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What is The Connection Between OCD & Paranoia?

“I hate going to work because my co-workers avoid me. Why do they avoid me? Because I have OCD and I am afraid of germs. More specifically, I am afraid of getting sick or making other people sick. I think I’ve always been this way, but now with coronavirus and its many variants popping up everywhere, my anxiety level is through the roof. Covid is stressing me and my co-workers are just making everything worse. They don’t know that I have OCD, but I’m pretty sure they have an inkling that something is wrong with me.

My co-workers watch me all of the time, waiting to see what I will do next so they can laugh and make fun of me. They make me nervous and very, very sad. I am meticulous about washing my hands, using hand sanitizer, and wearing a mask – and my co-workers know this. They think I’m stupid or “slow” and they want me to go away. I just know they are plotting to get me fired all because I want to be “germ-free.” I even had one of my co-workers ask me why I wash my hands so much.

I do wash my hands a lot – exactly 10x while at work. I can’t help it. But I am pretty sure that my co-worker went back and laughed at me with her friends. The thing is when I think people are laughing at me it causes me to wash my hands even more. All I can think about all day is how much my co-workers hate me. I truly believe that they are either trying to infect me with germs or get me fired. I know for a fact that they are plotting against me. And, the only thing that makes me feel better is to wash my hands and stay away from them. This happens every day.“

~Signed Anonymous Client

OCD involves repetitive thoughts and behaviors that are disturbing or intrusive, while paranoia involves the belief that someone or something is trying to harm, betray, and/or “trick” you.

But, can OCD make you paranoid? Yes!

However, to fully understand why this happens, you will need to learn the telltale signs of each condition (OCD and paranoia). OCD is an anxiety condition that involves all-consuming obsessions (upsetting thoughts, emotions, and images) and compulsions (ritualistic behaviors or specific “acts”).


Can OCD Actually Make You “Crazy?”

No, OCD will not make you “crazy.” However, it could cause you to experience anxiety-based paranoia.

OCD is a paralyzing, life-changing condition. It is so powerful that it can transform you into a shell of your former self. OCD is also a lonely condition. Many people with this condition feel as if they are “crazy” or “abnormal.” In fact, some people with OCD have reported that their lives feel foreign to them. Most, however, have struggled to understand what is prompting these disturbing thoughts and behaviors.

Obsessive thoughts and compulsive behaviors can become so severe that they cause you to question everything and everyone around you. This is where the paranoia factor comes into play. The truth is it is your own insecurities that are triggering the paranoia. These insecurities stem from stress, anxiety, and OCD. Because your thoughts and behaviors are involuntary and upsetting, it is impossible not to wonder what people are thinking and saying about you.

For instance, you may start to believe that your marriage is on the rocks because your spouse is tired of you constantly cleaning the house or checking things (i.e., doors, locks, windows, appliances, etc.) 2x, 3x, 4x, 5x, or 6x before going to bed. Your OCD could convince you that your hubby no longer loves you because of your behavior when nothing could be further from the truth. So, even though your husband loves you and does not plan to leave you, the thought of him leaving you for someone else ramp ups your anxiety. And, your anxiety triggers or aggravates your OCD symptoms.

What is Paranoia?

The term, “paranoia” is often used flippantly to describe someone, who is suspicious (sometimes for good cause) of someone or something. Many people throw the word, “paranoid” around to fit a certain situation, even if it does not apply to it. The truth is “paranoia” refers to someone who is genuinely afraid of someone or something.

For instance, a paranoid person may be extremely worried, concerned, or frightened that something will happen to someone he or she loves. Sometimes, the paranoia is justified (i.e., a cheating spouse) but many times it is not. Paranoia can also refer to a person, who is mentally ill and who has lost touch with reality. In this case, there is no reason to be paranoid. It is the mental illness that is fueling the paranoia.

Paranoia, regardless of its origin (i.e., stress, anxiety, OCD, or even psychosis), can be highly distressing and extremely terrifying. So, if you are struggling with OCD and anxiety-based paranoia, it is important to seek OCD help (i.e., OCD treatment, support, resources, and self-help tools) as soon as possible. With the help of an OCD-trained therapist or psychiatrist, you can develop a treatment plan that will help you gain control over your stress and anxiety.

Once you have a grasp on these two emotions (stress and anxiety), your OCD symptoms and paranoia should improve. Remember, your paranoia is stemming from your stress, anxiety, and OCD symptoms, so once they are effectively managed, your paranoia will improve or disappear altogether. With the right OCD treatment, you can stop living in the shadows and start living in the sunlight. And, with proper OCD management, you can finally start living without fear.

The Merriam-Webster Dictionary defines “paranoia,” “delusions,” and “compulsions” as:


  • “Organized” delusions of grandeur or maltreatment or abuse – usually absent of hallucinations
  • Being excessively or irrationally suspicious and cynical of others


  • Illogical beliefs, opinions, or emotions
  • Psychosis or an irrational belief, opinion, or emotion falsely directed at someone or something – A delusional person will maintain this viewpoint, even when presented with evidence that disputes it.


  • Involuntary and constant urges to engage in a specific behavior or perform a certain “act” to relieve one’s stress and anxiety (i.e., excessively cleaning the house because of a fear of germs, infections, and diseases)

Yes, there is a link between anxiety and paranoia.

It is common for people with anxiety to constantly worry about someone or something. In some cases, the angst is grounded in reality, but in others, it is not. It is also common for these individuals to be paranoid or feel as if something ominous is going to happen to them or their loved ones.

Sometimes, the suspicions are warranted, however, most of the time, they are not. Also, understand that a person can be anxious and paranoid, but not be psychotic. In other words, a person’s response to his or her anxiety and fear may be excessive and irrational, however, that does not automatically mean that he or she is delusional.

Listed below are examples of anxiety and paranoia:

  • “I cannot go grocery shopping because I am terrified, I will need to use the restroom and be forced to use a dirty and germ-filled public toilet. What if I catch something like Covid-19 from the bathroom stalls or toilet seat? Or, what if Covid-19 is in the air and I breathe it in, contract the virus, and die from it a few days later?” To avoid this, I schedule curbside grocery pickup at my local grocery store.
  • “I am always scared that I will lose my keys while I am running errands, so I always carry multiple copies with me. If I lose my keys then someone will find them and break into my car or home and rob me. So, I rarely go out, but when I do, I always take all of my key copies with me.”
  • “I am deathly afraid of going to social events, celebrations, parties, or get-togethers because I know that I will stand out and no one will talk to me. Or, people will huddle together in a corner and laugh and make fun of me. As a result, I will just end up looking foolish and stupid. So, I make fake excuses to friends, loved ones, acquaintances, and co-workers as to why I cannot attend their functions.

Note: Anxious people, who also struggle with paranoia, are prone to self-isolating and avoiding people and situations that are overwhelming or stressful. Thus, if your anxiety is not properly treated, it will not only make you paranoid, but also take over your life.

Did you know, our our self-help course has helped thousands of OCD sufferers better manage their symptoms?

"My OCD is finally manageable"

Jennifer S

Can OCD Really Make You Paranoid?

Yes, OCD can really make you paranoid if it is left untreated.

Hallmark signs of OCD are excessive fears, doubts, thoughts, beliefs, and compulsive behaviors (rituals and routines). When you have OCD, it is common to doubt your own brain. For instance, it can cause you to wonder if you turned off the oven or locked the door. The problem is this wonder or intrusive thought can make you check the oven or door many times before accepting that the oven is off or the door is locked.

Upsetting thoughts and ritualistic behaviors can trigger OCD-based paranoia. For instance, you may truly believe that your loved one or friend will be in a car accident if they try to drive in snowy and icy weather. So, you try to convince the person to avoid driving until it is sunny and clear. This is most likely an illogical fear, but to you, it feels very real. So, if you feel that your OCD is causing you to become paranoid, seek OCD help with a qualified therapist or psychiatrist.

Note: Understand that people with OCD have not lost their grips on reality, even if their fears, worries, concerns, and behavior are not always logical. In other words, a person with OCD understands that performing a certain action, such as obsessively cleaning the house multiple times a day to ensure that no one gets sick, will not actually prevent people from getting sick.

Once the person goes to work, school, or grocery shopping, and/or when people visit him or her at home, there is a chance that someone will become sick. If a virus is airborne, just stepping outside can cause someone to “catch” something. This person knows that he or she does not have the power to stop anything from happening.

Listed below are examples of OCD and paranoia:

  • “I hit a bump in my car this morning and I am pretty sure I ran over someone on my way to work. The only way I will know for sure is to keep checking until I’m sure that I did not kill someone this morning. However, just retracing my steps and checking the road for a dead body probably isn’t going to make my anxiety go away. I probably won’t believe that I did not hurt someone until I watch the news or read the newspaper and it does not list a hit-and-run that day.

And, I may not believe it then because the person could have drug himself or herself into the bushes. Then, it may be that he or she is dead but no one has found him or her. Perhaps, I should call the police, local hospitals, and nearby morgues to check if they know information about the person I hit. Maybe, that will give me some relief.”

  • “If I do not take 25 steps from my front door to my car, I will fail my college midterm exam. This could lead to me flunking the semester. If that happens it will take me longer to graduate and prevent me from getting my dream job. So, I make sure that I take exactly 25 steps from my front door to my car. If I mess up, I start over until I count the required number of steps. It is the only way I feel comfortable getting in my car and going to school.”
  • “If I do not listen to a Taylor Swift song, while picking up pieces of lint in my house every day, someone I love will develop a serious autoimmune condition and I will be to blame. So, I do this daily to keep everyone I love safe and healthy.”

Can OCD-Based Paranoia Turn into Schizophrenia?

No, it is unlikely that OCD-based paranoia will turn into schizophrenia. Schizophrenia is a mental health condition that is characterized by hallucinations and delusions. A person with an anxiety condition, like OCD, can experience schizophrenia-like symptoms (paranoia and psychosis), but clinical schizophrenia.

Schizophrenia-like symptoms (paranoia and psychosis) stem from anxiety and not from the actual mental health condition, schizophrenia. Once a person gets a solid grasp on his or her OCD, the schizophrenia-like symptoms (paranoia and psychosis) typically improve or disappear.

Note: It is possible for a person with OCD to also have schizophrenia. This is considered co-existing, co-occurring, dual, or comorbid conditions. However, having both full-blown conditions is rare. Also, keep in mind that some people with schizophrenia develop obsessions, which can sometimes lead to a misdiagnosis.

Can OCD-Based Paranoia Trigger Psychosis?

Yes, it can.

People with OCD are aware that their thoughts, beliefs, emotions, and mental images are faulty or illogical, however, they are unable to stop them. Many of these individuals want to stop performing certain “acts” or engaging in specific behaviors but have found it impossible to do so. These individuals engage in compulsive behaviors or “acts” because doing so eases their stress and angst and makes them feel safe and secure.

Keep in mind that people with OCD often feel as if they cannot trust their own minds. Ritualistic behaviors or routines can help relieve their distress – but possibly at the cost of experiencing paranoia and/or psychosis. OCD-based psychosis and paranoia can involve worries, fears, and phobias that are illogical, irrational, or unrealistic. In fact, most of the time, these thoughts, emotions, beliefs, and mental images are delusional and will not happen. Sometimes, people with OCD will try to justify their obsessions, compulsions, psychosis, and paranoia, which can sound peculiar or unreasonable to other people.

Unlike people with OCD-based psychosis and paranoia, people with schizophrenia-related psychosis and paranoia, are likely unaware that their thoughts are nonsensical. However, the worst thing someone can do is argue with a schizophrenic, who is suffering from psychosis and paranoia. It is also unwise to tell a schizophrenic that what he or she is saying simply does not make sense. Arguing with this individual will only worsen his or her paranoia and psychosis.

Psychosis and paranoia can be extremely frightening, regardless of the origin (i.e., anxiety/OCD, schizophrenia, paranoid personality disorder, delusional disorder, bipolar disorder, or dementia). People with OCD-based psychosis and paranoia tend to feel as if they are always at risk of being attacked, harmed, or criticized. Nothing feels “safe” when you are struggling with this condition.

For instance, a person with OCD-based psychosis and paranoia may truly believe that his or her loved ones have been replaced with aliens, monsters, robots, or imposters. Or, this person may believe that he or she has been cloned and is being controlled by someone or something else. The truth is knowing the best way to support someone, who is struggling with OCD-based psychosis and paranoia, can be challenging.

Listed below are examples of OCD-based psychosis and paranoia:

  • “Someone at work is sprinkling rat poison on my lunch to make me sick or kill me. My stomach has been hurting after lunch for two days. I am sure it is Mary. She is jealous of me so she is trying to get rid of me.”
  • “My doctor is using me as a “guinea pig.” He does not care about me or my health and well-being, he just wants to experiment on me to help other people. That is why he orders so much bloodwork each visit. He could care less if I died in the process.“
  • “If I eat this leftover food from last night, I will get salmonella poisoning. There are bacteria constantly growing in the food, so if I eat it, it will either make me really sick or cause me to die.”

Can Be OCD-Based Paranoia Be Treated?

Yes, it can.

The first step to treating OCD-based paranoia is to seek OCD treatment. OCD treatment typically involves lifestyle changes (i.e., getting sound sleep, exercising, and eating healthy foods), therapy (i.e., cognitive-behavioral therapy (CBT), mindfulness CBT, group therapy, acceptance and commitment therapy (ACT), family therapy, etc.), medications (i.e., antidepressants, anti-anxiety meds, or anti-psychotics), and/or self-help tools, like mindfulness meditation, yoga, and online OCD self-help courses like Impulse.

Impulse can teach you how to effectively manage your OCD (intrusive thoughts, compulsive behaviors, and anxiety-based paranoia), so it no longer has a chokehold on your life. Another benefit? Impulse also offers an OCD assessment that can help you determine the severity of your OCD symptoms and place you on the right path to recovery. The goal of Impulse’s self-help course is to empower you and provide you with tools and resources needed to finally be “free” of your OCD-based paranoia.

Our self-help OCD therapy course has helped 1000s of OCD sufferers since 2018.

"My OCD is finally manageable"

Jennifer S


DR. R. Y. Langham

Dr. R. Y. Langham has a B.A. in English, an M.M.F.T in Marriage and Family Therapy (Psychology), and a Ph.D. in Family Psychology. She is currently a medical, health & wellness contributor, copywriter, and psychological consultant

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