Paranoia is more or less mainstream these days, and not without justification. Thankfully, though, a great many fears remain baseless. Paranoid delusions like “someone has stolen my face,” or “everyone knows what I’m doing” are for the most part demonstrably false. They exist at the margins of clinical psychology, affecting only a small handful of patients, usually in conjunction with some other mental illness or head injury.

But for those suffering them, each of the ten delusions below are in fact absolute realities—in some cases confirmed over decades—and there’s no way to persuade patients otherwise. Many are even aware of how irrational they sound but continue to believe in them anyway. After all, as the old maxim goes, “just because you’re paranoid doesn’t mean they’re not out to get you.”

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