During an online press conference held to commemorate the single's release, Kang expanded on the meaning of "Paranoia" by sharing that "The theme in itself is heavy and distant, but since I'm resolving feelings I've personally felt, I wanted to express them honestly.

[3] In an interview with fashion-industry trade journal WWD, Kang revealed that he drew inspiration for the various tracks on Yellow from his personal experiences during a difficult period in his career and is credited as the main lyricist for the pre-released single "Paranoia".

There are various scenes that allude to social anxiety, panic attacks and the track's namesake paranoia, including a suffocating shot of Kang trapped underwater and moments where he's walking through a crowded space, increasingly fearful and wary of everyone around him.

[11] According to the Korea Music Content Association, Kang received two Gaon crowns during the eighth week of 2021 in part due to "Paranoia" ranking first in the download and BGM charts.

It was also included in Dazed Digital's list of the best K-pop tracks of 2021 where Taylor Glasby said "his clean vocal reigns triumphant amongst the warped screams and horror show bass".