my paranoia got so bad recently i checked my sorry butt into a hospital to get away from everyone i was scared of. i knew they couldn't get me there. now that i look back on it, that's pretty funny and totally screwed up. most people avoid those places.

anyway, i try reality checking like you mentioned. sometimes it's really hard to do that when the delusions take over because once they do, whatever i'm thinking has become reality in my head, so no amount of reality-checking works (and I don't bother trying).

if i'm not so delusional that they take over, then it's easier to not necessarily make the paranoia go away, but easier to handle it. i try to ground myself to what i'm feeling and not what i'm thinking. like the shoes on my feet, clothes on my back, cigarette in hand, etc. i focus on those things, which is basically a distraction, but it helps me when the paranoia starts to stress me out.

if the paranoia doesn't stress me out, and the delusions haven't taken over, i don't really do anything because i don't think its necessary.