Sybil Shaibu column: Are you Paranoid?


My parents are out to get me! This person is going to kill me!…these statements sound harsh right? Well the reality is that this is the painful truth for people that are paranoid. Feelings of paranoia are a normal part of the human experience and are particularly common among people who are vulnerable during times of extreme stress or trauma. However these paranoid feelings generally are not a cause for concern as they go away once the situation is over.

Though paranoid thoughts are fairly common in the general population; people tend to become paranoid when their ability to reason and assign meaning to things breaks down. The exact reason why this happens is unknown, it’s thought paranoia could be caused by genes, chemicals in the brain or by a stressful and traumatic life event. However, it’s likely a combination of factors is responsible.

What then Is Paranoia?

Paranoia is thinking and feeling as if you’re under threat even though there is no (or very little) evidence that you are. Under threat here means, feeling like people are watching you or acting against you. Paranoia is a symptom of some mental health challenges and not a diagnosis in itself. Paranoid thoughts can be anything from very mild to very severe and these experiences can be quite different.


Paranoia can manifest in several forms, and these are just some examples.

  • Being defensive, hostile and aggressive.
  • Being easily offended.
  • Believing you are always right and having trouble relaxing or letting your guard down.
  • Not being able to compromise, forgive or accept criticism.
  • Having trust issues/not able to confide in others.
  • Reading hidden meanings into people’s normal behaviors.
  • Over thinking interactions.
  • Being highly suspicious.

Types of Paranoia

Paranoia can be a feature of a number of mental health diagnoses, such as depression and bipolar disorder, but most commonly with psychotic disorders such as schizophrenia. However these three main principal conditions are associated with paranoia.

Paranoid Personality Disorder (PPD): It’s considered the mildest form and mostly people with this disorder tend to function well despite their trust issues with the world.

Delusional Paranoid disorder: This is mainly characterized by the dominance of a particular delusion (false belief) in the absence of any other mental illness. Clinical paranoia is more severe. It’s a rare mental health condition in which you believe that others are unfair, lying, or actively trying to harm you when there’s no proof. You don’t think you’re paranoid at all because you feel sure it’s true.

Paranoid schizophrenia: It’s considered the most severe type, and it’s characterized by strange delusions. Such as believing that one’s thoughts are being broadcasted over the radio as well as having bizarre hallucinations. A person with this disorder tends to find the world confusing and functions poorly without treatment.


The main cause of paranoia can be difficult to diagnose because an exaggerated sense of mistrust is common to a range of mental disorders and also occurs in some people with dementia. Another challenge is that a person with paranoia is highly likely to avoid doctors, hospitals and others all due to fear of being harmed. And this is due to their mistrust or trust issues with people. However, diagnosis may include;

  • Medical history
  • Physical examination
  • Assessment of symptoms
  • Psychological tests
  • Tests to rule out other psychiatric disorders that may be causing the symptoms.


Though there is no absolute cure for the conditions that cause paranoia, seeking treatment can help the person cope with their symptoms and help them live a happy life.

Treatment focuses on reducing paranoia and other symptoms while aiming at improving the person’s ability to function. Also, treatment depends on the underlying cause and may include psychological therapy or medicine.

People with paranoid thoughts can find it hard to trust people, doctors (mental health professionals) inclusive, and may have difficulty accepting treatment. Therefore, if someone you know has paranoia, it’s imperative not to tell them they are imagining things or that they are crazy. This is because the paranoid thoughts are very real to them. Understanding and support are the best ways of encouraging them to seek help from a professional.

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