Paranoid Personality Disorder

Paranoid personality disorder is a chronic and pervasive condition characterized by disruptive thought, behavior, and functioning patterns. People with paranoid personality disorder experience pervasive patterns of suspicion even though they have no reason to experience such distrust.

This disorder is thought to affect between 1.21 to 4.4% of U.S. adults. Individuals with paranoid personality disorder are at a greater risk of experiencing depression, substance abuse, and agoraphobia.

Symptoms of Paranoid Personality Disorder

Individuals with paranoid personality disorder typically experience symptoms that interfere with daily life. The primary characteristic of this condition is a chronic and pervasive distrust and suspicion of others.

Other symptoms of paranoid personality disorder include:

• Feelings that they are being lied to, deceived, or exploited by other people
• May believe that friends, family, and romantic partners are untrustworthy and unfaithful
• Outbursts of anger in response to perceived deception
• Often described as cold, jealous, secretive, and serious
• Overly controlling in relationships in order to avoid being exploited or manipulated
• Look for hidden meanings in gestures and conversations
• Find it difficult to relax
• Often hold negative views of other people
• Overly sensitive to criticism
• Overreacts in response to perceived criticism

While this mistrust is unfounded, their distrust of others makes it difficult to form relationships and can interfere with many aspects of life, including at home, school, and work.

How Is Paranoid Personality Disorder Diagnosed?

Because people with paranoid personality disorder do not think there is anything unusual or out of the ordinary about their behavior, this condition can be challenging to diagnose. 

People with PPD don't often seek help for their condition. However, they may seek help for problems stemming from paranoid personality disorder, including anxiety, depression, or relationship issues. 

To diagnose paranoid personality disorder, a doctor or mental health professional will ask questions about the symptoms a person is experiencing. However, this can also be challenging, since questioning might cause the person to become suspicious or hostile. 

Doctors and mental health professionals utilize the "Diagnostic and Statistical Manual of Mental Disorders" (DSM-5-TR) to make a diagnosis. This manual describes the symptoms and criteria needed to diagnose different mental health conditions.

Related Mental Health Conditions

Researchers suggest that around 75% of people with paranoid personality disorder also have another co-occurring personality disorder. Some of the common include:

• Avoidant personality disorder
• Borderline personality disorder
• Antisocial personality disorder

Other personality disorders aren't the only conditions that often occur alongside paranoid personality disorder. Other conditions commonly occurring include panic disorder and substance use disorders.

What Causes Paranoid Personality Disorder?

While the exact causes of paranoid personality disorder are not known, it is believed that both genetics and psychological factors play a role. There is also likely a strong genetic component since a family history of schizophrenia is considered a risk factor for paranoid personality disorder.

Treatment for Paranoid Personality Disorder

Paranoid personality disorder is generally treated with psychotherapy. With ongoing treatment and appropriate support, people with this condition can manage their symptoms and function more effectively in their daily lives.

Unfortunately, the paranoia and suspicion that are the characteristic features of the condition mean that people often don't seek help. After all, they don't actually think that they have a problem. T

The distrust and paranoia that characterize the condition also make it difficult for people with PPD to trust their doctors and therapists. This can make it challenging for healthcare professionals to establish a therapeutic rapport with the individual. This can make therapy less effective since the therapeutic relationship plays such a pivotal role in successful treatment outcomes.

Psychotherapy

Treatments for paranoid personality disorder usually focus on helping people develop coping skills. Therapy often focuses on building empathy, trust, communication, self-esteem, social relationships, communication skills, and general coping abilities.

Cognitive-behavioral therapy (CBT) is often effective in helping individuals adjust distorted thought patterns and maladaptive behaviors. CBT is a type of psychotherapeutic treatment that helps patients understand the thoughts and feelings that influence behaviors.

Ingrained paranoid beliefs and maladaptive thoughts play a role in maintaining paranoid personality disorder, which is why addressing these thoughts and beliefs through CBT can be helpful. CBT may help people with PPD become better able to trust others.

By challenging maladaptive thoughts and working to change harmful behaviors, people with this condition may become less suspicious of others, including friends and family, which can improve relationships and social interactions. In addition to addressing harmful thoughts and beliefs, CBT also works to help people with PPD better manage their responses to others.

Medication

While medication is not usually used to treat paranoid personality disorder, it may be used in cases where symptoms are severe or if an associated condition such as depression or anxiety is also present.

Drugs that might be prescribed include antidepressants, antipsychotics, and anti-anxiety medications. Medications alone are not recommended for personality disorders and are best used in combination with psychotherapy.

Takeaway

While paranoid personality disorder is one of the more common personality disorders, there is a lack of research on effective treatments. Part of this is because people with the condition are reluctant to participate in treatment and research. Those who can develop a successful therapeutic relationship can learn to manage their symptoms and have more successful relationships with others.