5 Strategies for Dealing with Paranoia

Patient Expert

Here are a handful of strategies for coping with paranoia.

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.

Reality test if you are out in public with a friend or family member. Ask them what they think is going on. Alternatively, when you're out in public on your own and interacting with another person or within the area of 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 at the same you change your perception of the event.

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.

See the good in what's happening. If you're aware 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 that you have an illness. Thus they believe their paranoid thoughts are the truth.

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 takeaways about what it's like to have 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 and that was 10 years after I was diagnosed. Even in 1997 the paranoia was 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 because you wonder what the people around you are thinking about you. Like when I worked in the office jobs and thought the female co-workers were talking about me.

Related information on managing paranoia:

Common schizophrenia symptoms

Improving schizophrenia symptoms with cognitive therapy

Cognitive therapy techniques for depression that can aid paranoia too