Paranoia

1) What it is

Paranoia is when you strongly feel that people may harm, judge, watch, or trick you, often without solid evidence. It can be mild and stress-related, or more severe when linked to trauma, severe anxiety, or psychosis.

2) What it feels like

• “People are watching or judging me.”
• “Others are talking about me.”
• “I can’t trust anyone.”
• “Something bad is about to happen.”

3) Common signs & symptoms

• feeling suspicious or unsafe around others
• believing people are talking about you
• overthinking situations and conversations
• struggling to trust people
• feeling constantly “on edge,” especially in public

4) Why it happens (causes & risk factors)

• high anxiety and chronic stress
• trauma or past betrayal
• sleep deprivation
• substance use (including cannabis)
• mental health conditions such as severe anxiety or psychosis

5) Triggers

• stress or pressure
• lack of sleep
• crowded or unfamiliar environments
• social interactions
• substance use
• feeling out of control or unsafe

6) What helps now

• reality check:
  ask “What evidence do I have?”
  then ask “Is there another explanation?”
• grounding and slow breathing
• remind yourself: “This is anxiety-driven, not a fact.”
• step away from triggering environments if possible

7) Daily self-help support

• stabilise the body: regular sleep, meals, hydration, routine
• reduce stimulation (lower caffeine, reduce alcohol or drugs)
• write it down:
  paranoid thought → evidence for → evidence against → balanced thought
• limit reassurance-seeking, which can reinforce paranoia

8) Professional treatment options

• CBT to challenge and reframe paranoid thoughts
• trauma therapy if symptoms are trauma-linked
• mental health assessment if symptoms are severe, persistent, or worsening

9) Medication

Medication may be considered if paranoia is linked to severe anxiety, mood disorders, or psychosis, and is prescribed following specialist or GP assessment.

10) Practical tips

• paranoia increases when the nervous system is overloaded
• sleep and routine are protective
• avoid excessive checking or scanning for threats
• focus attention on the present moment

11) When to seek urgent help

Urgent help if:

• paranoia is escalating rapidly
• you feel unsafe around others
• thoughts involve being harmed or controlled
• distress is severe or reality feels distorted

12) Where to get help (UK)

• NHS Talking Therapies (self-referral in many areas)
• GP referral for specialist mental health support
• Samaritans 116 123 (if distressed)

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