As mental health related topics are more commonly spoken about amongst friends and in media, there are terms used to describe experiences that may sound familiar to you, and those you may not have been aware of before. Words such as depression, anxiety, and bipolar are fairly commonplace today, while personality disorders and psychotic disorders might be less familiar. Despite increased use of mental health terms, there remains some confusion on what they mean from a clinical standpoint. How the terms are presented in media may not be an accurate reflection of their clinical basis.

One term I hear a lot in conversations is “paranoia”. People refer to feeling “paranoid” when they think they didn’t do something correctly, concern that someone is watching them or micromanaging, or when they feel like they are going “crazy” with different thoughts they might be having. While paranoia is a term commonly used when people refer to their mental health, the causes of the paranoia can come from various sources.

When people refer to “feeling paranoid” they are often referring to anxiety and not the more severe mental illness symptom of paranoid delusions. It is possible to experience both anxiety and paranoid delusions at the same time, but we will focus on the two experiences separately to better understand the terms.

First, paranoia when diagnosed as a mental health condition usually refers to paranoid delusions, which are beliefs that are strongly held by an individual. The person 100% believes the thoughts are true, despite evidence that would suggest otherwise. These types of thoughts are considered part of a psychotic disorder. In contrast, a person who has paranoid ideas stemming from anxiety can consider the thoughts are not true.

One way to differentiate between paranoia seen with anxiety and paranoia of a psychotic disorder, is to determine whether the person can consider the possibility the thoughts are not true. Let’s take the example of someone who thinks they are being followed. If the person has paranoid ideas that are a component of anxiety, then they will be able to consider evidence that it is not possible. You can show them no one else has been in that area for weeks so it wouldn’t be possible for them to be followed or show them video that shows no one is following them and they will believe this. They can consider the evidence and change their mind on whether something has happened.

For someone with paranoid delusions, you can provide the same evidence to them and they will continue to believe they are being followed. The video footage will show no one else around them, but they will convince themselves that the footage is wrong or incomplete because they are certain someone has been following them. No amount of evidence to the contrary will lead to a change in their beliefs. They firmly believe that the thoughts are real.

The content of the paranoid thoughts can be the same, but the difference lies in whether the person can believe that the thoughts are not true when given evidence to suggest they are not true. If the person can recognize that their paranoid thoughts may not be true, then it is a component of anxiety. When the person 100% believes the thoughts and is unable to consider information to the contrary, then it would be consistent with paranoid delusions.

So what would be some examples of paranoid thoughts that you have and could suggest anxiety and not a more severe mental health condition?

Worrying what other people think: People who are anxious often worry what other people think of them. These thoughts are usually negative and based on faults the person believes they possess.

Worrying that something bad might happen: People who are anxious tend to worry about something bad that might happen to them, their loved ones, or even generally in the world. The thoughts can feel consuming and difficult to not worry about. They think of worst-case scenarios for most everything and find it hard to not think about how to stop the event from happening.

Worry about making a mistake or failure: When someone is anxious, they often are unable to see the positives in situations. The negatives become glaring and what they focus on. As a result, they worry about all ways in which they can fail such as in relationships, as a partner, or at their job.

While you may have friends that call you “paranoid”, it is likely they are referring to paranoia associated with anxiety. Regardless of the cause, if you feel the thoughts are impacting your moods and ability to function, it is recommended you seek out evaluation from a professional. There are successful treatments for paranoid thoughts and they do not have to be a part of your life.

At Mindset Therapy we provide mental health services in Texas and Washington from trained professionals, via telepsychology, which allows you to attend the appointment from the location most convenient for you. Visit Mindset Therapy at https://www.mindsettherapyonline.com/ to learn more about the services offered and make an appointment. Also visit our YouTube page, Mindset Therapy, PLLC, for the Mental Health Minute series that provides quick pieces of information for common mental health issues.