How to help someone with paranoia, delusions and/or hallucinations
The most important aspect here is to ask the person you want to help. Everyone wants different forms of support. Some people want to be challenged, some want to be believed. How people want to be help vary between each person, so the best thing to do is ask the person if you can!
Paranoia
- If they are okay with it, ask the person how realistic the paranoia is. If they heard a noise that triggered it for example ask them of possible causes for it (a pet for example)
- Do things to make them feel safe. Give them a blanket, tell them that you’re thinking/praying for them.
- Don’t dismiss their fears. Don’t say “But no-one is going to break in!” This doesn’t help, and may make it so the person won’t express their fears to you in the future for fear you’ll judge them
- Don’t judge them. To them, they are scared. As silly as it may seem to you, to them it is real.
- Tell them if there’s anything at all you can do, to just say. Tell them you’re not judging them, you understand they’re scared, they’re not being silly, and that you want to help them.
- Give suggestions to how to counter what they’re scared of. If they worry something is in the dark, tell them they could turn a light on. (note: avoid doing this often if possible, it may form maladaptive behaviours that could damage the person in the long run)
Delusions
- Avoid arguing with the person about their delusions. Delusions are extremely fixed and difficult to change. The person believes they are real- by telling them they are not you make it so that person feels they can’t trust you
- Don’t be offended or hurt if a person forms a delusion about you. It may hurt a bit if your friend has a delusion that you want to hurt them, but remember that delusions don’t make acceptions. In their mind, no matter how good a friend you are, their delusion is convincing. Just give them space if they ask, ask if there’s anything you can do to convince them otherwise, and respect their emotions.
- With permission from the person, try and dispute their delusion. If they fear for example that their food is poisoned, ask them why they think that. Ask if they have any evidence.
- Make them feel safe. Continuing the food poisoning delusion, perhaps make them some new food to calm them down, or get them to make their own.
- Remind them that you are not there to judge them or tell them they’re wrong.
- Connect with the emotion of the delusion and validate them. E.g. “It must be scary thinking your friend is trying to hurt you.”
- Calm things down around the person. Often delusions are worsened by sensory overload, get the person to a calm, open, relaxing place.
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Show them with your body language that you are on the same side. Sit beside rather than in front of the person so they don’t see you as a threat.
- Stay calm yourself- don’t panic or get caught up in emotion- someone providing stability and rationality can really help.
- If you get frustrated, don’t express this at the time. It can be frustrating for a person to be fixed on a delusion and not being able to sway them- but remember, the delusion has a MUCH larger impact on them than it does on you. Remember to consider their side and their feelings.
Hallucinations
- As with all of the above, remember that to the person that the hallucination is real. No matter how much you say it isn’t, they are still experiencing it.
- Isolate them from the hallucination if you can. For example, if they hallucinate a person in their room, ask them to leave the room and lock the door for a short period, giving the hallucination possibly time to fade and to calm the person. (Note: the aim isn’t necessarily to get rid of the hallucination, but to calm the person and make them feel safe)
- Ask them what they can do to counter the hallucination. For example, if they have auditory hallucinations they could put on headphones to attempt to counter them.
- Accept that sometimes the hallucination can’t be gotten rid of. Sometimes it’s a case of keeping the person safe and waiting until it fades. This may be a case of the person going to sleep.
- Keep the person safe in the mean time. If they see bugs for example, tell them you have some spray to get rid of them, then perhaps spray some deodorant onto them. This seems silly, but has the chance of working.
- Keep the person calm if you can. If they hear voices for example, tell them the voices are only voices and can’t hurt them. Inform them you will get rid of any danger and will protect them.
- If they have sensory hallucinations, stimulate other senses. If they feel breath on their neck, try rubbing their neck to ‘cover’ the feeling.

