Paranoid Personality Disorder

Updated: Jan 20, 2021

By Shruti Varahala


What is PPD?

Paranoid personality disorder (PPD) is one of a group of conditions called "Cluster A" personality disorders which involve odd or eccentric ways of thinking. People with PPD also suffer from paranoia, an unrelenting mistrust and suspicion of others, even when there is no reason to be suspicious. This disorder usually begins by early adulthood and appears to be more common in men than in women.


Who Is More Susceptible?

The exact cause of PPD is not known, but it likely involves a combination of biological and psychological factors. The fact that PPD is more common in people who have close relatives with schizophrenia and delusional disorder suggests a genetic link between the two disorders (may run in the family). However, being susceptible to this disorder is not only limited to hereditary lineage, it can also stem from personal experiences that the person has gone through in their life.





Symptoms of PPD

Most of the symptoms that are visible with people who might have PPD are generally to how they communicate with others in both positive and negative situations. For example, symptoms can range from doubting the commitment, loyalty, or trustworthiness of others, and believing others are exploiting or deceiving them when that is not the case. They might also be reluctant to confide in others or reveal personal information because they are afraid the information will be used against them. Another common symptom is having a poor reaction to negative feedback such as the tendency to be unforgiving and hold grudges and having a bad reaction to taking criticism. Over analyzation of meaningless things is another common condition with people who have PPD such as reading hidden meanings in the innocent remarks or casual looks of others. They also tend to be easily angered and are quick to retaliate.


They also make judgements about their own character as well as have persistent suspicions about their partners being unfaithful and friends and close ones being deceitful leading to being generally cold and distant in their relationships with others. They believe that they are always right and are hostile, stubborn and argumentative, developing negative stereotypes of others. This results in the difficulty to relax.


Treatment of PPD

People with PPD often do not seek treatment on their own because they do not see themselves as having a problem. The distrust of others felt by people with PPD also poses a challenge for healthcare professionals because trust is an important factor of psychotherapy (a form of counseling). As a result, many people with PPD do not follow their treatment plan and may even question the motives of the therapist.


When a patient seeks treatment for PPD, psychotherapy is the treatment of choice. Treatment likely will focus on increasing general coping skills, especially trust and empathy, as well as on improving social interaction, communication, and self-esteem. The betterment of the communication skills and how to handle certain situations is a common way to treat people with PPD using psychological therapy, as that tends to be the most effective. Cognitive-behavioral therapy (CBT) can help someone with paranoid personality disorder recognize their destructive beliefs and thought patterns. By changing how these beliefs influence their behavior, CBT can help reduce paranoia and improve how well your loved one interacts with others.


Medication generally is not used to treat PPD. However, medications—such as anti-anxiety, antidepressant, or antipsychotic drugs—might be prescribed if the person’s symptoms are extreme, or if he or she also suffers from an associated psychological problem, such as anxiety or depression. However, antidepressants and other medication do tend to have certain side effects which can cause other complications. This is why medication is only saved as a last resort and is used very rarely when it comes to treating patients with PPD.



General Statistics/Data of PPD

From 2.3 to 4.4% of the general US population are estimated to have paranoid personality disorder. It is thought to be more common among men. There is some evidence of increased prevalence in families. Some evidence suggests a link between this disorder and emotional and/or physical abuse and victimization during childhood. PPD is one of the most common personality disorders found in young adults in America. However, it is said that people who tend to have the disorder might not even get it properly diagnosed at a clinic, due to the general lack of knowledge about what the personality disorder really is.

Does PPD Ever Go Away?

Like every emotionally related disorder, paranoid personality disorder is something that doesn’t occur in a person overnight. It takes a series of traumatizing events or imprinted genetics that run in the family for a person to inherit this specific disorder. Therefore, without extensive psychological therapy or treatment from doctors, the effects of this disorder on a person take time to completely go away.


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