Paranoid schizophrenia is a form of schizophrenia that causes people to experience extreme feelings of paranoia. While it was once considered a type of schizophrenia, it’s no longer a separate diagnosis. That said, paranoia is still a frequent symptom for people with schizophrenia. In fact, paranoid schizophrenia is the most common form and symptom experienced by the estimated 1.1% of the population who live with this mental health condition. 

Read on to learn more about paranoid schizophrenia symptoms and treatment options. 

What Is Paranoid Schizophrenia?

Schizophrenia is a mental health condition that impacts how a person thinks, feels, and perceives reality. It’s a lifelong condition, and the severity and range of symptoms can vary.

People with paranoid schizophrenia primarily experience what’s known as “positive” schizophrenia symptoms. Despite the name, positive symptoms aren’t beneficial. Rather, the term refers to symptoms that change a person’s thoughts and behavior. This may include hallucination and delusion. 

Someone with schizophrenia may also experience negative or cognitive symptoms, which are symptoms that interfere with things like motivation, emotional response, and the ability to function normally.  

Symptoms of Paranoid Schizophrenia

Symptoms of paranoid schizophrenia can widely vary. Hallucinations and delusions are prevalent in paranoid schizophrenia and are ultimately linked to the feelings of paranoia one might experience. 


A hallucination is the perception of something that doesn’t actually exist. This symptom of schizophrenia can impact all five senses. Types of hallucinations may include:

  • Visual hallucinations: These hallucinations cause someone to see things that aren’t there. Someone with schizophrenia may see faces, bodies, or even images of an event.
  • Auditory hallucinations: Auditory hallucinations are the most common type of hallucination (followed by visual) experienced by people with schizophrenia. People may hear sounds or voices, and for some, these voices may issue specific commands. 
  • Tactile hallucinations: These hallucinations occur when someone feels a physical sensation that isn’t real. Common sensations include the feeling of hands or insects crawling on or inside the body.
  • Olfactory hallucinations: Sometimes, a person may smell something that isn’t real. Someone may experience olfactory hallucinations that make them believe they’re in danger, like the smell of smoke.
  • Gustatory hallucinations: Gustatory hallucinations cause a person to taste things that aren’t present. While these hallucinations don’t always occur while eating, they can interfere with meals. 

It’s estimated that 70% of people with schizophrenia experience hallucinations. While visual and auditory hallucinations are among the most common paranoid schizophrenia symptoms, more than 50% of people experience multimodal hallucinations, which impact multiple senses. Hallucinations occur when a person is fully awake, and they generally feel completely real to the people who are experiencing them. 


Delusions are false beliefs that conflict with reality. Someone suffering from delusions will continue to believe something even if they’re shown evidence that the belief is false. Examples of delusions may include:

  • Somatic: Someone with somatic delusions may believe they’re ill, have a physical defect, or have something abnormal about their body.
  • Grandiose: Grandiose delusions cause a person to believe they’re exceptional in some way or have special abilities. Sometimes, a person may believe they’re wealthy, even when that’s not the case.
  • Persecution: Persecutory delusions cause someone to believe they’re being persecuted or harmed by an individual, group, or organization. People with delusions of persecution may believe they’re at the center of a conspiracy.
  • Control: Delusions of control lead someone to believe they’re being manipulated or controlled by an outside force. People with these delusions think they have no control over their behavior.
  • Erotomania: Erotomanic delusions cause a person to believe that someone is in love with them. This person is often a celebrity or someone they’ve never met.
  • Thought insertion: Someone with thought insertion delusions may believe that thoughts are being implanted inside their brain.

By definition, delusions are false beliefs that aren’t supported by evidence. While someone may experience delusions without hallucinations, or vice-versa, many people experience both symptoms. In some cases, delusions may appear after the onset of hallucinations. 

“Symptoms include preoccupation and suspicion of people, events, situations, and the environment, as well as the perception of people’s comments or actions as a threat and an inability to trust and form relationships.”

Talkspace therapist Dr. Muhammad Munir, MD

Diagnosing Paranoid Schizophrenia

If a person exhibits paranoid schizophrenia symptoms, a healthcare provider will usually run diagnostic tests to rule out other health conditions, such as brain injuries, tumors, infections, and other mental or physical health conditions. Some medical conditions can impact brain function, causing symptoms like delusions or hallucinations. 

Once other health conditions have been ruled out, a care provider will ask questions and observe the individual so they can learn more about their condition. 

To meet the criteria for a schizophrenia diagnosis, an individual must have 2 of the following 5 symptoms:

  • Hallucinations 
  • Delusions
  • Incoherent or disorganized speech
  • Unusual or disorganized movements
  • Negative symptoms

Once a schizophrenia diagnosis is made, a person can begin whatever treatment option is recommended by a mental health professional. Although there’s no cure for schizophrenia, there are many effective treatment options available. It’s possible for someone with paranoid schizophrenic behavior to lead a happy and fulfilling life. 

What Causes Paranoid Schizophrenia?

Experts don’t know exactly what causes schizophrenia, but it’s believed there are many contributing factors. Studies suggest that genetics can make a person more prone to schizophrenia, but someone with a family history of schizophrenia won’t necessarily always develop the condition. 

It’s likely that some people are at risk for schizophrenia but will only experience symptoms if they’re exposed to certain triggers. According to some research, childhood trauma can significantly increase the likelihood of developing schizophrenia later in life. Other potential triggers include stress and drug use.

Research also shows a connection between schizophrenia symptoms and neurotransmitters in the brain. Schizophrenia may occur when there’s an imbalance of certain neurotransmitters, such as dopamine and serotonin. It’s also possible that people who develop schizophrenia have an increased sensitivity to neurotransmitters.

Treatment for Paranoid Schizophrenia

Schizophrenia is usually treated through a combination of medication and psychotherapy. Medication for schizophrenia can help to manage positive paranoid schizophrenia symptoms like delusions and hallucinations. People experiencing these types of symptoms might be prescribed typical or atypical antipsychotics.

“A combination of therapy and medication management can help decrease the intensity of symptoms as well as help one learn to manage them effectively.”

Talkspace therapist Dr. Muhammad Munir, MD

Psychotherapy (talk therapy) is an effective way to treat negative symptoms such as social withdrawal or a general lack of interest in the outside world. Therapy for schizophrenia can help people work through past trauma and paranoia and develop the social skills they need to build healthy relationships. A therapist can answer questions like what is paranoid schizophrenia and provide valuable support.

Finding Support with Talkspace

There’s no cure for paranoid schizophrenia, but that doesn’t mean treatment isn’t extremely important. Without a proper treatment plan, individuals can experience more severe symptoms that impact every facet of their life. Thankfully, when someone with paranoid schizophrenic tendencies receives proper care, they can learn to manage symptoms and greatly improve their long-term outlook effectively. 

If you think you need help defining, diagnosing, or treating someone with paranoid schizophrenia, Talkspace is something you might want to consider. Our online therapy platform is changing the face of therapy. We provide online support from real, experienced, licensed mental health experts who can help you by diagnosing conditions like paranoid schizophrenia and then developing effective strategies for treatment. You don’t have to live with the debilitating effects of paranoid schizophrenia. Help is available, and Talkspace can be instrumental in you getting it.