Paranoia and schizophrenia: What you need to know
Medically reviewed by
Alex Klein, PsyD — Written by
Yvette Brazier — Updated on September 29, 2020
A person with schizophrenia may experience delusional thinking, including paranoid thoughts. It may not be possible for the person to distinguish between this and regular thinking.
Schizophrenia affects a person’s perception and can involve hallucinations and delusions. When these happen, it can be hard to know what is real and what is not.
Paranoid delusions can
cause a person to fear that others are watching them or trying to harm them. Also, a person experiencing a delusion
may believe that media such as the television or the internet are sending them special messages.
These feelings and beliefs can cause severe fear and anxiety, disrupt daily life, and limit a person’s ability to participate in work and relationships, including those with family.
Studies suggest that
nearly 50%Trusted Source of people with schizophrenia experience paranoia.
Is ‘paranoid schizophrenia’ a diagnosis?
Schizophrenia is a spectrum disorder, meaning that it encompasses several linked conditions, symptoms, and traits.
Before 2013, healthcare professionals considered paranoid schizophrenia to be a distinct type of the disorder. However, the
Diagnostic and Statistical Manual of Mental Disorders, which provides expert guidelines, now classifies paranoia as a symptom, rather than a subtype, of the disorder.
Experts explained their choice to remove the subtypes from the classification, citing “limited diagnostic stability, low reliability, and poor validity.”
How can people manage schizophrenia during COVID-19?
Signs and symptoms
Schizophrenia is a lifelong mental health condition. Symptoms often emerge when a person is in their
late teens to early 30s.
It can
affect a person’s:
- thought processes
- perceptions and feelings
- sleep patterns
- ability to communicate
- ability to focus and complete tasks
- ability to relate to others
Symptoms of schizophrenia can include:
- a lack of motivation
- slow movement
- changes in sleep patterns
- low libido, or sex drive
- a lack of self-care
- disorganized thinking
- changes in body language and emotions
- withdrawing from family, friends, and activities
- hallucinations and delusions
A delusion is something that a person believes to be true, even when strong evidence suggests that it is false. A person may believe that someone is planning to harm them, for example.
People with paranoia may
experience a combination of the following:
- feeling upset, anxious, angry, and confused
- being suspicious of those around them
- believing that someone is persecuting them
- fearing that someone is following, chasing, poisoning, or otherwise plotting against them
- feeling as if someone else is controlling their thoughts and actions
- feeling as if their thoughts are disappearing or being taken away from them
- suicidal thoughts and behavior
If a person experiences any of the above, they should receive immediate medical care.
Suicide prevention
If you know someone at immediate risk of self-harm, suicide, or hurting another person:
- Ask the tough question: “Are you considering suicide?”
- Listen to the person without judgment.
- Call 911 or the local emergency number.
- Stay with the person until professional help arrives.
- Try to remove any weapons, medications, or other potentially harmful objects.
Causes and risk factors
Schizophrenia is a neuropsychiatric disorder. The exact causes are unclear, but they likely involve a combination of genetic factors and environmental triggers.
Risk factors may be:
Genetic: Those with a family history may have a higher risk.
Medical: These may include poor nutrition before birth and some viruses.
Biological: Features of the brain’s structure or the activity of neurotransmitters, such as dopamine, may contribute.
Environmental: Stress, past trauma, and abuse
may trigger symptoms in people already at risk.
One
studyTrusted Source suggests that people with schizophrenia and paranoia may have social cognitive impairments that make it harder for them, for example, to recognize people’s emotions or trust others. However, drawing conclusions about this will require more research.
Use of drugs
Some
recreational drugs that affect the mental processes, such as amphetamines, cocaine, cannabis, and LSD, may trigger psychosis or schizophrenia in people with a susceptibility.
Experts say that the use of drugs is more common among people with schizophrenia, but it is
not clear whether the drugs trigger the disorder, or whether having schizophrenia increases the likelihood of using drugs to cope with symptoms.
Various substances can also
interfere with treatment. Anyone with concerns about the link between schizophrenia and substance use should speak with a doctor.
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