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How has paranoia become so widespread and obvious in these pandemic times?

Paranoia is not an infectious disease, but it may be contagious. It can grow in favourable circumstances and take advantage of modern technology as a persuasive evangelical tool.

Paranoia exists along a spectrum, ranging from eccentric, sometimes even amusing, personality traits, through paranoid personality disorders, to paranoid psychoses with delusional beliefs, the most severe being paranoid schizophrenia. At its core, paranoia is a sense of distrust, fear of others, suspiciousness and a tendency to interpret events in a self-referential and potentially threatening manner.

Prior to this century, paranoia would have led to the sufferers withdrawing from active participation in society, staying safe within their own four walls. Their delusions would perhaps only be evident to close contacts, unless their fear became severe enough for the sufferers to seek to defend themselves from persecution, with violence.

Paranoia was therefore rarely contagious. But there have been some circumstances that could lead to the spread of paranoia to others. In its simplest form, this could be the brainwashing of a close, dependent partner by someone with a paranoid psychosis, to produce a so-called “folie à deux”, shared madness. Or the contagion could spread to many associates, with potential catastrophic results. A few examples, in ascending order of horror, are the Waco siege, the Jonestown massacre and the Holocaust. These disasters were the work of charismatic, persuasive, narcissistic, grandiose, paranoid men. Their paranoid ideas were organised around religious or political frameworks. They exploited the insecurities and resentments of their followers, who took on the fervour and paranoid fanaticism of the leader to the point where they became so absorbed and isolated that they could not comprehend the destructive pathway down which they were being willingly led. Those past disasters were all eventually brought to a halt by saner forces in society, but not before great loss of life. They were examples of exception to the usual rule of paranoia being isolating.

The last three decades have been a game-changer for the contagion of paranoia. The Internet and social media have dissolved the walls that previously marked the safe edges of a sufferer’s existence. Suddenly, the boundaries have literally expanded to include possible interaction with the world. Anyone can go online and say anything, share ideas and opinions, research any topic, see the news and educate themselves or others. Individuals, groups and governments all have access to this tremendous resource, with the ability to use it for good or ill.

The Internet has provided fertile ground for the sharing of all kinds of fears, insecurities, and discontent. Out of these vulnerabilities can evolve paranoid conspiracy theories. People who are already becoming paranoid find validation for their fears and new ways of conceptualising their thoughts. Their beliefs can evolve and crystallise into complex delusional systems, shaped by their current environment and cultural beliefs.

Individuals with an established paranoid psychosis now no longer need to keep their delusions to themselves. If they are sufficiently persuasive and articulate they can begin to influence vulnerable contacts to take on their ideas and beliefs.

Thus, paranoia has become contagious. The Covid pandemic has then come along as a perfect breeding ground for much wider spread. People are anxious and isolated. The Internet has become an even more necessary source of social interaction. Fear turns into paranoid suspicions and these may coalesce into concrete paranoid beliefs, encouraged by an environment where it becomes difficult to differentiate facts from fake news or fantasy.

 Frankly illogical and paranoid ideas have become so widespread that it has become a real issue for mental health clinicians to properly differentiate true delusions from manufactured copies caught from the Internet. It is vitally important to make that distinction, in order that those suffering from serious paranoid psychoses get the support and treatment necessary for their own welfare and the safety of the community.

To counter the contagion of paranoia, we need to recognize that even the best of us can become subject to malign and damaging influences. We need to immunize ourselves by being hard-nosed in differentiating real events from fake news; real science from fake science; true experts from charlatans; and proven treatments from wishful thinking and snake oil remedies.Dr Donald Grant is a forensic psychiatrist with wide experience in clinical and medico-