Paranoia vs. Anxiety: Understanding the Differences

Accurate diagnosis is important for any mental health condition, especially when it comes to conditions that share some similarities, like paranoia and anxiety.

Diagnosis is a layered process in order to rule out any other conditions.


Before making any kind of diagnosis, your doctor will do a complete physical exam to rule out any underlying medical conditions that could be causing paranoia, like dementia.

They will also document your personal history to collect information about your health, behaviors, and lifestyle. This information may be an important factor in paranoia. For example, drug use may cause paranoia.

Your doctor may also order blood tests to check for any medical conditions that could be causing your symptoms.

They may also do some interviews or assessments in order to understand your thought processes and use the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) criteria to make a diagnosis of a paranoid-type disorder.


A physical exam is typically done in order to rule out illnesses that may be causing your anxiety. The doctor will also take a personal history to get more information about your:

  • symptoms
  • functioning
  • health behaviors
  • lifestyle

They may order a variety of tests to also rule out other medical conditions with symptoms that mimic anxiety symptoms.

The DSM-5 has certain criteria for anxiety disorders, and you may be given some questionnaires or tests that will then be reviewed. These can include:

Your healthcare professional will also use the DSM-5 to evaluate your symptoms to make an informed diagnosis.