It can be difficult to watch a loved one experience symptoms of paranoia. Your support can help them cope.
When someone you love experiences paranoia from a mental health condition, you might feel the urge to step in to help but might not know how.
Learning about paranoia and how to talk to someone with paranoid delusions may be a good first step.
“Paranoia is characterized by the intense feeling and belief that one is being threatened, targeted, and conspired against by others,” explains South Oaks Hospital medical director Youssef Hassoun, MD.
Delusions are false beliefs that someone holds onto despite evidence to the contrary. Paranoid delusions refer to false beliefs about being persecuted or in danger.
Paranoia is a symptom of many mental health conditions, including but not limited to:
- bipolar disorder with psychotic features
- depression with psychotic features
- schizoaffective disorder
- delusional disorder
- paranoid personality disorder
Only a health professional may be able to provide an accurate diagnosis. This is important because paranoia may also be a sign of something else, like a medication side effect.
Not everyone will experience paranoia in the same way, but there are several common signs that could indicate it.
Paranoia isn’t its own diagnosis. Rather, it’s a symptom of a few mental health conditions.
Here are some common signs that someone may be experiencing paranoia:
- extreme help-seeking behavior (e.g., calling loved ones, contacting the authorities) without a clear threat
- constant increased heart rate
- distrust of others, even loved ones
- feeling victimized, misunderstood, or persecuted
- attempting to run or hide without an apparent cause
- anxiety and stress related to paranoid beliefs
- strained relationships due to distrust
- hostile, aggressive, or argumentative behaviors
- attempting to defend themselves (e.g., verbally or physically)
- beliefs that aren’t based on evidence (e.g., they’re the “chosen one to save the world”)
It’s also important to know what paranoia isn’t.
Symptoms of paranoia as a result of a mental health condition are not to be confused with paranoia related to distrust.
“Distrust can be present among any of us, based on certain experiences we’ve had in the past that left us generally untrusting of others,” says Hassoun.
For example, it may be natural for someone who’s been repeatedly lied to, cheated on, or scammed to have a difficult time trusting others.
When considering symptom severity, Hassoun notes that psychiatrists usually take note of how it impacts the person’s ability to function every day.
“In schizophrenia, for example, paranoia leads to severe functional impairment, frequently preventing individuals from being able to take care of themselves, have meaningful jobs, continue to be able to have stable relationships with others, and, at times, leading to frequent hospitalizations,” he says.
Consider the following tips on what to do or how to respond to someone experiencing paranoia.
Don’t deny their experience
“[People living with paranoia] usually have a severe conviction of being in danger that others don’t necessarily share, and hence it’s considered delusional,” says Hassoun.
This doesn’t mean that the experience isn’t real for them, though.
“Challenging one’s delusions in a confrontational manner never ever helps,” he says. “On the contrary, this may alienate the person [or] lead them to be more aggressive, argumentative, and eventually agitated and possibly hostile.”
Remembering paranoia isn’t a personal choice may help you support your loved one.
“Partners and loved ones can help people experiencing paranoia feel seen and supported by not denying their experience or telling them their experience isn’t real,” adds Lesley Smith, a clinical social worker in Portland, Oregon with a history of working in mental health crisis intervention.
She recommends finding the balance between not confirming their fears but not denying them either. For example, you can try saying something like “It sounds like you’re really scared right now.”
Be kind and understanding
Offering kindness and compassion can reassure them that they’re supported and going to be OK, even if they don’t feel like it at the moment.
“It’s important to remember that paranoia (or any illness or symptom) does not summarize the individual,” advises Hassoun. “Don’t be afraid to shine a light on what’s beautiful in them to help them cope with intense feelings of insecurity, fear, or disappointment that they might have.”
To do this, he suggests mentioning:
- their past accomplishments
- recent milestones they’ve met
- a notable way they made you feel at some point
After a paranoia episode, Smith also suggests validating their experience and reminding them that you’re there for them.
Educate yourself about paranoia
Learning about paranoia, including what it is and what it isn’t, can help you become more informed as someone trying to offer support.
You can do this by:
Ask what you can do to help
Hassoun reminds you to simply ask: “What can I do to help?”
Other questions you can ask them include:
- what song they like
- which TV show they enjoy
- what makes them feel better
- what usually soothes them
Once you learn these answers, you can utilize them to help distract or calm down your loved one.
Reassure their safety
Smith notes that the most important thing to do is to help your loved one feel as safe as possible in the moment — physically, mentally, and emotionally.
To do this, try comforting them through their fears or helping them access relaxation and grounding strategies.
Hassoun says you can also “remind them of a similar experience that happened previously where they were suspicious of someone yet they found out that there was nothing to it and ask them if this could be the case now.”
Seek professional help
“Paranoia doesn’t make people dangerous, but sometimes when people are scared they do extreme things,” says Smith. “If you feel like you’re unsafe or the person you’re with is engaging in unsafe behavior, please reach out for support.”
If you have already tried speaking with your loved one and feel you need further help, consider contacting their therapist or a mental health professional. They may be able to guide you on how to best support them during (and after) the episode.
You could also contact the National Alliance on Mental Health to find resources for people living with paranoia and those looking to support them.
Smith notes that when necessary, calling emergency services might help, too, “especially if the paranoia is leading to thoughts of hurting themselves or others.”
If someone you love is considering harm
Help is available right now:
- Call a crisis hotline, such as the National Suicide Prevention Lifeline at 800-273-8255.
- Text HOME to the Crisis Text Line at 741741.
- Call or text the Postpartum Support International Help Line at 800-944-4773 (#1 Español, #2 English)
- The Trevor Project. LGBTQIA+ and under 25 years old? Call 866-488-7386, text START to 678678, or chat online 24-7.
- Veterans Crisis Line. Call 800-273-8255, text 838255, or chat online 24-7.
- Befrienders Worldwide. This international crisis helpline network can help you find a local helpline.
These tips can help you support someone who lives with paranoia, but understanding and care can only do so much.
Paranoia is a symptom of a mental health condition that can be managed with the help of a mental health professional.
“Family members need to know they’re not the primary therapist and their role isn’t to ‘fix what’s wrong,’” reminds Hassoun.
“The most important role that one could play is advocating for the well-being of their loved ones who are [experiencing] paranoia,” he adds. “[You] can have a therapeutic role by simply creating opportunities and circumstances for one to be able to cope better with these symptoms they’re having.”
Supporting your loved ones when they’re experiencing symptoms of paranoia is possible.
Here are some ideas of how to help someone with delusions:
- validate how they feel without reinforcing their fears
- be kind and understanding
- learn more about paranoia
- ask how you can help
- reassure them that they’re safe
- seek help or crisis intervention
Ultimately, it’s important to remember that managing their paranoia isn’t your responsibility. But your love and support can still offer them a helpful sense of comfort in times of need.