5 Strategies for Dealing with Paranoia

by Christina Bruni Patient Expert

Paranoia is a common symptom of schizophrenia. In fact, paranoid schizophrenia is the most common type of the disorder. Paranoia usually involves thoughts that something bad is going to happen to you. The thoughts are typically ungrounded, or if based on an event, are highly exaggerated. Suspicions include a fear of being exploited or harmed by others and doubts of loyalty among loved ones. A person with paranoia may perceive personal attacks from a passing comment and often holds on to grudges from past hurts.

Coping with paranoia includes a range of strategies. Here is a list to start with.

1. Take your medication every day as prescribed. Talk to your doctor about what you can do if you experience a side effect. Upwards of 75 to 85 percent of individuals diagnosed with schizophrenia require long-term medication. Often, a side effect can be stopped or minimized by changing the dosage, timing, or other changes.

2. Use a friend or family member to test your reality when out in public. Ask them what they think is going on. Alternatively, when you're out in public on your own and interacting with another person, ask yourself if there can be an alternative reason why something happened or a person acted a particular way. This involves dialectic thinking - accepting what's going on while simultaneously changing your perception of the event.

3. Develop a strong sense of self. Case in point: I was in the Washington Square Restaurant having lobster ravioli. I took out my pill box and took my pills. A guy at the table to the left of mine said something to his friends. I didn't care what he said even though I decided he was talking about me. You can simply choose to live with how you feel about it instead of beating yourself up for feeling that way.

4. See the good in what's happening. If you're aware that your thoughts are paranoid and might be unfounded, you have insight into what's going on. Upwards of 50 percent of individuals diagnosed with schizophrenia have anosognosia, a symptom that is a lack of awareness of your illness or any related issues. Thus, they believe their paranoid thoughts are the truth.

5. Develop an exit strategy or secret code. If you're with someone when the paranoia gets totally unbearable, use a code to bow out of the event. Tell your good friends in advance that you might start to feel unwell and will tell them when you need to go home. If you're in public and don't want to talk about the symptoms, use a code like "I'm getting a migraine. Can we leave?"

A few hopeful things to take away about paranoia:

  • Medication can reduce the effect of symptoms and in some cases totally stop symptoms.

  • The better able you are to minimize the effect of the symptoms, the easier it will be to function every day.

  • Things can get better as you get older. I went back to school in 1997, 10 years after I was diagnosed. The paranoia was still there, yet over time it faded. After finding a job in a library in 2000 when I was 35, I rarely experienced it.

  • Find the job you like and would be good at regardless of whether it's paid employment. In the right environment, you will flourish. Environment does have a big impact on symptoms. If you're cut off from what gives you joy, you will continue to harbor paranoia and wonder what the people around you are thinking about you. Seek the right job.

Christina Bruni
Meet Our Writer
Christina Bruni

Christina Bruni wrote about schizophrenia for HealthCentral as a Patient Expert. She is a mental health activist and freelance journalist.