What treatments are available?

If you are concerned about your feelings or behaviour and want to seek professional help, the first step is usually to visit your family doctor. Your family doctor will discuss your options with you, and may refer you to a specialist if you need additional support. Your views and wishes should always be taken into account when deciding on your treatment.

Talking treatments

Cognitive behaviour therapy (CBT) is a talking treatment that can be helpful for coping with paranoid thoughts. CBT involves examining your thinking patterns and the evidence you have for your beliefs. It then aims to help you find alternative interpretations to the ones that are causing you problems.

“I used a lot of CBT, examining negative thoughts and trying to compare them with evidence to the contrary. It helped to talk through this process with others who were more able to see alternative ‘evidence’ or ways of looking at things.”

Many other forms of talking treatments are available, including psychotherapy, family therapy and group therapy. Although they have different underlying ideas, they generally involve talking over personal experiences in detail, and exploring feelings.

If you experience paranoia, you might be finding it difficult to trust people. This means it is important to find a therapist that you feel comfortable with. You may also find it useful to agree with your therapist on what you will do if your paranoia worsens. For example, you may decide to pause sessions until you feel able to start again.


Medication is not normally prescribed to treat paranoid thoughts. However, you may be offered medication to relieve other symptoms you are experiencing, such as depression, anxiety or psychosis (seeing, hearing or feeling things, or holding unusual beliefs that other people do not). If you are prescribed any medication, your doctor should give you an explanation of what it is for, possible side effects and any alternative treatment options. Make sure you are aware of the possible benefits and negatives before you start the medication.

Antidepressants and minor tranquillisers

If you are anxious or depressed, your family doctor might recommend antidepressants or minor tranquillisers. While many people find these drugs helpful in controlling the symptoms of paranoia, both types of treatment can cause side effects.


If you have received a diagnosis of paranoid schizophrenia, or delusional or paranoid disorder, you are likely to be offered an antipsychotic drug to reduce your symptoms. Antipsychotics may reduce paranoid thoughts, hallucinations, incoherent speech and thinking, and confusion. The drugs can also control anxiety and serious agitation, make you feel less threatened, and also reduce violent, disruptive and manic behaviour. However, not everybody finds antipsychotics helpful, and many people experience unwanted side effects, such as problems with movement, weight and sexual function.

Complementary and alternative therapies

Some people find complementary and alternative therapies such as hypnotherapy, massage and acupuncture helpful in managing the anxiety and upsetting feelings associated with paranoia. However, this type of treatment does not work for everyone, and there is little clinical evidence to demonstrate that these treatments have any effect. If you do choose to use a complementary or alternative therapy, make sure you understand it fully, and that you see an accredited practitioner.

Arts therapies

Arts therapies are a way of using the arts – for example, music, painting, clay, dance, voice or drama – to express yourself in a therapeutic environment. They are carried out with the help of a trained therapist. The therapist helps you understand the art that you create in relation to your experiences and state of mind.

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