What Is Paranoid Schizophrenia?

Medically Reviewed by Smitha Bhandari, MD on February 21, 2024
3 min read

Schizophrenia is the most common example of this mental illness. 

It is a kind of psychosis, which means your mind doesn't agree with reality. It affects how you think and behave. This can show up in different ways and at different times, even in the same person. The illness usually starts in late adolescence or young adulthood.

People with paranoid delusions which often accompany this illness are unreasonably suspicious of others. This can make it hard for them to hold a job, run errands, have friendships, and even go to the doctor.

Although it's a lifelong illness, you can take medicines and find help to stop symptoms or make them easier to live with.

Delusions are fixed beliefs that seem real to you, even when there's strong evidence they aren't. Paranoid delusions, also called delusions of persecution, reflect profound fear and anxiety along with the loss of the ability to tell what's real and what's not real. They might make you feel like:

  • A co-worker is trying to hurt you, like poisoning your food.
  • Your spouse or partner is cheating on you.
  • The government is spying on you.
  • People in your neighborhood are plotting to harass you.

These beliefs can cause trouble in your relationships. And if you think that strangers are going to hurt you, you may feel like staying inside or being alone.

People with schizophrenia aren't usually violent. But sometimes, paranoid delusions can make them feel threatened and angry. If someone is pushed over the edge, their actions usually focus on family members, not the public, and it happens at home.

You could also have related hallucinations, in which your senses aren’t working right. For example, you may hear voices that make fun of you or insult you. They might also tell you to do harmful things. Or you might see things that aren’t really there. Learn more about the symptoms of paranoia.

Your doctor may prescribe an antipsychotic drug to make the delusions go away. It could be pills, a liquid, or shots. It can take a few weeks for these drugs to work fully, but you could start to feel a little calmer quickly. You might need to try more than one to find a medication or combination that's right for you.

Even when you feel better, keep taking your medicine. If you stop, your delusions will probably come back.

Avoid using marijuana, alcohol, nicotine, cocaine or other stimulants, and street drugs. They can keep antipsychotic drugs from working well. They can also cause paranoia or make it worse.

You might have to take different kinds of drugs for other symptoms, too. Get more information about medications used to treat schizophrenia.

 

Once your delusions are under control, counseling can help you get along with others, hold a job, go to school, take care of yourself, and have friends.

People with schizophrenia who get counseling are also more likely to stick with their medications.

A kind of counseling called cognitive behavioral therapy can teach you how to manage symptoms that don't go away, even when you take your medicine. You'll learn to test whether you're having delusions and how to ignore voices inside your head.

Positive, encouraging support from family and friends really helps, too.

Because some antipsychotic drugs can make you gain weight, you might also want to get help with diet and exercise. Read more on the different types of therapy for schizophrenia.

There might be times when your paranoid delusions or other symptoms are so severe that you have to go to the hospital. You'll be cared for so you and your loved ones stay safe.

If you recognize that you're having trouble, you can be admitted voluntarily. But if you think you don't need help when you really do, the law may allow a doctor or other mental health professional to admit you involuntarily if you are unable to care for yourself or may be dangerous to yourself or someone else. Know when to call the doctor or 911 for severe psychosis symptoms with schizophrenia.