What is Paranoia and When Does it Become a Problem?

In this edited excerpt from An Introduction to Coping with Paranoid Thoughts, authors Katie Pownell and May Sarsam help us to understand what paranoia is, and when it can become problematic.

We have probably all come across the term ‘paranoia’. It is a commonly used word because paranoid thoughts are quite common. Paranoia is the experience of feeling strongly suspicious or mistrustful about people, things or the world, when most other people around us do not feel there is a good enough reason to feel that way. It can involve us holding beliefs that others are trying to harm us in some way, or are talking about us, laughing at us, know things about us, or are planning something against us. The beliefs can be very strong, and people who are experiencing paranoia can feel that they are absolutely true, beyond a shadow of a doubt. Even if we have an awareness that our paranoia might not be entirely based in reality, the thoughts can be incredibly distressing, and can have a major impact on our quality of life.

Common examples of paranoid thoughts are:

• people are talking or laughing about you behind your back
• others are trying to harm you in some way
• you are at risk of being harmed, or your life is in danger
• people are deliberately trying to trick, upset or annoy you
• you are being watched or targeted by other people or agencies
• people are trying to steal from you in some way
• others are using double meanings to threaten you

Research has shown that paranoid thinking happens across a range or ‘continuum’, with very common experiences at one end, like suspiciousness when something unusual happens, to very strongly held, specific beliefs at the other, less common end, for example thinking that someone intends to do you serious harm.

The intensity of the paranoid thoughts can also range from mild to severe. For most people, the thoughts might come and go quickly; we can dismiss them without too much effort, and they cause little distress or impact on our lives. For some people however, the thoughts really bother us; they stick around, we tend to spend a long time paying attention to them and they can start to have a big impact on our day-to-day functioning. 

It is important to consider whether our thoughts might be accurate, and based on real concerns, evidence or threats. How can we tell? Beliefs are described as ‘paranoid’ when they don’t seem to fit in with what other people around us think is a reasonable concern, even when those other people have access to the same information or evidence that we do. Paranoia becomes a problem when those thoughts, concerns and beliefs start to get in the way of us living a normal life. 

Paranoid thoughts tend to involve four elements:

• something harmful could happen to us or those we care about
• someone or something is deliberately intending to cause that harm
• the idea is difficult to dismiss and keeps coming up
• other people around us don’t agree with our assessment of what is happening

The impact of paranoia varies from person to person. Some may be able to continue as usual with their lives and find that they are only affected at certain times or in certain situations. However, for others, the paranoia becomes quite influential in their lives and limits them in a number of ways. For example, we may begin to avoid certain places or people, or may change some of our usual activities or behaviours. This can make relationships with others harder to keep going, which can leave us feeling isolated, or even result in more anxiety or worry about what others around us might be thinking. 

Struggling with paranoia might also result in us feeling cut off, lonely and alone with our experiences, which can be upsetting. As well as this, having a belief that we are in danger prevents us from living our lives in the way that we would like to, which might result in us feeling sad or hopeless about the future. Frustratingly, all these impacts can increase our stress levels considerably, which in turn can increase the frequency of our paranoid thoughts, and so again the cycle continues.