Treatment of paranoia can be extremely difficult because patients are both reluctant to seek help and suspicious of those who try to offer help. Paranoid behavior can be a greater problem for family and friends than for the patient, who does not recognize that a problem exists. Patients tend to be suspicious of the types of questions a mental health professional may ask regarding their history of paranoia. In addition, patients with paranoia often fear real or imagined dangers associated with hospitalization or treatment with medications.

Nonetheless, psychotherapy and medications remain the mainstays in relieving a patient’s symptoms of paranoia. Psychotherapy tends to focus on helping improve a patient’s social functioning despite their paranoid thoughts. Some evidence suggests that merely talking about suspicions and self-doubts can make such thoughts less intrusive. Art therapy, family therapy and group therapy may also be effective in diminishing the effect of paranoid delusions.

If the paranoia is related to certain mental disorders, most notably paranoid schizophrenia, Antipsychotic medications are usually used. Patients with paranoia may resist these treatments. However, those who are unable to take oral medications consistently can be given injections of antipsychotic medications that provide treatment for several weeks.