Paranoid Personality Disorder: Signs and Treatment

People with Paranoid Personality Disorder often lead an isolated life and withdraw from any social interactions.

Paranoid personality disorder

Is categorized under Cluster A or Eccentric Personality Disorder. A person with this kind of mental disorder shows signs of pervasive, paranoia, irrational suspiciousness and mistrust to people. Hypersensitive and easily insulted to other people’s behavior—innocent actions that meant to do no harm but perceived as an attack to his ego. Always on the lookout as if something threatening is going to happen. Very observant to their surroundings searching for any signs to affirm their suspicions, they cling on their biases and past experiences and may not accept or look to other evidence proving their suspicion groundless.

People with this Personality Disorder often lead an isolated life and withdraw from any social interactions. They are incapable of maintaining relationships. And may even reject friendships even the person prove to be trustworthy. They have a strong desire to appear self-sufficient, thus, rebuke any outside support. They see harmless jokes as threatening and demeaning and often lead to resentments that may prolong for an unjustified period of time.


Symptoms normally begin to show at childhood or early adolescence and its likelihood appears to be predominantly male. Research estimates about 2.3 and 4.4 percent of the general population.

Researchers still do not know what causes this personality disorder. Studies suggest that it involves hereditary or environmental or a combination of both. They are commonly detected to families with genetic links to Schizophrenia and delusional disorders. Family background also plays a role in the development of paranoid personality disorder. Childhood trauma may have shaped the person’s belief why he perceives the world in a mistrustful way.


A lasting distrust and baseless suspicion are the hallmarks of a paranoid personality disorder. Because of these traits, they are basically defensive and argumentative; making it hard for them to form a workable relationship.

Enlisted below are the criteria’s derived from World Health Organization’s ICD-10 and American Psychiatric Association’s DSM-V of detecting paranoid personality disorder.

1. Unforgiving

They hold persistent grudges that endure for an unjustified period of time.

2. Hypersensitivity to criticisms and setbacks

They beat their selves by ruminating on the thought.

3. A tendency to see malicious intent

Even in the innocent remarks and the casual look of others.

4. A tendency to distort experience

They misread harmless behaviors as a direct attack on their character. Usually, retaliates or responds in a combative manner.

5. Mistrustful

Even to people who showed trustworthiness. They are incapable of revealing personal information, in fear that it might be used against them.

6. Tends to be self-righteous

They react with hostility in a difficult situation in order to preserve their ego.

7. High-strung

They have difficulty in calming their selves.

8. Irrational suspicion

They always believe that others are in a constant plot to injure them.

9. An irrational explanation to everything

They feel like the entire universe is always conspiring against them.

10. Appears self-independent and condescending

Often, acts in hostility if their authority is questioned.

11. A tendency to be controlling in relationships

They always believe that their partner is committing infidelity.

12. Negative stereotypes towards others

They believe that they are more superior.

There are other disorders that have the same symptoms with PPD. These are Schizophrenia and Borderline Personality Disorder. And because of the similarities, giving a clear diagnosis can be challenging.

Anxiety and depression may contribute to the development of PPD that affects a person’s mood and overall outlook on life. Thus, there is a probability of progress when these factors are first taken into consideration.


Treatment can be difficult because a person with Paranoid Personality Disorder may be in denial and believe that there is nothing abnormal with their behavior. As mentioned, they have a general distrust to others and may even act inappropriately if someone questions their character or psychological state. Instead of reaching a consensus, both parties may even get into an argument. People with PPD may even perceive it as confirmation that it’s meant to demean them. Patience and sympathy are the keys. It will take time to convince a loved one to seek a mental health professional.

When the patient finally confides to seek professional help, the first step is that the primary care provider will ask about the symptoms and your history. Then they will evaluate the data you submitted and conduct physical examinations to look for other medical conditions you may have. And then the primary care provider may send you to a mental health professional for further assessment.

The mental health professional will conduct a comprehensive evaluation. The process may take a while because they may ask you in detail about your childhood, home atmosphere growing up, relationships, school, and work life. And may even ask you in an imagined situation to see how you will respond to stimuli’s. This is to better assess your situation and give you an accurate diagnosis. After the evaluations, the mental health professional will his diagnosis and provide a treatment plan, and may give medical prescription depending on your situation.


The success of the treatment may depend on the patient. It may depend on his willingness to cooperate with the treatment. People with PPD may find it difficult accepting that they have to undergo treatment. But success is very attainable.

Psychotherapy is one method used in this treatment.

Through this method, the patient will learn:

  • techniques to cope with his disorder
  • how to manage his feelings of paranoia
  • to communicate in a social setting

Medications depend on the mental health professional’s assessment. When you have other conditions, like Depression and Anxiety, most likely they will give you a prescription for medication. And combining medication with psychotherapy increases the chance of success.

Prescriptions may include:

  • Antidepressants
  • Antipsychotics
  • Benzodiazepines

Psychotherapy and medication gives a higher rate of success but ultimately, success depends on patient cooperation to treatment. And cooperation to treatment eventually leads to a much fulfilling life and healthier relationships. However, there is no cure for PPD. Symptoms will show up but when it does, the patient already knows how to manage it through his experience from therapy.

On the other hand, people who resist treatment may lead to defective lives. And their inability to cope with their surroundings will have a negative effect to have fulfilling relationships.

symptomps of paranoid disorder

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