persecutory delusions
Written by: THE BALANCE
Medically reviewed by Dr. Sarah Boss, MD
Last updated: January 19, 2026
Fact checked
Quick Summary
  • When someone believes that others are out to get them, they might be going through persecutory delusions despite having enough evidence suggesting the contrary.
  • These false beliefs may seem foolish or silly to others, but people experiencing them may genuinely believe them and shape their entire lives around them.
  • This fear of damage combined with irrational thoughts typically mimics an underlying mental health condition and warrants immediate help before the problem worsens to take control of the entire life.
Reading time: 10 min

When someone believes that others are out to get them, they might be going through persecutory delusions despite having enough evidence suggesting the contrary. These false beliefs may seem foolish or silly to others, but people experiencing them may genuinely believe them and shape their entire lives around them. This fear of damage combined with irrational thoughts typically mimics an underlying mental health condition and warrants immediate help before the problem worsens to take control of the entire life. Fortunately, with proper treatment and professional support, it is possible to keep this condition under control and treat it with the right sources.

Persecutory delusions, also known as persecutory delusion disorder, occur when an individual starts believing someone is out to get or harm them, even when evidence suggests otherwise. It is a kind of paranoid thinking that can be a symptom of many mental illnesses. There are different types of persecutory delusions, depending on their intensity. While some people have very mild levels of these cognitive disturbances, others may experience very severe forms of them that may impair their everyday life.

Everyone may sometimes experience false beliefs about people being out to get them. However, for people with persecutory delusions, these beliefs are so harsh that they take a serious toll on their lives. The seriousness of this illness warrants immediate help before significantly reducing the quality of life.

An individual with a mental health illness may experience different types of persecutory delusions. While they are more commonly associated with schizophrenia, these delusions may also tend to occur with bipolar disorder and severe forms of psychosis. Sometimes, they may also indicate a delusional disorder, an illness that causes delusions for at least one month without any psychotic symptoms.

Some common examples of persecutory delusions include:

  • “My neighbors get into my house at night and steal my money out of my purse.”
  • “The police are following me because they want to capture and torture me.”
  • “The government is slow-poisoning me through drinking water.”
  • “An evil spirit is out there trying to kill me.”
  • “My next-door neighbors are spying on me.”

People who report persecutory delusions may also talk about “they” being out there to get me without articulating who “they” are. Sometimes, these delusions may become so intense that the victims may try to report their concerns to other authorities. When the leaders fail to respond, they may grow suspicious and believe that the authorities are involved with the other party and trying to harm them together. Such people may also feel confused about why their family members and friends are not sharing their concerns and may become angry that no one is taking action.

People who develop persecutory delusions tend to have many common factors relevant to how they think, behave, and feel. However, experts are still determining whether these factors trigger these delusions or if the delusions cause these factors to occur. Mentioned below are the six things individuals with persecutory delusions may have in common:

Worry and Rumination

People with persecutory delusions tend to spend much time worrying. Many studies have revealed that these people’s worry levels are comparable to those suffering from anxiety disorders. These people also spend much time imagining catastrophic ideas and implausible consequences. For such people, a worry period often precedes persecutory delusions. People with underlying anxiety and persecutory delusions can benefit from seeking treatment for anxiety. 

Negative Thoughts

People who feel inferior, different, or vulnerable are generally more likely to feel paranoid and develop persecutory delusions. A study performed in this aspect has found that having negative thoughts about oneself can successfully predict the persistence of persecutory delusions in people. [1] Experts also believe that individuals with persecutory delusions tend to be overly critical of themselves with very low levels of self-compassion.

Interpersonal Sensitivity

Most people who experience persecutory delusions have higher interpersonal sensitivity. What this means is that such people feel more vulnerable when they are around other people due to a constant fear of rejection or criticism. They are also more likely to interpret everyday events as hostile attempts coming from others. This high level of interpersonal sensitivity that these people display is also associated with high levels of depression and anxiety.

Abnormal Internal Experiences

Many people with persecutory delusions tend to misinterpret external events. However, research believes this factor is only true when the victim has an unsettled internal state. Perceptual disturbances, feelings of depersonalization, and unexplained anxious arousal can cause an individual to seek answers in their surroundings. For instance, a person who has gone through an adverse life event may feel “off.” As a result, they may try to blame their environment for why they are feeling so bad.

Insomnia

Experiencing insomnia and other sleep-related problems also greatly increases the odds of experiencing paranoid ideation, sometimes up to by three times. Poor sleep is also another factor that predicts if someone continues to experience persistent paranoia. However, because insomnia is a treatable condition, managing it by improving sleep quality can be vital to reducing persecutory delusions.

Irrational Reasoning

Many people who experience persecutory delusions naturally like to jump to conclusions. Such people gather very little information before they can make any decisions and are usually very impulsive in everyday tasks. For instance, these people may assume that a person they do not know is holding up a phone because they are trying to record them. Similarly, they may also believe that a group of people laughing near them is making fun of them. Such people also exhibit a poorer working memory of performance, low intolerance of uncertainty, and low IQ levels.

Treatment for persecutory delusion disorder typically varies, depending on the type of mental illness someone is suffering from. Sometimes, an underlying issue like past trauma or insomnia requires attention to treat this delusional issue. Similarly, some people may benefit from controlling their anxiety levels.

Therapy

Research has concluded that cognitive behavioral therapy, or CBT, can effectively control persecutory delusions in individuals. [2] As a part of this therapy, a trained therapist helps patients reduce their rumination and worry, which, in turn, keeps the delusions in control. CBT can also cause a significant decrease in other symptoms of paranoia.

Medication

Depending on the triggering illness, medications like antidepressants, mood stabilizers, and antipsychotic drugs can also be used to benefit people with persecutory delusions.

Support Services

People with persecutory delusions often struggle to complete everyday tasks, such as running errands, going to work, or paying the bills. They may also require professional support services to help them with everyday tasks.

Inpatient Hospitalization

Sometimes, the level of persecutory delusions becomes so intense that the afflicted individuals may start distrusting the professionals who are taking care of them. To handle such unstable patients, inpatient hospitalization might be required.

Supporting someone who is going through persecutory delusions can be extremely hard. You might need to spend a lot of time trying to make them understand how they are being persecuted. Other times, the afflicted individuals may also believe that you might be out to get them. However, remember that whatever a person with these delusions is going through is not their fault, and you may need to keep working on their circumstances with patience to experience any improvement. Consider trying the following tips to make things better and easier.

Have Empathy

As someone whose close family member or friend suffers persecutory delusions, you may be tempted to believe that their thoughts are too irrational to be mended. You may also reconsider helping them as you fear your efforts may do more harm than good. A better approach to handling these circumstances is to focus on how your loved one might feel. Try using the following phrases to get your concerns across with gentleness:

“I notice that you have been overwhelmed lately.”

“I can imagine how stressful this must be for you.”

Seek Support for Yourself

A support group can easily help you learn about resources and strategies that other people in similar situations have benefited from. Whether the person experiencing persecutory delusions is your sibling, child, parent, or partner, consider seeking therapy to better understand their illness and learn how to cope with it. If appropriate, a therapist can also coach you on conducting reality testing that you can use with your loved ones to help them out. 

Consider Family Therapy

Attending family therapy sessions with a trained therapist can help you learn how to best respond to a person experiencing persecutory delusions. A therapist can also help you guide what to say and how to best support them to improve their recovery outcomes.

FAQs

Do persecutory delusions go away?
People with persecutory delusions are so deep in their irrational beliefs and thoughts that others may believe they can never get out of it. It is, however, essential to remember that these people are not in this situation by choice, and with treatment, they can successfully get over their delusions with professional support. In most cases, treating the underlying mental health issue triggering these delusions may cause them to go away on their own.
Can anxiety trigger persecutory delusions?
Yes, in some people with anxiety, the level of this mental illness may sometimes reach a level called persecutory anxiety state, a type of panic attack. Such type of anxiety has the ability to trigger persecutory delusions.
How common are persecutory delusions?
Persecutory delusions, also known as delusions of persecution, often occur as a part of other mental health disorders. At its lowest, 10 to 15 percent of individuals experience paranoia and persecutory delusions. In most cases, these delusions are regarding their self-safety and the safety of others.
What causes persecutory delusions?
Persecutory delusions have different causes, such as childhood trauma and psychosis. Other factors triggering it may also be related to genetics, biological factors, and societal norms. These include: 
Biological factors such as brain abnormalities or imbalances in chemicals in the brain
Childhood trauma can sometimes trigger paranoia and persecutory delusions
Societal factors like books, movies, and pop culture may increase or even fuel persecutory delusions
Genetic factors like positive family history can also increase the risk of experiencing persecutory delusions
Are there any types of persecutory delusions?
Yes, persecutory delusions can be of different types. One of these types includes somatic delusions, where a person believes they have a medical problem or a physical defect. Another type is erotomanic delusions, where a person falsely believes someone is in love with them.

References

[1] Fowler, D., Hodgekins, J., Garety, P., Freeman, D., Kuipers, E., Dunn, G., … & Bebbington, P. E. (2012). Negative cognition, depressed mood, and paranoia: a longitudinal pathway analysis using structural equation modeling. Schizophrenia bulletin, 38(5), 1063-1073.

[2] Freeman, D., & Garety, P. (2014). Advances in understanding and treating persecutory delusions: a review. Social psychiatry and psychiatric epidemiology, 49(8), 1179-1189.

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