia, especially delusions of stealing, marital infidelity, abandonment, and persecution.

Hallucinations (incredibly visual hallucinations) are also common, especially in Lewy body dementia.

Delusional disorder (2%) and schizophrenia spectrum disorders (1%)

These two conditions have many symptoms that overlap with dementia, delirium, or other conditions that affect thinking.

Doctors must exclude these more common conditions before diagnosing a person with schizophrenia or delusional disorder.

Schizophrenia affects approximately 0.1-0.5% of people over 65.

Many were diagnosed earlier in life, but some people can develop the disease later.

The delusional disorder affects approximately 0.03% of older adults.

Treatment for paranoia

People with paranoia often do not seek help.

They believe that they are not the ones who have the problem but that everyone else is in disarray.

Treating people with paranoia is problematic because, in their critical and litigating minds, they see flaws in others but cannot see their problem behavior.

Medication benefits some patients with paranoia.

Certain anti-anxiety medications, antidepressants, and antipsychotics can effectively treat patients with extreme symptoms or an associated psychological disorder, such as depression or anxiety.

Treatment can effectively control paranoia, but it can be difficult because the individual may have suspicions about the therapist. However, if left untreated, the disorder will be chronic.

Many consequences of the disorder may need to be addressed, such as the loss of a job and housing and the disruption of family relationships.

Extra help from programs like family self-help, housing services, and professional assistance can help ease the stress of PPD symptoms.

Psychotherapy is the best treatment method for PPD because, many times, people with the disorder have ingrained problems with interpersonal functioning.

Treatment of paranoia depends on the underlying cause, and sometimes simply stopping alcohol or recreational drug use cures the problem completely.

However, many people with paranoia may have difficulty accepting treatment, so it can take a long time for recovery to occur.

While there is no absolute cure for conditions that cause paranoia, treatment can help people cope with their symptoms and live happier and more productive life.

Treatment depends on the type and severity of the condition but may include medications (anti-anxiety medications or antipsychotics can relieve some of the symptoms).

However, people with paranoia can often refuse to take medication because they fear it will harm them.

Medication is the primary treatment for psychosis, schizophrenia, or delusional disorders.

Psychotherapy, including cognitive behavior therapy, can help people cope with their symptoms and improve their ability to function.

This can be especially helpful in people with mild paranoia or paranoid personality disorder.

Coping skills can also be taught, such as relaxation therapy, techniques to reduce anxiety, and behavior modification.

Patients who are in treatment often decide to end it too soon.

Most people with paranoia experience their symptoms throughout their lives and need sound therapy.

Hospital admission, in severe cases, is sometimes necessary until the condition causing the paranoia stabilizes.