How To Overcome Paranoia

Dr Thanh-Tam Pham - 11/9/2018


Everybody has suspicious, unfounded mistrust or irrational thoughts from time to time but when they are persistent and excessive that they become a problem.

Paranoia is an unfounded or exaggerated distrust of others, sometimes reaching delusional proportions.

Paranoia may be a symptom in a number of mental conditions mainly in paranoid personality disorder, delusional paranoid disorder and paranoid schizophrenia but also in some degree in depression and dementia.

When you are paranoid, you assume that other people will exploit, harm or deceive you even if no evidence exists to support this belief.  You feel a sense of threat and fear that something bad will happen and other persons are responsible. You are in constant fear of being harmed:

-  psychological or emotional harm:  you are thinking that someone is spreading rumours about you, talking about you behind your back, discriminate against you. This can cause difficulties for you to function socially.

- physical harm: you may have the feeling of being watched, followed or monitored or there may be some kind of conspiracy operating to get and kill you (persecutory delusion). This can lead to fear of going out and hypervigilant behaviour.

-financial harm: you are suspicious that people are trying to trick you to get your money or try to steal from you. This will cause problem in forming a business relation.

I have seen many elderly patients with dementia who are so paranoid that they tried to hide their personal belongings and they forget where they put them and blame on their carer to steal from them. One patient even thought that someone stole her dentures.

- fear of being betrayed: you may have recurrent suspicions without reasons that your partner is being unfaithful. This will cause relationship problem as you become possessive and try to control your partner’s movements.


Possible causes of paranoia

-         Genetic study is inconclusive that genes are the cause of paranoia

-         Certain drugs such as cocaine, marijuana, amphetamine can alter brain chemistry and can bring on paranoid thoughts, feelings and behaviour.

-         Traumatic life events: abuse in childhood may distort the way a person thinks and feel throughout life.

-         A combination of factors: genetic and environmental factors may cause paranoia.

Self help treatment

The symptoms may range from mild to delusional beliefs. In the scope of this discussion, we only focus on the mild paranoid belief and you have to seek professional help with a psychiatrist or a psychologist for the treatment of the more severe paranoia.

Treatment for paranoia depends on the underlying cause. Stopping the use of alcohol and drugs can be the first step and may solve the problem altogether.


1- Recognize that you have paranoid thinking:

Many people with paranoid beliefs do not recognize that they have unfounded mistrust toward other people. They often have problems with close relationships. Some with mild paranoia may function normally in the society but they may be more on the defensive and be more aggressive and argumentative. Because of their unfriendly behaviour, people will respond to them accordingly and it will further convince them that they are right in their belief that everyone is not to be trusted.

The symptoms are:

-         Be easily offended and not cope with any type of criticism

-         Find it difficult to trust others

-         Assign harmful meanings to other people’s remarks

-         May view someone else’s accidental behaviour as though it is with malicious or threatening intent

-         Not being able to compromise

-         Find it difficult if not impossible to forgive and forget

-         Assume that people are talking behind their back

-         Be overly suspicious, thinking that other people are lying or scheming to cheat them

-         Not being able to confide in anyone

-         Consider the world to be a place of constant threat filled with bad people

-         Feel persecuted or believe in unfounded conspiracy theories

-         Isolate themselves in order to avoid situations that may frighten them or judging them.


2- Practice mindfulness:

You need to practice mindfulness that is seeing things as they are in front of you without much interference from your subjective thinking.

You may have a past experience of physical or emotional abuse and you now believe that you cannot trust anyone else in this life.  You have to let go of the past otherwise you let the past controlling your present life and you are actually helping the previous perpetrators to harm you more and more. You have to regain the control of your own life by accepting the past injury was already done and nothing you can do to change it but you can now change your thinking to avoid further harm to be done to your current life.

What you see is what it is and do not put more of your interpretation to the meaning of what you see by using your past experience or your projection towards the future that is not there as yet. This will distort the reality. Try to collect objective information about the reality and not assign harmful meanings on whatever you see using your own imagination.


3- Have an insight about yourself:

Practice mindfulness will give you an insight and acceptance about yourself. You may have a problem with low self-esteem and low self-confidence that may be the cause of your fear of being harmed by other people. If you are confident about yourself you will not be fearful about who are out there that try to harm you. You will deal with the problem as it comes and you do not need to anticipate that people will cheat, talk behind your back.

Practice Vipassana meditation:

It involves simple observation and awareness of the changes in breathing and the perpetual changes of the body and the mind. You learn not to react to the thoughts and sensations that come and go and you can understand that nothing is permanent.

Everything in life is impermanent that is everything is changing including your perception about yourself, your low self-esteem and low self-confidence.


5- Cultivate empathy and compassion.

You will see that most of the thoughts that come into your mind are thoughts about future harm, that people are generally bad, untrustworthy.

You may have resentful emotions towards others and you are unable to understand and connect with other people’s feelings. You therefore are unable to have empathy toward others.

You have to see that you and everyone else are all human beings that come into this life with good and bad seeds and we are equal in term of suffering.

If you cultivate the good seeds and do good deeds for other people you will see that people will be kind and loving toward you. But if you have bad thoughts about others, you are actually stimulating and cultivate their bad seeds to show to you.

You can practice loving kindness meditation. The practice always begins with developing a loving acceptance of yourself. If you may find feelings of unworthiness, of self-doubt or negativity, you have to accept them without any judgement or criticism. It is like if you see that your own child has all the imperfections, you still love your own child any way. It will help you to develop loving kindness toward yourself.

If you do not have loving kindness towards yourself, it is impossible to develop loving kindness to other people. Loving kindness is therefore the antidote of paranoia.