Schizophrenia: Helping Someone Who Is Paranoid

Topic Overview

You may be able to tell when someone is paranoid. The person may accuse others of trying to harm him or her or may look around fearfully. The person may talk about protecting himself or herself from attack.

Here are ways to help the person who is paranoid:

• Don't argue. Ask questions about the person's fears, and talk to the person about the paranoia if the person wants to listen to you. If someone is threatening you, you should call for help.
• Use simple directions, if needed. Tell the person that no harm will come to him or her and that you can help. For example, "Sit down, and let's talk about it."
• Give the person enough personal space so that he or she does not feel trapped or surrounded. Stay with the person but at a distance that is comfortable for him or her and you. Stay more than an arm's reach away.
• Call for help if you think anyone is in danger.
• Move the person away from the cause of the fear or from noise and activity, if possible. Ask the person to tell you what is causing the fear. Make a direct statement that you are not afraid.
• Focus the person on what is real.
• Tell the person everything you are going to do before you do it. For example, "I'm going take out my cell phone."

To help with situations that may cause paranoia:

• Help the person avoid things he or she fears. For example, if the person is afraid of dogs, avoid them.
• Keep lights turned on if the person tells you that this makes him or her less scared.
• Talk about the person's fears when he or she is not paranoid, and make a plan for handling the fears when they occur.
• Help the person make a list of his or her fears. At the end, consider asking the person to write, "These things are not going to hurt me. These fears are symptoms of my illness. They will go away if I seek help." Don't insist that the person does this. Doing so may make the person include you as part of the paranoid belief.