Insights into Psychology

What Is… Paranoia and Paranoid Delusions?

Insights into psychology: Paranoia

In this series, I dig a little deeper into the meaning of psychological terms.  This week’s term is paranoia.

Kind of like anxiety and depression, the word paranoia often gets tossed around fairly loosely in common parlance, but in a psychological/psychiatric sense it has far more significance. Google Dictionary defines paranoia as:

a mental condition characterized by delusions of persecution, unwarranted jealousy, or exaggerated self-importance, typically elaborated into an organized system. It may be an aspect of chronic personality disorder, of drug abuse, or of a serious condition such as schizophrenia in which the person loses touch with reality.

It also gives this subdefinition:

suspicion and mistrust of people or their actions without evidence or justification

Wikipedia differentiates paranoia from phobias and other irrational fears, as paranoia contains an element of blaming other(s)  Someone who’s paranoid may also be likely to attribute greater significance to coincidences.

Psychosis and paranoia

Paranoid patterns of thinking can occur outside of psychosis, but paranoia is perhaps most commonly recognized as being the basis of paranoid delusions.  Delusions involves beliefs that are not based in reality but are firmly held onto despite all evidence to the contrary. Delusions are a type of psychotic symptom, as are hallucinations. 

Paranoid delusions occur in illnesses like schizophrenia and schizoaffective disorder, but may also occur in other illnesses including mood disorder.  Drugs, particularly crystal methamphetamine, can also trigger paranoid delusions.

Paranoid personality disorder

Paranoia may also occur in the context of paranoid personality disorder.  Someone with paranoid PD isn’t delusional, but they have a longstanding pattern of suspicion and mistrust.

Wikipedia lists the following DSM-5 symptoms of paranoid personality disorder:

  1. “Suspects, without sufficient basis, that others are exploiting, harming, or deceiving them.
  2. Is preoccupied with unjustified doubts about the loyalty or trustworthiness of friends or associates.
  3. Is reluctant to confide in others because of unwarranted fear that the information will be used maliciously against them.
  4. Reads hidden demeaning or threatening meanings into benign remarks or events.
  5. Persistently bears grudges (i.e., is unforgiving of insults, injuries, or slights).
  6. Perceives attacks on their character or reputation that are not apparent to others and is quick to react angrily or to counterattack.
  7. Has recurrent suspicions, without justification, regarding fidelity of spouse or sexual partner.”

Five subtypes of paranoid personality disorder have been identified by psychologist Theodore Millon: obdurate, fanatic, querulous, insular, and malignant.  May I just say, I absolutely love his word choices.

Other subtypes of paranoia in general that have been identified include erotic, persecutory, litigious, and exalted.

Associated psychological biases

According to Wikipedia, social circumstances have a significant influence on the tendency to develop paranoia.  Feelings of powerlessness, external control over one’s circumstances, and victimization can contribute to paranoia, and lower socioeconomic status can heighten these effects.

Three key psychological biases tend to accompany paranoia.  The sinister attribution error involves overestimating the untrustworthiness of others.  There is a disproportionately self-referential perspective on social interaction, and the actions of others are seen as being particularly directed at the paranoid individual.  There is also an exaggerated perception of conspiracy, with an overestimation of the likelihood that others’ actions are coordinated against the paranoid individual.

Conspiracy theories

So, you’ve got paranoid delusions as a psychotic symptom, paranoid personality disorder, and what else?  Well, that’s where we find Alex Jones of Info Wars.  He’s a conspiracy theorist, and he’s pretty out there, to the least.  While he may have a psychiatric condition, it’s very possible that he’s just a run of the mill non-psychiatric nutbar with non-clinical paranoia.

Paranoia can show up in different ways, and keep in mind that the word itself may not capture those nuances.  There’s a big difference between paranoia as in schizophrenia and paranoia as in Alex Jones.  And personally, I’d much rather spend time with someone who’s psychotically paranoid than with someone who is conspiracy theorist paranoid.

You can find the rest of the what is… series in the Psychology Corner.


book cover: Making Sense of Psychiatric Diagnosis by Ashley L. Peterson

Making Sense of Psychiatric Diagnosis aims to cut through the misunderstanding and stigma, drawing on the DSM-5 diagnostic criteria and guest narratives to present mental illness as it really is.  It’s available on Amazon.

For other books by Ashley L. Peterson, visit the Mental Health @ Home Books page.

18 thoughts on “What Is… Paranoia and Paranoid Delusions?”

  1. That is a great blog post!!

    The paranoia I struggle with on a daily basis can be described thusly: if I have to interact with a stranger (on the sidewalk, or someone who’s a cashier, or someone at the store, etc.) I can’t make eye contact or general conversation with them because it will pollute my energetic field; and with the eye contact, they can see into my soul and I into theirs. That’s very discomfiting, so I look away and don’t engage. And I’m not making this up–there’s a very nice woman who works at the local pastry shop who keeps trying to act all normal around me and draw me out. She’ll ask me casual questions and that sort of thing, as if I’m shy and need to be encouraged. I know she means well, but it just puts pressure on me. None of that is really an issue online or with friends, although I’ve had one friend who commented on how I yank my body away from her when she stands too close to me. (I didn’t realize I was doing it, but… I was.) She wasn’t being critical, so I explained to her about energetic pollution. She’s the spiritual sort who thinks mental illness should be treated with spiritual healing rather than meds. (I know, right?) But she was afraid she smelled bad, or something, so I put her mind at ease. I do feel persecuted at times, too, like when I go to the grocery store and they have cameras showing my face all over the place. (It’s to prevent shoplifting.) I’ll see the cameras and tell them, “I am not a shoplifter!” And then, when there’s a camera bearing down on me at the U-Scan, I’ll flip it off.

    1. It’s annoying that some people don’t realize that it’s better to just back off. If someone clearly wants to be left alone, just let it be!

  2. Pretty interesting. After reading some of the categories, I felt I was a bit paranoid. But, I know I’m not. It was just a super bad week.
    I do believe that conspiracy theorist are definitely out there, and are certainly paranoid about too many things. I watched this docuseries on Netflix a while back about the 9/11 conspiracies. These people were out of the ever lovin’ minds.

    1. There’s a quote from somewhere that’s along the lines of: it’s not paranoia if they’re really out to get you. That seems to apply rather well to dealing with your family…

  3. I’ve known people like this and they were always men, convinced that they were being denied the status or respect or money or whatever they were entitled to because of whatever reasons. Not necessarily a conspiracy but always someone or some set of circumstances to blame other than themselves.

  4. Great post!

    Paranoia has to be the worst symptom of my illness, I spent a good 6 months terrified because I believed a certain organization was after me, it was the worst feeling ever, I was in a constant state of panic. Thankfully the medications I’m on now keep it under control

  5. I have been paranoid several times, and I have a lot of extreme thoughts but luckily I’m not diagnosed or have paranoia according to the psychological term. But this can be really scary and like you wrote in the beginning people are using this word in their everyday conversations.

  6. Very happy to see such a unique post about such a ‘taboo’ subject that people don’t like, or maybe just don’t know how, to talk about. Great post – super informative!

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