The severest form of paranoia is persecutory delusions

https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(16)00066-3/fulltext

Persecutory delusions are viewed as threat beliefs, developed in the context of genetic and environmental risk, and maintained by several psychological processes including excessive worry, low self-confidence, intolerance of anxious affect and other internal anomalous experiences, reasoning biases, and the use of safety-seeking strategies.

The delusions run my life. I just try not to think about them.

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If the persecution is real it’s a different story.

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