Following the Diagnostics and Statistical Manual of Mental Health (DSM-V), paranoid schizophrenia and all other schizophrenia subtypes cannot be diagnosed. The simple reason is that a diagnosis was not helping clinicians properly treat people with these conditions. ¹

Still, even though you can’t be diagnosed with paranoid schizophrenia, you can experience paranoid symptoms. In fact, paranoid symptoms remain one of the top criteria for diagnosing schizophrenia. ²

Paranoia is a term used to associate a sense of distrust. People who struggle with schizophrenia tend to have an irrational, yet fixed, belief that they are in danger. These symptoms can produce hallucinations and delusions that lead to even worse mental conditions, such as confusion, anxiety, and mistrust of others.

Throughout this article, we’re going to take a deeper look into paranoid schizophrenia and its respective symptoms.

What Are Paranoid Delusions?

Delusions are one of the most common symptoms of paranoid schizophrenia. These are fixed beliefs that are false in reality. ³ For example, one may assume someone is always watching them even when this isn’t true.

Delusions are powerful. Even when presented with information that a belief is false, people with paranoid schizophrenia will continue to believe their delusions. The following are the most common types of delusions:

• Control – the belief that you are being controlled or manipulated beyond your influence.

• Grandiosity – the belief that you hold special powers or abilities that most people don’t experience.

• Jealousy – the belief that someone is deceiving you. For example, you may believe your significant other is being unfaithful when they’re completely committed.

• Persecution – the belief that your life is interfered with or the center of a conspiracy.

• Reference – the belief that there are environmental cues directed towards yourself. For example, when ads appear on television that you have a fixed interest in. Or, when a song comes on the radio that speaks to you.

• Somatic – the irrational belief that your body is experiencing a disease.

• Thoughts Insertion – the belief that other forces are putting ideas into your mind.

People who experience paranoid delusions often feel as though they’re being judged, unable to trust other people, and are at risk of harm. Furthermore, they may feel completely isolated in their experiences and misunderstood by people around them. Naturally, this can lead to loneliness and symptoms of depression.

What Are Paranoid Hallucinations?

Paranoid hallucinations are similar to paranoid delusions in the sense that they bring upon a false idea of reality. However, the key difference is a paranoid hallucination appears through false sensory perception. ⁴ As such, hallucinations can affect the following:

• Auditory (sound)
• Gustatory (taste)
• Olfactory (smell)
• Tactile (touch)
• Visual (sight)

Paranoid schizophrenia most commonly affects sight and sound. In other words, people with this symptom will hear and see things that aren’t there. These experiences can include:

• Hearing voices from a specific source (i.e. a speaker)
• Hearing voices that are conversing or telling you what to do
• Hearing sudden sounds when nothing is present
• Hearing specific sounds (such as humming, screaming, whistling, or laughing) when no one is around
• Seeing faces and bodies appear from nowhere
• Seeing images that aren’t really there (sometimes linked to an event)

Paranoid hallucinations can be unwelcoming and overwhelming. In turn, they may lead to confusion and anxiety.

Living With Paranoid Schizophrenia

The most common trait among those living with paranoid schizophrenia is isolation. When you’re experiencing paranoid delusions and hallucinations, you experience high levels of anxiety and will find it difficult to explain these experiences to other people. ⁵

In turn, day-to-day experiences become a nightmare. Whether it’s building/maintaining a relationship, holding onto employment, or simply engaging in certain daily tasks. Paranoid schizophrenia can take a huge toll on the mind, body, and spirit.

Dr. Lisa Cowley, a schizophrenia treatment specialist, put it perfectly when she said: “To these folks, their symptoms appear like they are really happening. So, if they feel like the government is spying on them through cameras in their home, they wouldn’t go see a psychiatrist or psychologist, they would try to contact authorities.”

Some people with paranoid schizophrenia become aware of their mental illness as symptoms progress and intensify. In other cases, a person might be so lost in their delusions and hallucinations, they may avoid seeking help.

In either case, family members and support services need to encourage treatment. This is the only way for people to overcome paranoid schizophrenia and get back into a daily routine.

Paranoid Schizophrenia Treatment

As of this time, medical professionals don’t have a cure for schizophrenia. However, several treatment options are available to help you live out a full and productive life. These include two sets of therapies: ⁶

• Medication – Usually, anti-psychotics, to help calm disorderly delusions and hallucinations.

• Psychotherapy – Usually, cognitive behavioral therapy (CBT) to help identify negative behaviors and work towards positive ones. This therapy may be in an individual setting, group setting, or other supportive services.

Studies have found that the combination of these two treatments is most effective for paranoid schizophrenia. It may also benefit you to look into more natural ways to treat your symptoms, such as organic supplements and mindful meditation.

How to Support a Loved One

However, even with treatment, the best way for someone to overcome paranoid schizophrenia is with a support system. By practicing healthy limits and remaining patient, a supporter can have many positive effects on an individual that may just go beyond traditional treatment.

If you have a loved one who struggles with schizophrenia, here’s how you can support them:

• Advocate – Always encourage your loved one to follow through with their treatment plan, whether it’s taking their medication or going to therapy sessions.

• Avoid Arguments – Arguing has the potential to worsen symptoms of paranoid schizophrenia. With a bit of patience, you must listen to what your loved one has to say and do your best to make them feel safe.

• Be Ready for Paranoia – Paranoia tends to manifest in patterns, allowing you to understand it better. Even when your loved one is not feeling paranoid, plan for potential fears or threats.

• Be Their Reality Check – As mentioned, it can be difficult for someone who struggles with paranoid schizophrenia to know what’s real. This makes it important to have those around them who can help identify what’s real and less concerns brought upon by delusions and hallucinations.

• Give Them Space – One of the biggest symptoms of paranoid schizophrenia is feeling alone. However, your loved one may also feel trapped or surrounded. If they advocate these feelings, you’ll want to provide them with space and alone time.

• Practice Self-Care – If you can’t take care of yourself, how can you take care of a loved one? You need to be aware of your physical, mental, and spiritual needs. By working on these, you’ll have more energy to help a loved one.

• Seek Help When Necessary – You may be led to believe that your loved one is in danger of harming themself or those around them. If so, you must call a medical professional or law enforcement.

Final Word

It’s not easy to overcome paranoid schizophrenia. Hallucinations and delusions can feel so real that a person may feel lost. However, no matter how lost you may feel, we guarantee help is available.

References

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² Holder SD, Wayhs A. Schizophrenia. Am Fam Physician. 2014 Dec 1;90(11):775-82. PMID: 25611712.

³ Bovet P, Parnas J. Schizophrenic delusions: a phenomenological approach. Schizophr Bull. 1993;19(3):579-97. doi: 10.1093/schbul/19.3.579. PMID: 8235460.

⁴ Mueser KT, Bellack AS, Brady EU. Hallucinations in schizophrenia. Acta Psychiatr Scand. 1990 Jul;82(1):26-9. doi: 10.1111/j.1600-0447.1990.tb01350.x. PMID: 2399817.

⁵ Fett AJ, Hanssen E, Eemers M, Peters E, Shergill SS. Social isolation and psychosis: an investigation of social interactions and paranoia in daily life. Eur Arch Psychiatry Clin Neurosci. 2022 Feb;272(1):119-127. doi: 10.1007/s00406-021-01278-4. Epub 2021 Jun 15. PMID: 34129115; PMCID: PMC8803722.

⁶ Patel KR, Cherian J, Gohil K, Atkinson D. Schizophrenia: overview and treatment options. P T. 2014 Sep;39(9):638-45. PMID: 25210417; PMCID: PMC4159061.