Delusions (Paranoia)

By | June 10, 2022

Delusions or paranoia are when a person perceives threats that are not real. As a rule, delusions occur in the context of a psychosis. The reason for this is a disturbed brain metabolism.

What are delusions?

Delusions are characterized by people assuming threats of some kind that do not exist in reality, but “only happen in their heads”, so to speak. These feelings of threat can be of many kinds: for example, a suspected conspiracy by fellow human beings, by extraterrestrials, by secret services, by the devil, etc.¬†For definitions of cardiomyopathy, please visit

What form the paranoia takes typically depends on the circumstances of the person affected. Delusions can lead people who feel threatened to take actions they would otherwise not do. They may also become aggressive as part of an imagined self-protection and pose a threat to themselves or others. This is what makes the phenomenon so dangerous and often requires hospitalization.


Usually, paranoia (of whatever kind) is rooted in psychosis, and there are different types of psychosis: bipolar, schizoaffective, and schizophrenic. Due to a disturbed brain metabolism, which mainly affects the messenger substance dopamine, the perception of those affected is distorted or wrong.

Causes for a psychosis with the following delusions can be a genetic disposition, drug use, alcohol abuse or a general mental overload. Psychoses often occur in particularly stressful life situations that those affected cannot cope with: exam situations, social differences with loved ones or a new phase in life.

As a result of the overload, the chemical balance in the brain is upset, so to speak, which results in distorted perception. The person concerned tries to explain the strange feelings that come over him and thus creates a delusional system.

Symptoms, Ailments & Signs

Paranoia leads to hallucinations and delusions. Those affected distrust their environment. Often no distinction is made between strangers and those close to them. You feel that others want to harm you. Patients sense lies and fraud everywhere. In extreme cases, there is even constant fear of death.

There is also the feeling of being constantly observed. Aggression and megalomania characterize everyday life. They act remarkably odd and bossy in ordinary situations. When women and men are confronted with their delusions, they flatten them out. They are not amenable to any rational insight. In most cases, they even reinforce counter-arguments and make their illness worse.

In their supposed perspicacity, they persuade themselves that the contrary views are proof of their right path. Patients suffer internally – even if they don’t want to admit it to the outside world. They feel despised by those around them. A low self-esteem often characterizes the condition.

The mental behavior disorder has complex characteristics. It also accompanies a number of other disorders such as neuroses, personality disorders and schizophrenia. Sometimes it occurs after alcohol and drug addiction. Scientists have found that paranoia can accompany Alzheimer’s patients. Tumor diseases in the brain also promote delusions.

Diagnosis & History

Conspiracy theories or delusions of persecution give doctors a first valid clue to an existing psychosis, because these are typical signs. Frequently, those affected have already become conspicuous several times in advance and usually only go to a doctor at the insistence of relatives or friends.

Most of the sufferers have built up a veritable delusional system with the help of which they categorize reality and interpret the living environment. Through a longer, sensitive conversation, a doctor can find out whether paranoia or psychosis is present. If the psychosis is not treated, it can become chronic, ie permanent.

With early intervention, however, successful treatment with medication is usually possible. As a rule of thumb, it is estimated that about one-third of patients make a full recovery, another third relapse, and another third remain trapped in the condition.


The risk of complications related to delusions increases with the duration of the illness and the absence of psychotherapeutic or drug treatment. The paranoid flare-ups are particularly relevant for the occurrence of possible complications that are not due to the permanent state of paranoia and the personality disorders associated with it.

Due to the delusions, such flare-ups can increasingly lead to action on the part of the person concerned, which endangers him and his environment. This can lead to acts of violence, for example, because people are delusional in believing that something or someone needs to be protected. Even nonsensical actions in this context can sometimes lead to economic and social problems. Legal consequences for the person concerned are also conceivable.

Megalomania just occurring fuels these complications. All of these actions are also risky for those around the person concerned, as they become part of the delusion and corresponding fears and anger are projected onto them. The behavior of the paranoid, which is characterized more and more by a delusion, leads to an alienation from the environment and to the loss of the professional capacity over time.

In addition, paranoia is almost always associated with other personality disorders, most of which have depressive and self-injurious elements. Accordingly, as a complication, there is also the risk of the person concerned harming themselves – up to and including suicide.

When should you go to the doctor?

People who temporarily report the visual perception of figures or shadowy figures should continue to observe their impressions. If these irregularities increase in scope and intensity, the affected person needs medical help. If the reasons can be traced back to a situation of overload, emotional overload or insufficient sleep, spontaneous healing occurs in most cases. Stressors should be reduced and sleep hygiene must be optimized for lasting relief. A characteristic of delusions is the lack of insight on the part of the affected person into the events that have been experienced and described.

Behavioral problems, an aggressive demeanor and a vehement defense of perceptions indicate irregularities. If the impressions of the person concerned cannot be understood objectively, this should be discussed openly. In severe cases, a public health officer should be called, since there is no other way of making a diagnosis due to the lack of insight into the illness.

If the person concerned believes that they are being followed, that they are being given thoughts, or that they are receiving calls to action from imaginary figures, they need help. If there is no connection to reality, if everyday obligations can no longer be fulfilled or if hysterical behavior occurs, a doctor should be consulted. Self-destructive acts or assaults of a verbal or physical nature towards other people are considered warning signs. A doctor’s visit should take place as soon as possible.

Treatment & Therapy

So-called neuroleptics, which must be taken regularly, are administered to treat paranoia or delusions. These neuroleptics act as a buffer for the overstimulated brain (too much dopamine) and contain the psychosis if the right medication is chosen.

Since not so much is known about psychoses and neuroleptics, it is often necessary to try out which drug or which combination of drugs works. Accompanying talk therapy is also useful in order to help the person concerned to find their way back to reality and to work through what supposedly happened, because it was or is very real for the patient.

Often one works with so-called benzodiazepines, sedatives, for a not too long period of time, so that the person concerned can, for example, sleep and generally calm down again. However, these must be discontinued after a few months because they have a high potential for addiction. Inpatient treatment is often required overall until the patient has stabilized again and no longer poses a threat to himself or the environment.


In order to prevent a new wave of delusions, it is necessary to take the medication regularly and to consult a specialist regularly. Those affected also need a regular daily routine and should be as socially integrated as possible. Appropriate activity that clearly structures the day can also work wonders. Alcohol or drugs should not be consumed.


Similar to comparable mental illnesses, delusions require professional follow-up care. There are different forms of delusion, so there is no universal aftercare. In the case of paranoia, psychotherapeutic follow-up care in the form of individual or group therapy has proven itself. Each patient must find out for himself which method is appropriate for him.

The disease affects those affected far beyond the completed treatment. In many cases, patients remain marked by the mental disorder for life. The goal of follow-up care is a stable condition after successfully completing psychotherapy. Relapses should be avoided. The patient must become aware of the situation that triggers delusions in him.

Many patients become disabled as a result of the disease. In this case, too, the person concerned receives psychological support during follow-up care. His self-confidence must be stabilized, otherwise depression may develop in addition to the delusions. During follow-up care, the patient learns to pay more attention to themselves. To do this, they have to find their own way.

If he keeps his distance from certain acquaintances for the time being and needs time for himself, this is not fundamentally a concern, but can be part of his healing path. If the patient seems satisfied with the decision and if his condition improves, the therapist should allow this step and accept it as correct.

You can do that yourself

When a patient suffers from delusions (paranoia), this is very distressing for him as well as for those around him or his family. In order to be able to do something about the underlying psychosis, it is important to know what caused it. If overloading has triggered the delusions, the patient should slow down and allow themselves long breaks to recover. A regular sleep/wake cycle is also an advantage here.

If the consumption of drugs or alcohol is the cause of the paranoia, there is a strict ban on drugs or alcohol. In any case, a person who is prone to psychoses should ensure a healthy lifestyle. In this way he supports his own recovery and does not endanger it additionally. In addition to a balanced diet, a healthy lifestyle also includes sufficient exercise, preferably in the fresh air. Sport regulates metabolism and improves mood.

The medication prescribed by the doctor must be taken consistently. Unauthorized attempts to let go usually result in renewed paranoia. In any case, psychotherapy is helpful, in which the current life situation of the patient is also explored. Here it is important to determine where disease triggers are hiding and what is behind the paranoid thoughts.

Regular meditation and breathing exercises are other ways to counter delusions. Tapping acupressure (EFT) is also recommended as a self-help measure. It helps against emerging fears, stress or panic attacks.

Delusions (Paranoia)