Paranoid Personality Disorder: Causes, Symptoms & Diagnosis
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Paranoid Personality Disorder

What Is Paranoid Personality Disorder?

Paranoid personality disorder (PPD) is a type of eccentric personality disorder. An eccentric personality disorder means that the person’s behavior may seem odd or unusual to others. An individual with paranoid personality behavior is very suspicious of others. They mistrust the motives of others and believe that others want to harm them. Other hallmarks of this condition include the reluctance to confide in others, bearing grudges, and reading “demeaning” or “threatening” meanings in even the most innocent of comments or events. A person with PPD can be quick to feel anger and feel hostile toward others.

PPD usually appears in early adulthood. According to the Cleveland Clinic, PPD appears to be more common in males than females.

Treatment for PPD can be challenging because the individual with PPD has intense suspicion and mistrust of others. A mental health professional must establish trust with the patient. This trust enables the patient to confide in the professional and believe that they have a disorder.

What Are the Causes of Paranoid Personality Disorder?

Causes

The cause of paranoid personality disorder is unknown. However, researchers believe that a combination of biological and environmental factors can lead to paranoid personality disorder.

The disorder is present more often in families with a history of schizophrenia and delusional disorders. Early childhood trauma may be a contributing factor.

What Are the Symptoms of Paranoid Personality Disorder?

Symptoms

Often people with paranoid personality disorder don’t believe that their behavior is abnormal. It may seem completely rational to a person with PPD to be suspicious of others. However, those around them may believe this distrust is unwarranted and offensive. The person with PPD may behave in a hostile or stubborn manner. They may be sarcastic, which often elicits a hostile response from others, which in turn “confirms” their original suspiciousness.

A person with PPD can have other conditions that can feed into their PPD. For example, depression and anxiety can affect a person’s mood. Mood changes can make someone with PPD more likely to feel paranoid and isolated.

Symptoms include:

  • believing that others have hidden motives or are out to harm them
  • doubting the loyalty of others
  • being hypersensitive to criticism
  • having trouble working with others
  • being quick to become angry and hostile
  • becoming detached or socially isolated
  • being argumentative and defensive
  • having trouble seeing their own problems
  • having trouble relaxing

Some symptoms of PPD can be similar to symptoms of other disorders. Schizophrenia and borderline personality disorder are two disorders with symptoms similar to PPD. It can be difficult to clearly diagnose these disorders.

How Is Paranoid Personality Disorder Diagnosed?

Diagnosis

Your primary care provider will ask you about your symptoms and history. They’ll also do a physical evaluation to look for any other medical conditions you may have. Your primary care provider may send you to a psychiatrist, psychologist, or other mental health professional for further testing.

The mental health professional will perform a comprehensive assessment. They may ask about your childhood, school, work, and relationships. They may also ask you how you would respond to an imagined situation. This is to gauge how you react to certain situations. For example, they may ask what you would do if you found somebody’s wallet on the sidewalk. The mental health professional will then make a diagnosis and form a treatment plan.

How Is Paranoid Personality Disorder Treated?

Treatment

Treatment for PPD can be very successful. However, most individuals with this condition have trouble accepting treatment. To a person with PPD, they don’t see their symptoms as unwarranted. If an individual is willing to accept treatment, talk therapy or psychotherapy are helpful. These methods will:

  • help the individual learn how to cope with the disorder
  • learn how to communicate with others in social situations
  • help reduce feelings of paranoia

Medications can also be helpful, especially if the person with PPD has other related conditions such as depression or anxiety disorder. Medications may include:

  • antidepressants
  • benzodiazepines
  • antipsychotics

Combining medication with talk therapy or psychotherapy can be very successful.

What Is the Long-Term Outlook?

Outlook

The outlook depends on whether the individual is willing to accept treatment. Individuals who accept treatment can hold down a job and maintain healthy relationships. However, they must continue treatment throughout their lifetime because there’s no cure for PPD. Symptoms of PPD will continue but can be managed with care and support.

People with PPD who resist treatment may lead less functional lives. PPD may interfere with their ability to hold down a job or have positive social interactions. 

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