Why Do I Feel Paranoid?

From the WebMD Archives

Do these thoughts sound familiar?

  • Are other people talking about me?
  • Was I just lied to?
  • Is someone watching me?

Thinking things like this can be normal. But they could point to a mental health symptom if you lose the ability to judge whether they are likely to be true.

Everyone has thoughts like these from time to time. You might think of them as “paranoid.” But “you’re probably really having an anxious thought,” says Thomas Rodebaugh, PhD, an associate professor of psychology at Washington University in St. Louis.

Most people use the word “paranoid” to describe occasional suspicions or fears that they know aren’t rational or realistic. But experts define it as an ongoing way of thinking. It involves truly believing that others are mean, lying, unfair, and “out to get you.”

It's pretty rare. Even so, “worries or concerns you might describe as 'paranoid' can be troubling,” says Simon Rego, PsyD, director of psychology training at Montefiore Medical Center-Albert Einstein College.

But in many cases, you can take steps to have fewer of these thoughts or avoid them altogether.

Reasons You Might Feel Paranoid

Too Little  Sleep

One restless night probably won’t trigger paranoid thoughts.

“But regular sleep deprivation can make it hard for you to think clearly. If you go without sleep long enough, you can actually hallucinate,” Rego says.

If you’re really tired, you’re more likely to argue with and misunderstand others, too. And that may make you think other people are saying, thinking, or doing things that aren’t in your best interest.

That’s why it’s smart to aim for at least 7 hours of shut-eye a night. See your doctor if you’re sleeping that much but still feel tired or paranoid.


“Intense stress can increase the odds you feel suspicious or somewhat paranoid,” Rego says.

It’s not clear why, but tension causes a rise in chemical and cellular changes that keep your brain from working its best, experts say.

“You might even feel suspicious or questioning during times of positive stress, like when you’re planning for a wedding,” he says.


To ease the tension and clear your head, exercise regularly, see your friends, and take time to relax.


Many people worry they’ll say or do something that embarrasses them or causes others to judge them. Experts call this social anxiety.

It can lead to “thoughts that you might interpret as paranoid,” Rego says. “For example, if you walk into a party and don’t know anyone, your initial reaction might be to think, ‘Everyone here knows I’m alone.’” (If your social worries are constant or overwhelming, you could have social anxiety disorder, which is also known as social phobia.)

When you feel really anxious for any reason, even outside of social situations, you could have thoughts that aren’t realistic but are hard to shake. Cognitive behavioral therapy might help. That’s where you identify and change your thoughts so you feel better. It helps to ease all types of anxiety and stress, too.

A Psychiatric Disorder

mental illness called paranoid personality disorder may be the reason for your thoughts. A person with this condition may not believe every paranoid thought he has. But he will have a habit of feeling mistrustful of others, or thinking people are out to get him, Rodebaugh says.

Another serious brain disorder, schizophrenia, causes paranoia and psychosis, a state in which a person can’t identify what’s real. “Most of the time, individuals with schizophrenia aren’t aware their thoughts are paranoid,” Rodebaugh says. Usually, it’s their friends and family who recognize their loved one is having anxiety-fueled thoughts.

Even if you feel paranoid, it’s unlikely that a psychiatric disorder causes the condition. But consider talking to a psychologist or psychiatrist if you’re worried.

Drug Use

Some drugs, including marijuana, may contain chemicals that can make some people feel paranoid for a short time. These thoughts usually ease up as those chemicals leave your system.

But if you’re prone to mental illness, using drugs may boost the odds you’ll get a psychiatric disorder that can involve paranoia.

Memory Loss

Alzheimer’s disease and other forms of dementia result from brain changes that can also contribute to suspicious thoughts and habits. If someone you love has dementia, remember that changes in their behavior, like paranoid statements or actions, are due to their disease.


How to Ease Your Mind

If you’re concerned you’re losing touch with reality, see a mental health doctor right away. But if you just have occasional fears that seem “paranoid,” try changing the way you talk to yourself.

“Instead of saying, 'I’m paranoid,' say, 'I’m worrying about something that probably isn’t true or realistic,'” Rodebaugh says. “Not labeling it as paranoid can make it seem less negative. And that may help you decide what to do about the way you’re feeling.”

No matter what, if you have any kind of thoughts that regularly upset you or keep you from living life the way you want, talk to a clinical social worker, psychologist, or psychiatrist.

It doesn’t mean that you have a mental disorder or that something’s “wrong” with you. Instead, “It means you want to learn to be more flexible in the way you view things. And that can make you feel more comfortable, even in really stressful or difficult situations,” Rego says.

WebMD Feature Reviewed by Joseph Goldberg, MD on December 19, 2015
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