Paranoid Personality Disorder: Information, Symptoms, Treatment and More

Paranoid Personality Disorder is the name of a Personality Disorder that is characterised by intense paranoia, along with suspiciousness and mistrust of others.

The disorder forms part of the Cluster A ‘odd and eccentric’ category of personality disorders. Typical symptoms include paranoia, hypervigilance and isolation. The disorder shares some similarities with Schizophrenia.

Paranoid personality disorder can be a difficult condition to live with each day. But with support and an effective treatment plan, symptoms can improve – aiding an improvement in overall wellbeing.

What are the symptoms of Paranoid Personality Disorder?

The symptoms of Paranoid Personality Disorder can differ slightly depending on the person. However, there are some uniform symptoms.

For this situation to be deemed a fully blown personality disorder, the symptoms should have been present for a long time. Typical symptoms include:

• Paranoia – especially regarding the motives of others
• Suspiciousness of others
• Hypervigilance – waiting for a supposed hostile action
• General mistrust of others
• Being overly sensitive to criticism
• Often feeling like they are in danger
• Struggle to make friends
• Observe events, rather than participate in them
• Tend to isolate themselves
• Struggle to relax
• Hold grudges for considerable length of time
• Believe there are hidden meanings to the everyday words of others

These symptoms will lead to a person seeing the world in a very different way to other people. They will think, behave, and feel differently. These symptoms will

What are the causes of Paranoid Personality Disorder?

The cause of Paranoid Personality Disorder is not known. However, there seem to be risk factors involved in the condition.

Genetics appears to play a role. Conditions on the Schizophrenic Spectrum (which many consider Paranoid Personality Disorder to be on) often run in families [1]. Therefore, genetics can be a risk factor.

Upbringing is also believed to play a role. Those in unsafe environments growing up will become used to scanning for threats, being vigilant, and seeing others as hostile.

Similarly, childhood trauma such as bullying or emotional abuse could be a factor. As personality develops in younger years, trauma in youth can help to shape a person’s view of the world. They may become suspicious around others.

Other factors may be social rejection, harmful coping strategies, and substance abuse. A range of areas may contribute to this difficult personality style developing.

It is very important to note that this condition often arises when a person is poorly treated by others. Therefore, it is almost natural for them to see the world in this way. In fact, it is nearly always quite a tragic case when someone develops this condition.

Diagnosis of Paranoid Personality Disorder

Paranoid Personality Disorder is a difficult condition to have to live with. Anyone exhibiting the symptoms associated with this disorder is encouraged to visit their doctor.

At an appointment, the doctor will ask the individual a range of questions. They will seek to gain an understanding of their situation, and aim to review their overall mental wellbeing.

If the doctor believes that a personality disorder may be present, they will usually refer the individual to a Community Mental Health Team (CMHT) – which is a team of mental health professionals.

A mental health professional would then usually conduct out a full assessment of symptoms. They will gauge information about the individual through a series of questions and open discussions.

Importantly – for any personality disorder to be diagnosed, an individual will need to have displayed such behaviour on a long-term basis.

For Paranoid Personality Disorder to be diagnosed, a minimum of four of the following symptoms should be present:

• The person believes – without any rational reason – that others are intent on harming or exploiting them
• They are reluctant to speak in confidence with others due to the belief that the person will any information they gain against them
• Has unjustified doubts about the loyalty or trustworthiness of friends, colleagues, or family members
• The above could also extend to their partner – with them having pervasive suspicion of their loyalty
• Reacts to everyday events or throwaway comments from others as being threatening or having a hidden message
• Holds long-term grudges
• Quick to react or defend themselves when people are supposedly criticising them

It is possible that a different condition will be diagnosed. Paranoid Personality Disorder certainly crosses over with other mental health conditions.

How is Paranoid Personality Disorder treated?

It can be incredibly challenging to treat personality disorders. These disorders involve personality traits which have been ingrained in a person for several years.

The good news though is that Paranoid Personality Disorder can be treated. Usually, a form of talking therapy is used, though medication can also be prescribed if needed. But treatment definitely takes time.

Talking Therapy

Some form of talking therapy can be used to treat Paranoid Personality Disorder. Due to feelings of paranoia and a general mistrust of others, having an effective therapist-client relationship can prove difficult, yet is very important.

Many different types of therapy exist – with a choice being made based on individual circumstances. Some of the common types include:

Psychoanalytical Psychotherapy: Psychoanalytical Psychotherapy is a talking therapy that aims to help uncover and resolve unconscious beliefs that cause psychiatric conditions. Traumatic experiences that may or may not be buried in the unconscious mind can be highlighted and processed. Psychoanalytical psychotherapy involves talking to a trained therapist. The therapist can show the individual how early memories and past traumas have affected their thinking, behaviour and attitude in the modern day. Psychoanalytical psychotherapy is especially useful for any condition that involves past trauma. Renowned neurologist Sigmund Freud developed this therapy, which is typically completed over a long-term basis.

Mentalisation-based Therapy (MBT): MBT uses a range of techniques to try and help an individual understand themselves and their thoughts more. Mentalisation itself is the ability for an individual to think about thinking – essentially allowing an individual to examine their own thoughts, and the effect they have. MBT can help an individual understand what goes through the mind of others, as well as making an individual more aware of what happens in their own mind. This form of therapy is useful in various personality disorders.

Along with the above, there are many other types of talking therapies available. For more information, you can see our dedicated Therapy section.

Medication

There is no medicine that is specifically licensed for the treatment of Paranoid Personality Disorder. However, some symptoms can be helped by some medicines.

Antipsychotics at a low dose can help with feelings of paranoia. Antidepressants could also be used – if the individual is experiencing low mood or anxiety due to their symptoms.

Antipsychotics: Antipsychotics (also known as neuroleptics) block the effect of dopamine – a chemical in the brain that is heavily linked to psychotic symptoms like hallucinations. They can also be useful for stabilising mood, and treating anxiety. They are not suitable for everyone however, and are often associated with many side effects like weight gain, dizziness and dry mouth.

Antidepressants: Antidepressants can help to improve and regulate mood. They should improve motivation and restore energy. SSRI Antidepressants are the most commonly prescribed. They act on the brain chemical serotonin – which is thought to help in regulating mood and emotion. They may include side-effects such as a dry mouth, sexual problems and nausea, though these should hopefully be short-term. Other classes of antidepressants are available in the event of an inadequate reaction.

Other

It has been suggested that Paranoid Personality Disorder may be a mild form of Schizophrenia. It is possible that someone with this personality disorder will go on to develop Schizophrenia – which would then require different treatment.

Summary

It is often a very sad case whenever a person has gone through experiences that result in a diagnosis of Paranoid Personality Disorder.

But by getting a diagnosis, treatment can take place – with the aim of seeing a major improvement in symptoms. For more information, feel free to take a look across our website.

See Also

• Personality Disorder Section
• What Is The Prognosis for Personality Disorders?
• Therapy Homepage
• Medicine Homepage