Paranoia and Anxiety: Are they Related

Community Member

(Somebody's watching me)

And I have no privacy

Whooooa-oh-oh (I always feel like)

(Somebody's watching me)

Tell me, is it just a dream

When I come home at night

I bolt the door real tight

People call me on the phone

I'm trying to avoid

But can the people on TV see me

Or am I just paranoid?

Lyrics to Rockwell's "Somebody's Watching Me"

Many of you have probably heard this song before, Rockwell's one hit wonder of the 80s, Somebody's Watching Me. Every time I hear it I think of how difficult it must be to have paranoia. Although this song was meant to be entertaining, for the person who suffers from paranoia, intrusive thoughts of persecution and fear are anything but entertaining. They can be downright disabling.

I have some experience as a witness to the horrific effects of full blown paranoia. I grew up with a mother who has paranoid schizophrenia.   I can tell you from my experience that stress and anxiety always fueled my mother's paranoid episodes and subsequent breaks from reality. During these times logic flew out the window. Reasoning and rationality on my part only served to make my mother cling onto her delusions with a heightened ferocity. If I did not "believe" that there were aliens on our roof or that my dead grandmother had faked her own death and was trying to poison us, I was considered the enemy. My own identity was often questioned when my mother would accuse me of being an imposter. Just try to prove that you are really you to someone who thinks you are tricking them. It would be a difficult feat for anyone let alone a child.

The one thing I learned about paranoia growing up is that it is hell for the person experiencing it and for the individual's family. If paranoia was a beast it is an animal born from raw fear and terror. It jacks up that flight or fight instinct to unimaginable levels. Anxiety fuels, feeds, and sustains paranoia. Likewise, paranoia can cause anxiety and panic. It raises the question of which is the cause and which is the effect?

Is paranoia a symptom or a co-existing condition of anxiety? Can paranoia be associated with other psychiatric conditions?

In reviewing the literature there is no clear-cut consensus on how to answer this first question. Certainly not everyone who suffers from anxiety will experience paranoia. But it is true that those who have a paranoid episode will experience stress, fear, and anxiety.

Mainly we think of schizophrenia when we speak of paranoia but paranoia can co-occur or be a symptom of a wide variety of mental and medical illnesses.

Here are just some of the disorders which can be associated with symptoms of paranoia:

  • According to authors Freeman and Garety (2006) precursory paranoid delusions can occur in patients having depression, mania, post-traumatic stress disorder, dementia, and epilepsy.

  • Paranoia can also be present in diagnoses of Brief Psychotic Disorder, Delusional Disorder, Alcohol and other Substance Abuse or Dependence, Agoraphobia, and Obsessive-Compulsive Disorder (American Psychiatric Association).

Does one have to be psychotic to experience paranoia?

As you can see from the list above, in the broadest of definitions, paranoia does not have to mean that you experience a break from reality. Paranoia exists on a continuum. We all have our paranoia threshold if you will. Everyone has had times when they have felt more suspicious of other's motivations. Sometimes these fears turn out to be valid as when you suspect that your boss is lying about how well the company is doing and then you come to work one day and find that half of your co-workers have been let go. Sometimes what we may label as "paranoia" may be a honed sense of picking up cues from our environment which may pose a threat. There is a big difference between being cautious and observant of others and your environment and thinking that people are plotting against you through your TV set. The continuum of what we label as paranoid behavior is wide.

Paranoia may also be more common than we think. A review of 15 studies (Freeman, 2006) shows that: ""the rate of delusional beliefs in the general population is higher than that of psychotic disorders and that delusions occur in individuals without psychosis."

Other research shows that one in three people in the UK regularly suffers from paranoid or suspicious fears, leading experts to surmise that paranoid thoughts may be as common as depression or anxiety.

What is paranoia?

If you look in the literature for a definition of paranoia you are going to discover a wide variance of definitions. The basic gist of it however, is that the individual with paranoia feels that others have hostile or aggressive motives. The person suffering from paranoia may be fearful that others are deceptive, not to be trusted, and pose some sort of threat. As we have discussed in this post, everyone has times where you feel more guarded or even suspicious of others. But when one cannot distinguish between reality (sometimes people do talk about me but it isn't always bad things they are saying) and delusion (the CIA has hired special assassins to kill me because I am the coming of Christ) then you may be dealing with paranoia as part of psychosis.

Yet whether your paranoia is mild and non-delusional or part of a full blown psychotic break, stress and anxiety are always the fuel which sets paranoia ablaze. And once it begins it is an awfully difficult fire to put out.

In a future post we will discuss why paranoia is so prevalent in our society and how to prevent paranoid thoughts from becoming intrusive and entrenched.

Do any of you experience paranoia as part of your anxiety? How have you coped? Do any of you have a loved one with paranoid thoughts or tendencies? What is that experience like for you? Tell us your story. We want to hear from you

For more information about paranoia please refer to the following Health Central articles and resources: