A person holding their pillow tightly while being tied to the symptoms of paranoid schizophrenia.

Artwork by Monjira Sen

A person holding their pillow tightly while being tied to the symptoms of paranoid schizophrenia.

Understanding Paranoid Schizophrenia

Medically reviewed by

Written by Riddhima Poddar

Schizophrenia is a chronic mental health disorder that affects a large number of people across the world. It is associated with symptoms like hallucinations, delusions, paranoia, and more. Schizophrenia was once classified into multiple sub-types based on the severity of different symptoms associated with it. Paranoid Schizophrenia is one of the subtypes with severe symptoms. 

What exactly is Paranoid Schizophrenia? 

“Have you ever felt like you were being watched or followed? Imagine feeling that all the time. This paranoia around your daily functioning is one of the main traits of Paranoid Schizophrenia,” says Dr. BR Madhukar, Medical Director, Cadabams Group. 

Paranoid schizophrenia was previously a sub-type under Schizophrenia. It is a chronic condition that affects how people think, feel, behave, and relate to themselves and the world. 

Diagnostic and Statistical Manual of Mental Disorders (DSM-5),  states that one can no longer be diagnosed with ‘Paranoid Schizophrenia’. However, symptoms of ‘paranoia’ or the ‘positive symptoms’ remain important criteria for diagnosing a person with Schizophrenia.

Who does it affect?

The condition is not seen to be more common in any gender or other societal group. However, symptoms often appear earlier in men than women. Men are diagnosed with paranoid schizophrenia usually in their early 20s, while women tend to be diagnosed later (late 20s to early 30s). It is important to note that the severity of the symptoms or the disorder is dependent on multiple factors, including genetics, environment, and psychological factors.

How common is this condition?

Schizophrenia, as a condition, affects up to 1% of the population of the world. Paranoid schizophrenia, a once-used subtype to denote the prominent symptoms, was considered the most common form of schizophrenia. It is especially distressing due to the increased severity of paranoid symptoms like delusions and hallucinations.

Signs of Paranoid Schizophrenia

The onset of paranoia is not abrupt. It is a gradual change that a person might experience in their perceptions about themselves and the world. Paranoid Schizophrenia symptoms usually entail:

  1. Hearing, seeing, and tasting things that others don’t
  2. Behaving strangely, holding on to unusual beliefs or thoughts
  3. Social Isolation: distancing from friends and family 
  4. Lack of personal hygiene or self-care
  5. Not being able to think clearly, pay attention, and function adequately.
  6. Disorganized speech

The above signs persist in people diagnosed with Paranoid Schizophrenia. Usually, a psychotic episode is accompanied by the delusion of persecution and hallucinations.

Delusion of Persecution

It is a false and unfounded belief that individuals or government authorities are out to get them or hurt them. People may experience heightened feelings of anxiety and fear. Their ability to distinguish the real from the unreal diminishes.

They may start reading too much into people’s everyday behavior. They may also think that what they hear on the radio or television are secret messages directed toward them.


These are false visual, auditory, olfactory, and tactile perceptions. The most notable of these are auditory hallucinations. People claim to hear voices outside their minds- in external spaces as if somebody is talking to them.

Signs that immediate medical attention is needed

There are certain situations that can be classified as medical emergencies. These include situations where the person is facing extreme delusions or hallucinations and is completely disconnected from reality. During this period, they may exhibit a tendency to harm themselves or others, necessitating immediate care and medical attention. 

Paranoid Schizophrenia Causes: What are they? 

The exact causes of schizophrenia with paranoia are difficult to ascertain. However, mental health professionals agree that genetic and environmental factors could increase the risk of developing schizophrenia. 

A neuropsychiatric disorder, it is suspected that dopamine and glutamate may also play a role in the development of the disorder.

Can psychoactive drugs cause Paranoid Schizophrenia?

Since the 1980s, research has indicated a correlation between the use of psychoactive drugs like marijuana and the development of such disorders. However, little is known about its causality. Whether the use of drugs causes the disorder or if people with Paranoid Schizophrenia use it to self-medicate and cope with the symptoms is debatable. 

Research on the topic lacks specificity. Studies highlight that even among heavy cannabis users, only 2.5% of people show symptoms of paranoid schizophrenia. 

It is advisable to consult a professional if concerns surrounding the use of drugs and the development of psychosis emerge.

How is Paranoid Schizophrenia diagnosed?

All mental health disorders can only be diagnosed by a trained mental health or medical professional. Paranoid schizophrenia is usually diagnosed by a psychiatrist. They will take down a person’s entire health history and family history. Paranoid schizophrenia diagnosis could also include certain blood tests and scanning for the psychiatrist to rule out physiological conditions that may cause similar symptoms.

Certain psychometric assessments also could be used to make the diagnosis more precise. Usually, a psychiatrist and a clinical psychologist work in tandem to arrive at a diagnosis. 

Treatment Options for Paranoid Schizophrenia

Although there is no cure for schizophrenia, treatment focuses on minimizing the symptoms that a person with schizophrenia may experience. 

Mental health professionals rely on antipsychotic medications to treat schizophrenia with paranoia. 

Electroconvulsive Therapy (ECT) is used for those who might be resistant to medication or show catatonic symptoms. This is used as a last resort.

Individuals seeking treatment for paranoid schizophrenia also find it helpful to take regular therapy sessions along with their medication. 

These sessions help people to restructure their thoughts and perceptions. This subsequently brings about a shift in how they might respond in social situations. Cognitive Behavioral Therapy is a popular approach that has been adopted. It helps teach people with schizophrenia coping strategies and skills that might come in handy to manage symptoms or difficult social situations.

Effects and Side-effects: Paranoid Schizophrenia Medication

Medication aims to block the effect of dopamine in the brain. This reduces the positive symptoms of schizophrenia, such as delusions and hallucinations. Schizophrenia manifests itself differently in different people. This means psychiatrists may try different combinations of drugs and doses to achieve the desired result of managing the symptoms.

In some cases, anti-depressants or anti-anxiety drugs are also prescribed.

Possible Side-Effects of Medication

Antipsychotic drugs may or may not have adverse side effects. Possible side effects include

  • dry mouth
  • dizziness
  • weight gain 
  • diabetes
  • blurred vision 
  • tardive dyskinesia- the movement of the jaw, lips, and tongue that cannot be controlled.
  • drowsiness or lack of energy
  • loss of menstrual periods in women
  • constipation
  • sexual problems due to hormonal changes

Severe reactions like blood dyscrasias, sudden death, and neuroleptic malignant syndrome are less common.

Dr. Arun, a consultant psychiatrist at Cadabam’s, notes that “They (families and individuals) sometimes fail to understand that the medication is imperative for an individual to stop their paranoid Schizophrenia symptoms. Stopping the paranoid schizophrenia medications usually leads to relapses.”

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Making a Difference Daily: The Power of Everyday Habits

Paranoid schizophrenia is a disorder that significantly disrupts a person’s daily life and habits. A person might have difficulty in spheres including personal hygiene and self-care. Here’s how having daily routines can help a person battling schizophrenia:

  • Creates Stability: Routines provide a sense of stability, reducing stress and anxiety that can increase the severity of schizophrenia symptoms.
  • Improves Functioning: They help improve daily functioning and independence by structuring time for self-care, recovery, and medication.
  • Supports Treatment Compliance: Routines with time set aside for medication management and therapy sessions promote adherence to treatment plans. This is incredibly crucial for managing symptoms of the disorder.
  • Helps with Symptom Management: Having a regular routine can help caregivers identify symptoms of an episode very early, allowing for treatment to be administered in the initial stages.
  • Promotes Social Engagement: Structured routines that include social activities can encourage interaction and support from friends and family, fostering a supportive network that is vital for recovery and well-being.

Is Rehabilitation Necessary?

Treatment for paranoid schizophrenia focuses on curbing the intensity of the positive symptoms. However, it is rehabilitation that makes all the difference!

WHO defines rehabilitation as “a set of interventions designed to optimize functioning and reduce disability in individuals with health conditions."

The rehabilitation process involves social skills training based on an assessment of the individual's strengths. When the individual’s functioning is enhanced, it is natural that their dependence on their caregivers will decrease. It empowers them and improves their agency. 

Under the expert supervision of psychiatrists, psychologists,  and social workers, rehabilitation makes the transition of the individual- from the clinical setting into society as a functioning member- seamless.

Caring for a person with Paranoid Schizophrenia

It is with family and friends that people with paranoid schizophrenia find immense support. However, the physical, psychological, and even economic challenges they face may often be overlooked or not adequately acknowledged. 

Delusion of persecution in people with paranoid schizophrenia hurts family members. They feel that they have been wronged- a feeling that may compound itself into unresolved resentment. 

Furthermore, psychotic relapses are often perceived by caregivers as a result of their shortcomings. This adds to their stress as well as evokes a sense of guilt. Caregivers also experience an emotional and economic burden that is often not addressed.  

This is where counseling plays an important role. It addresses the emotional needs of the caregivers and realigns their expectations. It assists in restoring the relationship between the caregivers and the patient by helping the caregivers separate the individual from the symptoms.

How do we help?

We have been treating Schizophrenia for over three decades. We understand what it means to watch a loved one fight paranoid schizophrenia. Through our journey to being a leader in mental healthcare, the goal has always been to offer comprehensive help for all disorders. 

Moving from place to place, professional to professional, hospital to hospital, while trying to figure out how you can help your loved one is not an experience anyone deserves to go through. That is why we have consolidated all treatment offerings in one place. 

Our guarantee to you is that no matter the type of disorder or severity, you will find a treatment option at Cadabams. We are here to help you.

If you are searching for a solution to your problem, Cadabam’s Rehabilitation Centre can help you with its team of specialized experts. We have been helping thousands of people live healthier and happier lives for 30+ years. We leverage evidence-based approaches and holistic treatment methods to help individuals effectively manage their Paranoid Schizophrenia. Get in touch with us today. You can call us at +91 96111 94949.


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1. What are the Signs that Immediate Medical Attention is Needed?

Schizophrenia is a disorder that can cause medical emergencies. Signs that emergency help is needed include severe hallucinations or delusions that can cause a person to harm themselves or those around them. 

2. How Does Paranoid Schizophrenia Affect Daily Life?

Paranoid schizophrenia disrupts a person’s daily life completely. It affects their personal hygiene, their academic life, professional life, and personal relationships as well. It can also cause them to become a danger to themselves or those around them.

3. How is Paranoid Schizophrenia Diagnosed?

Paranoid schizophrenia is diagnosed through a combination of psychiatric interviews and psychometric assessments. Certain diagnostic tests and scans are also used to rule out other physiological conditions.

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