Paranoia and schizophrenia: What you need to know

Paranoia and schizophrenia: What you need to know

A person with a disorder on the continuum of schizophrenia can experience delusions, and what is generally called paranoia.

Such delusions may trigger concerns that others plot against the victim. From time to time everybody can have a paranoid thought. We may find ourselves on a rough day saying “Oh boy, the whole world is out to get me! “But we acknowledge that is not the case.

Individuals with paranoia also have a wide network of paranoid ideas and thoughts.

This can lead to a disproportionate amount of time spent dreaming up ways to defend the individual from their supposed persecutors. This can lead to issues both at work and in relationships.

Important facts about paranoia in schizophrenia

Here are a few key points regarding schizophrenia paranoia. More specifics are given in the main article.

  • People with schizophrenia often experience confusion and fear and they may have delusions that someone is plotting against them.
  • Since 2013, the subtype “paranoid schizophrenia” is not separate but a part of schizophrenia.
  • Medications and other treatment enable many patients to manage their condition.
  • Lifelong treatment is usually needed to stop symptoms from returning.

Overview: Paranoia and schizophrenia

Schizophrenia can cause fear, confusion, and delusions. The person may believe someone is persecuting them.
Schizophrenia can cause fear, confusion, and delusions. The person may believe someone is persecuting them.

Paranoid disorder was considered a form of disorder prior to 2013, but in 2013 the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) reclassified anxiety or delusions as a symptom rather than a subtype.

Because of their “limited diagnostic stability, low reliability and poor validity” the subtypes were excluded from the diagnostic criteria.

They were not treated as stable conditions, and did not assist in diagnosing or treating schizophrenia-related disorders.

The DSM is developed by the American Psychiatric Association ( APA) to help standardize definitions of mental illness of various forms.

Signs and symptoms

Schizophrenia is a psychiatric condition of a chronic or long term nature. It affects the processes of thinking of the person, and makes it hard to think clearly.

This will affect the emotions of the person and their ability to interact, concentrate, complete tasks, sleep and relate to others.

It can lead to anxiety, uncertainty and actions and suicidal thoughts.

Symptoms can include:

  • hallucinations and delusions
  • disorganized thinking
  • lack of motivation
  • slow movement
  • changes in sleep patterns
  • lack of attention to hygiene
  • changes in body language and emotions
  • lack of interest in social activities
  • low libido, or sex drive

Not all suffering from the disease should have all these symptoms.

Sometimes, signs develop between the ages of 16 and 30.

The person can note changes in patterns of sleep, emotions, motivation , communication and the ability to clearly think. That is the disease ‘s early, or “prodromal,” phase.

An acute episode is more pronounced. Panic, anger , and depression can feelings. It can be appalling for the victim, who is most likely not expecting it to happen.

Good care and support will help people deal with schizophrenia. Medications can stabilize the condition and many live and work without the condition as they would without. However, if the person stops taking the medication, symptoms often return.

Delusions are a common characteristic. A illusion is something that the individual believes is real, even though strong evidence indicates it is false. For instance , the person might think someone they know is trying to harm them.

Along with delusions, there may be auditory hallucinations and perceptual disturbances, or hearing things that are not there. Occasionally there are visual hallucinations.

It could lead to physical and emotional isolation, alienation from society, anger and anxiety. Many people with paranoia symptoms are going to be afraid and try to avoid others.

Some people are expressing their fears and frustration through aggression and violence but many are becoming a target of violence and exploitation.

Causes and risk factors

Causes of schizophrenia
A person with schizophrenia may feel detached and isolated.

Schizophrenia is a condition of a neuropsychiatric component. The exact causes are unknown but a combination of genetic factors and environmental stimuli is likely involved.

Symptoms can arise from a dopamine and possibly serotonin imbalance, both of which are neurotransmitters.

Risk factors include:

Genetics: Having a schizophrenia family history raises the chances of developing it.

When there is no family background, there is less than 1 per cent risk of having schizophrenia. When a parent has the disorder, the risk of having it is 10 percent.

Other factors that may contribute are:

  • a viral infection in the mother while she was pregnant
  • malnutrition before birth
  • stress, trauma, or childhood abuse
  • problems during delivery

Frequently, stressful experiences occur before schizophrenia is diagnosed.

The person may start experiencing bad temper, anxiety and a lack of focus before acute symptoms appear. This can cause issues in relationships.

Such causes are often blamed for the development of schizophrenia, but it may be that the crisis caused early symptoms.

It’s hard to know if schizophrenia induces those pressures, or whether it occurs as a result.

Parental age may be a factor because people with schizophrenia are born to older parents more often than not.

Schizophrenia has been related to the use of drugs which influence the mind and mental processes.

It’s unclear whether this is a cause or an consequence.

One argument is that the use of psychoactive drugs could trigger symptoms in susceptible people.

People with the condition may use cannabis because they have more pleasure in it. Some say it’s helping them cope with the symptoms.


A doctor will ask about the medical and family history of the patient, and will perform a physical exam.

Diagnostic tests can include a blood test to rule out certain possible symptom causes, such as dysfunction of the thyroid, alcohol , and drug use.

Imaging scans such as an MRI or a CT scan can show brain lesions or other brain structure abnormalities. A brain function can be measured by an electroencephalogram ( EEG).

Also a psychological evaluation will take place.

The psychiatrist will ask the patient about their patterns of thoughts , feelings, and behavior and their symptoms when they begin, their severity and their impact on daily life.

They will try to find out how often and when episodes have taken place, and whether the patient has any thoughts about harming themselves or others.

It can be helpful to converse with friends and family.

Diagnostic criteria

Relevant requirements, set by the DSM-5, must be met to validate a diagnosis.

The person must have two symptoms, at least:

  1. Delusions
  2. Hallucinations
  3. Disorganized speech
  4. Grossly disorganized or catatonic behavior
  5. Negative symptoms, such as emotional flatness, lack of pleasure in everyday life

Both symptoms must include at least one of the first three listed as follows: delusions, hallucinations or demoralized speech.

The following criteria are also necessary:

  • social and occupational dysfunction
  • symptoms must present for at least 6 months
  • no diagnosis of another mood disorder or drug or alcohol abuse.

It can take some time to reach a diagnosis.


A man speaking with his doctor
Counseling can help a patient develop and maintain social, work, and life skills.

Schizophrenia and paranoia can last a lifetime, but treatment may help alleviate symptoms.

Treatment should continue, even if symptoms appear to have receded.

Once treatment stops, symptoms sometimes reappear, particularly if they have already returned after medication had previously stopped.

Options depend on symptom severity and type, age and other factors.


Antipsychotics will alleviate the troubling feelings, hallucinations and delusions. These can be given as tablets, as liquids, or injected daily. Some side effects may occur.

Many medications, depending on the individual ‘s symptoms, can include antidepressants, anti-anxiety medicines, and a mood-stabilizing medicine.


An individual with serious symptoms can need to be taken into hospital. It can help to keep the person healthy, provide sufficient nutrition and maintain sleep. Often partial hospitalisation is possible.

To people with schizophrenia, compliance or adherence to medicine can be difficult. If they stop taking their medication they may return to the symptoms. Hospitalization can help individuals get back to their medicine while keeping them safe.

Psychosocial treatment

Psychotherapy, rehabilitation, and training in social and career skills may help the patient function independently and decrease the risk of relapses. Support can include improving communication skills, finding work and accommodation and joining a support group.

Electroconvulsive therapy

Electroconvulsive therapy ( ECT) involves sending through the brain an electrical current to produce controlled seizures or seizures. The seizure is thought to cause a large release of neurochemicals within the brain. Side effects could include memory loss in the short term. ECT is important in the diagnosis of catatonia, a condition that occurs in certain schizophrenia sufferers.

ECT may be of assistance to patients who have not responded to other treatments.

Many patients quit taking their medication within the first 12 months of care, so ongoing help is required.

Caregivers and family members will support the person who has a diagnosis by thinking about schizophrenia as much as possible and by helping the patient to pursue their treatment plan.

Caregivers and family members will support the person who has a diagnosis by thinking about schizophrenia as much as possible and by helping the patient to pursue their treatment plan.


If no treatment is given to a patient with paranoid schizophrenia symptoms, there is a serious risk of severe mental health, physical health , financial, behavioral and legal problems.

These can affect the life of each part of the individual.

Possible complications may include:

  • depression
  • suicidal thoughts and behavior
  • malnutrition
  • unemployment
  • homelessness
  • prison
  • inability to study
  • being a victim of crime
  • illnesses related to substance abuse and tobacco smoking

A significant number of schizophrenia sufferers smoke heavily and regularly. Some medicines can interfere with ingredients in tobacco and other substances.

What schizophrenia is not

A popular misunderstanding is that schizophrenia means a “split personality,” which is not true and does not describe the condition

Also people with schizophrenia are thought to be violent.

Much as certain people commit violent acts without schizophrenia, it is the same with people with schizophrenia, but there is no unavoidable link. Some are more likely to get themselves in trouble than others.

Knowing a person with schizophrenia will help them find a solution to deal with different ways of doing things.