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Paranoid Thriller

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A sub-genre of Psychological Thriller revolving around characters who believe they have uncovered shady goings-on beneath the veneer of everyday life and/or are pursued by some kind of conspiracy run by a shadowy organization. The key difference from Conspiracy Thriller is that the work focuses on the unstable mental state of the protagonist rather than on the exact nature of the conspiracy, and the audience is never sure (at least not until the end, and sometimes not even then) whether the character is really uncovering something, or that there truly is a shadowy organization, or whether they're just imagining it.
May overlap with World of Mysteries (this is how the characters in this genre usually see the world around them), Mockstery Tale, and Mockspiracy (if it turns out that the whole conspiracy never really existed).

Examples
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In A Beautiful Mind, a young gifted mathematician is hired by the intelligence services to find hidden messages in newspapers by a secret Communist organization; he soon becomes paranoid, suspecting nearly everyone around him of being a Communist spy. It turns out that he suffers from schizophrenia, and the whole story of his involvement with intelligence services was a delusion.
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 A Beautiful Mind
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Serial Experiments Lain has the protagonist uncover a transhumanist conspiracy using the internet, all while leaving it ambiguous as to how much of the plot is her schizophrenic delusions.
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 Serial Experiments Lain
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In The Tenant, a shy tenant in an apartment complex starts to believe that his neighbours are conspiring to gaslight him. The Gainax Ending leaves it unclear whether he just went off his rails, or something sinister is indeed going on at the apartment complex.
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 The Tenant
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Closed Nightmare
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 Closed Nightmare (Video Game)
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In The Game (1997), the main character joins a mysterious Alternate Reality Game which soon becomes threatening, and begins to interfere with his everyday life, driving him to paranoia, since he doesn't know the intentions of the people behind it, and who is and who isn't involved in it. It turns out that The Game Never Stopped, and almost everyone was in on it.
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 The Game (1997)
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Higurashi: When They Cry switches between this and Religious Horror, depending on the main character's current understanding of what's going on. Characters repeatedly go insane trying to understand why one person dies and one disappears every night during the Cotton-Drifting Festival. There actually is a conspiracy going on, but the characters' progressing paranoia in the different retelling usually works to keep them hunting down Red Herrings, like the local Yakuza family.
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 Higurashi: When They Cry (Visual Novel)
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Guyana: Crime of the Century, an Explotation Film based on the real-life tragedy that occured in Jonestown, Guyana on November 1978. It follows James Johnson (a Roman à Clef fictionalization of Jim Jones) and his increasing paranoia over the US government's interest in uncovering the shady truth behind the difficult life in his commune (Johnsontown, a fictionalized version of Jonestown). The paranoia is reciprocrated, as congressman Lee O'Brien (a fictionalization of Leo Ryan) becomes increasingly worried about the health of the commune's inhabitants, especially due to the pressure he's receiving from the friends and relatives who recurringly ask about them.
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In The Crying of Lot 49, the protagonist Oedipa believes that she uncovered a centuries-old conspiracy involving an underground mail delivery company, Trystero. The novel implies that the whole Trystero story may be a practical joke by Oedipa's late husband or even hallucination of hers, but it might be real as well; the open ending never resolves this.
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In Foucault's Pendulum, the three main characters invent a parody conspiracy theory to mock the real-life conspiracy theorists and occultists. Eventually they come to believe in it themselves, and become targets for an actual secret society. From this point, the narrative becomes increasingly paranoid and incoherent, with the protagonist believing that nearly every item has a hidden meaning, and nearly every bystander is following him, and the novel doesn't clarify which of the events happened in reality, and which were hallucinated by the protagonist.
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Eyes Wide Shut has the protagonist infiltrate a mysterious masked orgy apparently thrown by rich and powerful members of the society. He is exposed, and though he manages to make it out, he starts feeling that he's pursued by the members of the conspiracy, and a couple of other people are seemingly Killed to Uphold the Masquerade. However, the details are never clarified, and there are some hints that the whole story was a dream.
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In Under the Silver Lake, a young slacker in his 30s spends his days investigating the disappearance of a young woman he fell in love with by looking for hidden clues in pop music, video game magazines, and cereal boxes. He encounters some weird characters, including a Hobo King and a woman in an owl mask who seduces and kills men in their sleep, and eventually gets to the bottom of the conspiracy... However, a number of scenes imply that he is an Unreliable Narrator, and at least some of this stuff may be happening only in his head.
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The Ballad of the Flexible Bullet by Stephen King is about the paranoid writer Reg Thorpe who believed in the existence of Fornits (a kind of luck-elves who lived in typewriters and brought inspiration to writers), and that some sort of sinister conspiracy was about to kill the Fornit that lived in his own typewriter. The protagonist, who is Thorpe's editor, gradually loses his grip on reality and starts to believe in Reg's fantasies, largely due to his own alcoholism. The story leaves it unclear whether or not the fornits and the conspiracy really existed, but there are some implications that they did.
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 Skeleton Crew
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Mizzurna Falls
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Flightplan (2005) is about a woman whose daughter disappears from a plane in the middle of a transatlantic flight, but there are no records of the girl on the flight and no one will admit she was ever there. Two thirds of the film is spent unsure of whether the mother is delusional or being conspired against, but it turns out to be the latter.
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 Flightplan (2005)
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The Conversation focuses on a private surveillance specialist who believes himself to have uncovered a murder plot by his employers, but the main focus of the film is on his deteriorating mental state as he becomes obsessed with the titular conversation he was tasked with recording. While the film was released during the middle of the Watergate scandal and bears many similarities to those events, it was actually written before Nixon even got elected.
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In Jacob's Ladder, a Vietnam veteran suffering from PTSD believes he is pursued by government agents who want to silence him, as well as by demons and fantastic monsters. Throughout the movie it remains unclear which, if any, of his bizarre experiences are real, and which are hallucinatory, but in the end, it turns out that all of it was his Dying Dream, and he never made it out of Vietnam; demons pursuing him are actually angels who want to help his soul ascend to Heaven.
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The following is a list of statements referring to the current page from other pages.

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Madness Tropes
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The Index Is Watching You
 Serial Experiments Lain / int_819deed9
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 Eyes Wide Shut / int_819deed9
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 Flightplan (2005) / int_819deed9
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 Jacob's Ladder / int_819deed9
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 The Conversation / int_819deed9
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 The Game (1997) / int_819deed9
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 They Look Like People / int_819deed9
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 Under the Silver Lake / int_819deed9
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 Foucault's Pendulum / int_819deed9
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 Skeleton Crew / int_819deed9
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