Separating Paranoia from Anxiety

Mike Hedrick
The Schizophrenia Blog
3 min readSep 27, 2023
Photo by Cosiela Borta on Unsplash

If you suffer from paranoid delusions you’ve probably heard it time and time again that your paranoia is just social anxiety, and while there’s a function of anxiety in your delusions, paranoia seems to be a deeper, more sinister animal.

It used to bother me to no end when people would tell me my paranoia was social anxiety. I’ve had an innate fear of people since day one with my illness, and when people would say that, it felt like they were minimizing the intensity of what I felt and for that I became reactionary.

Mind you social anxiety is a huge problem for a lot of people and I don’t aim to lessen that, it’s just that paranoia is, at least I like to believe, kind of like a step above normal anxiety.

Paranoia is the delusion that the people around you are going to hurt you in some way while anxiety is just the worry that they won’t like you or that you’ll embarrass yourself.

It’s very easy to see how they can be confused with each other.

In my experience, paranoia is like walking around downtown and knowing that the people around you have motives purely to hurt you and to cause you harm in some way. because of that you have to remain hyperaware of your surroundings, you have to see and evaluate everyone and everything within eyeshot to determine whether it/they have the potential to mess with you, and you have to situate yourself in a safe space among this situation to keep tabs on them and any obstacles that may limit you from exiting.

Social anxiety on the other hand feels duller, more like just a worry that you’re not a part of the group and that you don’t fit in somehow.

I guess what I’m saying is that, for me at least, the difference between the two is the notion of imminent danger.

I fully acknowledge that other people might not see it this way and have an entirely different experience of the two as well.

I equate paranoia more with post traumatic stress disorder, in that you were hurt or irrevocably changed by a situation you found yourself in. One that, hence the name, caused a significant measure of trauma. I feel as though paranoia is a function of being on constant guard for that same or similar trauma.

What’s the point though? Why does this matter? Mainly, the healing for anxiety and the healing for trauma based disorders differs so it’s important to be cognizant of the things you are experiencing and feeling.

It’s important that you recognize what steps you need to take in order to handle the situation correctly, in a way that minimizes severity in order for you to push through until the time comes where you can leave the situation.

That said, social anxiety is a beast all it’s own and I applaud people who live and deal with that in their daily lives.

It takes an immense amount of strength to live with mental illness regardless of your diagnosis or the symptoms that you suffer with.

It’s important though to get the right treatment for your particular brand of crazy and with the help of a psychiatrist and a counselor, that treatment can be correctly determined.

No matter what you’re dealing with though, I want you to know that your experience is valid. You are important and you deserve to feel comfortable.

Regardless if it’s anxiety or paranoia, you’re allowed to be afraid and you’re allowed to get out. Your mental well being is and always will be the most important thing.

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Mike Hedrick
The Schizophrenia Blog

Writer living with schizophrenia. Work published in The New York Times, Washington Post and Scientific American among others.