What Causes Paranoia? – Forbes Health - Forbes

Paranoia is the distressing feeling an individual might experience when they believe, without evidence (or very little evidence), that someone wishes to do them harm. Fueled by anxiety and fear, an episode of paranoia causes individuals to believe there are very real threats to their well-being, even when there is evidence to the contrary.

While anyone may experience a moment of paranoid thinking, when episodes are severe and persistent, they may signal a serious mental health condition such as schizophrenia or paranoid personality disorder, says Elaina DellaCava, M.D., a psychiatrist at Weill Cornell Medicine and New York Presbyterian Hospital in New York.

"Paranoia has a range of severity. For some people, low-level paranoia can occur when under stress, when sleep deprived or after a traumatic event," says Dr. DellaCava. "It can occur in individuals living with dementia or who have had brain injuries, and can also occur in individuals who abuse recreational drugs or who are withdrawing from drug use."

Common examples of paranoid thoughts might include believing the following:

• People talking about you behind your back
• You're being tracked or spied on
• Others are working to diminish your image or character
• You're in danger of being physically harmed
• You are under the government's control

Non-Clinical Paranoia vs. Clinical Paranoia

Paranoia exists on a spectrum, from mild to severe. While many people may experience mild paranoid thoughts on occasion, others deal with more severe episodes with greater frequency. When one experiences paranoia at a more severe level, it may warrant a clinical diagnosis.

"We may all experience occasional bouts of paranoia, such as feeling watched or overly suspicious of others," says Harold Hong, M.D., a psychiatrist in Raleigh, North Carolina. "However, when these feelings become persistent and impact daily functioning, it may be a sign of a mental health disorder."

While Dr. Hong says it can be difficult to distinguish non-clinical paranoid thinking from a diagnosable disorder, there are a few important distinctions. The following are signs that you may need help from a mental health provider:

• Intense and irrational suspicions that are persistent over weeks or months
• Fixed beliefs that are inconsistent with reality and cannot be changed by evidence or logical reasoning
• A significant disruption in social, occupational, and/or other important areas of life functioning
• Experiencing significant emotional distress due to the paranoid thoughts and their consequences (e.g., negative impact on mood and behavior)

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