Paranoid delusions are typically a symptom of the mental illness known as delusional disorder, though they may also accompany other mental illnesses such as schizophrenia. Treatment for paranoid delusions usually involves intensive, and often long-term, psychotherapy. Psychoactive medications may be useful in the treatment of some types of paranoid delusions, especially where the patient erroneously believes himself to suffer from a medical condition or physical deformity. Social support, especially from family and friends, is also considered important for those struggling to recover from paranoid delusions. These delusions typically occur when the patient bears strange, untrue beliefs.
Psychiatric professionals generally agree that these patients can benefit from a comprehensive program of psychotherapy, if the therapist proceeds gently and with respect for the patient's feelings of suspicion. These patients may often suffer from concurrent anxiety or depressive disorders, so it is often considered best to offer treatment for these conditions at first. Most experts believe the effective therapist will begin to gently challenge paranoid delusional beliefs only after the patient has learned to trust the therapist, which can take several months of regular therapy.
Once the therapist has gained the patient's trust, a combination of therapeutic techniques can help the patient gradually recover. Individual psychotherapy and cognitive behavioral therapy (CBT) are usually used to help the patient slowly understand his disordered thought processes and correct them. Therapists are usually advised to be direct, honest and supportive. Focusing on correcting the patient's life problems and saluting his gains are usually considered more effective strategies than criticizing the patient or encouraging him towards introspection. Social-support therapy is also considered useful, since it can help the patient learn how to function normally in a social setting, and family therapy can help the patient's loved ones learn how to offer support to the patient's recovery.
While anti-psychotic drugs are available for the treatment of paranoid delusions, they often aren't effective. Many patients fail to take these drugs consistently, or refuse to take them altogether. This may be because the nature of their delusional disorder makes them distrustful of others, so that they come to believe that the drugs will harm them in some way. This suspicion can also make it difficult to treat these patients through psychotherapy, since they usually have difficulty establishing a relationship of trust with the therapist. Many patients suffering from paranoid delusions resist therapy and some refuse to submit to it at all, and institutionalization usually isn't recommended unless the patient is considered dangerous.