What Are Paranoid Delusions?

Key Takeaways

• Paranoid delusions involve irrational thoughts and fears that someone is being persecuted.
• People with these delusions may become angry or hostile when challenged about their beliefs.
• Paranoid delusions can be caused by schizophrenia, bipolar disorder, or other mental health issues.

Paranoid delusions are a symptom of psychosis. They involve irrational thoughts and fears that one is being persecuted. A person with paranoid delusions may believe that others are conspiring against them or spreading rumors about them, or even think that their partner has been unfaithful when there’s no proof.

Paranoid delusions can be associated with disorders such as schizophrenia and bipolar disorder.

Paranoid delusions are sometimes considered to be “bizarre” delusions because the content of the delusion can be very strange and completely implausible. This differs from non-bizarre delusions, such as believing that your house might be broken into soon or that someone might want to hurt you.

They may also lose touch with reality and see themselves as persecuted by the people around them. In many cases, it’s difficult to be close with someone who has paranoid delusions, because they often worry about their loved ones turning against them.

What Causes Paranoid Delusions?

There are various factors that can cause paranoid delusions, such as the following:

Sometimes, paranoid delusions are not linked to another cause and are diagnosed as delusional disorder. But, most of the time paranoid delusions are associated with a primary mental illness.

What Is an Example of a Paranoid Delusion?

There are many types of paranoid delusions. Below are some examples:

• Delusions of persecution: A belief that others want to cause harm or injury to you or someone close to you. For example, a woman might think she is being followed by a stranger who wants to kill her.
• Delusions of reference: Beliefs that certain events and happenings are directed at oneself; for example, a song on the radio is about you.
• Delusions of grandeur: Belief that one possesses special powers or talents that other people don’t have; for example, a woman might believe that she has exceptional artistic and musical abilities.
• Delusions of control: Thoughts that the actions of others are being controlled by some outside force; for example, a man might believe that the news media are poisoning his food.
• Delusions of being watched: The belief that others are always watching you or monitoring your behavior; for example, a woman might think she’s being videotaped while inside her home.
• Delusions of jealousy:The belief that your partner is being unfaithful when there’s no proof; for example, a man might believe his girlfriend is cheating on him without any evidence to support this belief.

What Are the Symptoms of Paranoid Delusions?

There are a number of signs and symptoms that may indicate a loved one is experiencing paranoid delusions:

• The individual holds persecutory beliefs (the belief or conviction that they’re being attacked, harassed, cheated, persecuted, or followed). They may be guarded, secretive and suspicious toward others. They may believe that others are trying to poison or drug them, spy on them, attack them, or plot against them.
• The individual experiences auditory hallucinations (hearing voices), which typically support, reaffirm, and perhaps even exaggerate the delusional beliefs; for example, they might hear a voice telling them that their partner is cheating on them. They may also have delusions related to their hallucinations, for example, they might believe that the television or radio broadcasts their thoughts.
• The person has trouble distinguishing between reality and fantasy. These symptoms are usually associated with psychotic disorders such as schizophrenia.
• The person displays disorganized thinking, leading to rambling narratives in conversation, illogical patterns of reasoning, or unpredictable changes in the topic during conversation.

Can You Get Rid of Paranoid Delusions?

Paranoid delusions can be caused by a number of factors including brain injuries and mental health conditions.

These symptoms are usually best treated with a combination of medication and psychotherapy, which is also known as “talk therapy.” With treatment, most people show some improvement in their condition.

Treatment for Paranoid Delusions

If you or a loved one is experiencing symptoms of paranoid delusions, talk to your doctor as soon as possible. The earlier they’re diagnosed, the earlier treatment can start. A doctor will use an exam and lab tests to rule out medical conditions that may be causing symptoms.

If paranoid delusions are the result of substance abuse, detoxification may help lessen symptoms. If there’s no clear cause for them and they are not due to drug or alcohol use, you may be diagnosed with a mental health condition such as schizophrenia or bipolar disorder.

Medications are available to reduce symptoms of delusions and other symptoms that occur in conditions like schizophrenia and bipolar disorder. One type of drug that helps treat these disorders is called antipsychotic medication (also known as neuroleptic drugs). These work by changing the activity of certain chemicals in the brain that affects mood or thought.

If you have paranoid delusions, you may not want to take medication because you don’t believe that your symptoms are due to a mental health condition. You may need to start treatment against your wishes, but only if the safety and well-being of yourself or others are at risk.

You may also be offered counseling to help with underlying problems. This can include talking therapies or family therapy. A therapist will work with you to identify the cause of your paranoid delusions and offer tools to cope with them. Therapy can also help improve your mental well-being so that your symptoms are reduced.

How to Help Someone With Paranoid Delusions

If you know someone with paranoid delusions, there are several things you can do to help:

• Offer support. Let the person know that you’re willing to listen if they want to talk. Show interest in their fears and worries so they don’t feel judged or isolated. Avoid patronizing them, which will only reinforce their feeling of being judged by others.
• Reassure them when they’re in the company of others that you’re there for them and willing to help if needed. You can also offer to accompany them when they need to go out, in order to provide further reassurance.
• If the person with paranoid delusions is receiving treatment, encourage them to continue taking their medication. You can also offer to accompany them on visits to their therapist or doctor. This will show support and help them to feel safe discussing concerns.
• Join a local or online support group. This can help you find helpful resources, as well as meet people who are experiencing similar problems. You can also offer support to others who are coping with paranoid delusions.
• Help them find stress relief. Relaxation exercises like mindfulness meditation can be useful in managing stress and anxiety, which may make symptoms more manageable. You can help by encouraging the person to take up a relaxation exercise or joining them for yoga classes, for example.
• Be understanding. While it’s important to be supportive, you also need to respect that they may not want help or advice. Remember that there is no “right” way for someone with paranoid delusions to be feeling and behaving.

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

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By Arlin Cuncic, MA

Arlin Cuncic, MA, is the author of The Anxiety Workbook and founder of the website About Social Anxiety. She has a Master’s degree in clinical psychology.

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