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How to Deal with Bipolar Paranoia?

February 2, 2024

6 min read

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Author : United We Care
Clinically approved by : Dr.Vasudha
How to Deal with Bipolar Paranoia?


Essentially, bipolar disorder is a mental illness characterized by phases of severe lows and highs. These lows and highs, in medical terms, are called depression and mania. While there are no direct symptoms of paranoia within bipolar, it can occur due to the illness itself. 

Paranoia is a sub-symptom of psychosis in which an individual is excessively suspicious without cause. Let’s find out below what it entails exactly. 

What is bipolar paranoia?

Practically, bipolar disorder can have varying impacts on an individual. There are several types of bipolar disorder depending on the frequency and intensity of manic as well as depressive episodes. These episodes mimic phases where an individual goes through a range of symptoms. Psychosis could accompany any of these phases. 

Currently, the precise mechanism of why psychosis develops within bipolar is unclear. However, causes such as sleep deprivation and changes in the brain do show some relation to the development of psychosis. Within psychosis, paranoia is a common and highly occurring symptom. 

Particularly, paranoia is the fear or anxiety that others around you want to or are planning to harm you in some or the other. The fear arises through highly anxious thoughts, creating apprehension from others. In medical terms, this suspicious thinking towards others is a part of delusions. Therefore, paranoid delusions can occur in individuals who have bipolar disorder. 

Symptoms of Bipolar Paranoia

Essentially, paranoia is a symptom of psychosis. You will experience the symptoms of psychosis in combination with your bipolar symptoms. This means that during the depressive phase of bipolar, you will experience paranoia and other related symptoms. Below mentioned are the symptoms of psychosis:

Symptoms of Bipolar Paranoia

  • Difficulty in organizing thoughts
  • Tendency to stay isolated or away from others
  • Overly analyzing mundane events or incidents that they have a special meaning
  • Paranoia 
  • Hearing of voices 
  • Delusions, i.e., believing something is real without any evidence for it
  • Irrational thinking 

Without a doubt, paranoia can only occur along with other psychosis-related symptoms. However, during a manic or depressive phase, paranoia might particularly intensify. Paranoia refers to disorderly thinking and increased suspicion of others. The suspicion stems from the belief that someone is going to hurt me or there are reasons for others to harm me. In order to be paranoid, these thoughts do not have any evidence or traces in reality. 

What Triggers Bipolar Paranoia?

Firstly, untreated or misdiagnosed bipolar could lead to worsening of symptoms. Since bipolar affects your mood, thoughts, and brain functioning, it will create related disturbances if left untreated. Moreover, bipolar occurs in phases and might confuse clinicians with depressive disorder only or manic episodes only. This creates confusion in medications. 

Secondly, bipolar episodes can interfere with your daily functioning, which makes you more susceptible to other mental health issues. Psychosis has been known to increase due to lessening of sleep or insomnia. Insomnia or disturbed sleep due to bipolar phases could also induce symptoms of psychosis and paranoia particularly. 

Finally, ongoing stressors and regular substance abuse could worsen your symptoms of bipolar and interfere with treatment. This leads to disorderly thinking, increased delusions, and paranoid thinking. It is important to remember that paranoia never occurs in isolation with bipolar; rather, several psychosis-related symptoms develop simultaneously. 

How to Deal with Bipolar Paranoia?

As mentioned above, there are several aspects that need to be addressed to deal with bipolar disorder and paranoia. Not only can the phases affect day-to-day functioning, but they also reduce the ability to think properly and socialize. For this reason, it’s important to have a combination of treatments addressing social, occupational, and psychological disturbances caused by the symptoms. Let’s find out how below:

Psychiatric intervention 

Indeed, medical assistance can be essential in dealing with both bipolar disorder and paranoia. One of the main concerns with bipolar paranoia is the range and number of symptoms that can lead to misdiagnosis. This is why you have to reach out to licensed and trained psychiatrists for diagnosis. Furthermore, a trained professional can also guide you in understanding how symptoms manifest in your daily functioning. 

As discussed, accurate diagnosis is one of the key parts of dealing with bipolar paranoia. Mainly because the diagnosis will help you get the right combination of mood stabilizers (for bipolar symptoms) and antipsychotics (for paranoia/psychosis), these medications not only help deal with the symptoms but also help your brain mechanisms maintain functioning in the long term. 


Other than medical intervention, psychotherapy has been the most commonly used method to deal with bipolar paranoia. Psychotherapy usually refers to talk therapy carried out by licensed and trained psychotherapists (psychiatrists, psychologists, and psychiatric social workers). There can be several different types of psychotherapies designed and tailored on the basis of areas impacted by a mental illness. 

Particularly for bipolar paranoia, Cognitive Behaviour Therapy or CBT has been the most sought-after form of psychotherapy. CBT focuses on working on the irrational thoughts that arise due to faulty beliefs and their relation to maladaptive behavior. CBT can be especially helpful in bipolar paranoia as it addresses negative thoughts related to depression and the suspiciousness caused by paranoia. 

Social support

Finally, social awkwardness and a tendency to isolate are some of the main issues caused by bipolar paranoia. To address this, support groups and methods to increase social support are considered to be significantly helpful for patients with bipolar mania. While enhancement of social support alone is not enough, when combined with medication and psychotherapy, it can provide significant improvement in functioning. 

To clarify, support groups refer to a predesigned set of meetings where individuals with similar concerns get together to deal with specific issues caused by the illness. The group meetings are moderated by a mental health professional or a social worker who has experience with the said illness. In every meeting, different problem-solving is initiated to reduce the individual burden of the symptoms of bipolar paranoia. 


In conclusion, paranoia is one of the main symptoms of psychosis that can accompany bipolar disorder. Bipolar paranoia is triggered by several factors, such as untreated bipolar symptoms, sleep disturbances, and misdiagnosis. 

All in all, bipolar paranoia requires a multifaceted approach to dealing with mood episodes and affected functioning. It is important to reach out to trained professionals for the management of the disorder and accurate guidance. For a one-stop solution to professionals, guides, and programs designed specifically for your concerns, reach out to Kareify


[1] C. Z. Burton et al., “Psychosis in bipolar disorder: Does it represent a more ‘severe’ illness?” Bipolar Disorders, vol. 20, no. 1, pp. 18–26, Aug. 2017, doi: https://doi.org/10.1111/bdi.12527.

[2] S. Chakrabarti and N. Singh, “Psychotic symptoms in bipolar disorder and their impact on the illness: A systematic review,” World Journal of Psychiatry, vol. 12, no. 9, pp. 1204–1232, Sep. 2022, doi: https://doi.org/10.5498/wjp.v12.i9.1204.

[3] B. K. P. Woo and C. C. Sevilla, “New-Onset Paranoia and Bipolar Disorder Associated With Intracranial Aneurysm,” The Journal of Neuropsychiatry and Clinical Neurosciences, vol. 19, no. 4, pp. 489–490, Oct. 2007, doi: https://doi.org/10.1176/jnp.2007.19.4.489.

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Author : United We Care

Founded in 2020, United We Care (UWC) is providing mental health and wellness services at a global level, UWC utilizes its team of dedicated and focused professionals with expertise in mental healthcare, to solve 2 essential missing components in the market, sustained user engagement and program efficacy/outcomes.

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