Paranoid schizophrenia

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By Mayo Clinic staff

Signs and symptoms of paranoid schizophrenia may include:

  • Auditory hallucinations, such as hearing voices
  • Delusions, such as believing a co-worker wants to poison you
  • Anxiety
  • Anger
  • Emotional distance
  • Violence
  • Argumentativeness
  • Self-important or condescending manner
  • Suicidal thoughts and behavior

With paranoid schizophrenia, you're less likely to be affected by mood problems or problems with thinking, concentration and attention.

Key symptoms
Delusions and hallucinations are the symptoms that make paranoid schizophrenia most distinct from other types of schizophrenia.

  • Delusions. In paranoid schizophrenia, a common delusion is that you're being singled out for harm. For instance, you may believe that the government is monitoring every move you make or that a co-worker is poisoning your lunch. You may also have delusions of grandeur — the belief that you can fly, that you're famous or that you have a relationship with a famous person, for example. You hold on to these false beliefs despite evidence to the contrary. Delusions can result in aggression or violence if you believe you must act in self-defense against those who want to harm you.
  • Auditory hallucinations. An auditory hallucination is the perception of sound — usually voices — that no one else hears. The sounds may be a single voice or many voices. These voices may talk either to you or to each other. The voices are usually unpleasant. They may make ongoing criticisms of what you're thinking or doing, or make cruel comments about your real or imagined faults. Voices may also command you to do things that can be harmful to yourself or to others. When you have paranoid schizophrenia, these voices seem real. You may talk to or shout at the voices.

When to see a doctor
If you have any paranoid schizophrenia symptoms, seek medical help as soon as possible. Paranoid schizophrenia doesn't get better on its own and may worsen without treatment. However, if you're like most people with paranoid schizophrenia, you may not recognize that you need help or that you even have symptoms. This is because your delusions or hallucinations seem very real to you. Family and friends or people at work or school may be the ones who initially suggest you seek help.

Getting treatment from a mental health provider with experience in schizophrenia can help you learn ways to manage your symptoms so that you have the best chance of leading a productive and happy life. If you're not ready to seek treatment, try to work up the courage to confide in someone, whether it's a friend or loved one, a health care professional, a faith leader or someone else you trust. They can help you take the first steps to successful treatment.

Helping someone who may have paranoid schizophrenia
If you have a loved one you think may have symptoms of paranoid schizophrenia, have an open and honest discussion about your concerns. You may not be able to force someone to seek professional help, but you can offer encouragement and support and help your loved one find a qualified doctor or mental health provider.

If your loved one poses a danger to himself or herself or to someone else, you may need to call the police or other emergency responders for help. In some cases, emergency hospitalization may be needed. Laws on involuntary commitment for mental health treatment vary by state.

Suicidal thoughts
Suicidal thoughts and behavior are common when you have paranoid schizophrenia. If you're considering suicide right now and have the means available, talk to someone now. Call 911 or your local emergency services number.

If you simply don't want to do that, for whatever reason, you have other choices for reaching out to someone:

  • Contact a family member or friend
  • Contact a doctor, mental health provider or other health care professional
  • Contact a minister, spiritual leader or someone in your faith community
  • Go to your local hospital emergency room
  • Call a crisis center or hot line
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DS00862 Dec. 16, 2010

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