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Paranoid personality disorder (A complete guide)

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This guide will help to identify the symptoms of paranoid personality disorder, its causes, and also highlight its treatments, to give a piece of comprehensive knowledge about paranoid personality disorder. 

What is paranoid personality disorder?

Paranoid personality disorder (PPD) is an eccentric, personality-related psychological disorder, in which there is a strange perspective of thinking is involved. The patients suffer from paranoia, mistrust, and extreme suspicion of people and events, even in situations where there seem to be no reasons to be suspicious or distrusting.

This psychological disorder usually develops in early adulthood, and more males suffer from this disorder, as compared to females. People suffering from this disorder appear to be odd or peculiar in a way that they often stand out as uncommon and weird to other people. Studies in pathophysiology have been able to gather data that suggests that paranoid personality disorder affects between 2.3% and 4.4% of the general population. 

Additional hallmarks of this disorder add to being extremely reluctant and beware of confiding in people in general, and finding some threatening meaning in things that do not usually exist. People who have a paranoid personality disorder can be very bipolar in terms of their moods and can deviate from being angry very quickly. 

There may be several factors as to why a patient may be acting extremely paranoid and mistrusting. It may be personal issues or environmental stress. Either way, for whichever reasons the patient may be feeling paranoid, it can cause many problems and communication issues with the relationships the patient shares with people.

Due to which, the patient may end up being alone, since being paranoid about everything can be a turn off in the eyes of many people. Paranoid personality disorder (PPD) is a severe issue when it comes to people’s personalities as paranoia is unhealthy for public and social interactions and gatherings. The patient may also be left behind in several aspects of their social life due to their disorder. 


Patients who have a paranoid personality disorder (PPD) are usually very vigilant, or their surroundings are generally on guard with whatever seems to be happening around them as they believe that someone or something may cause them harm, and this thinking is constant.  Some common symptoms of paranoid personality disorder are:

People with paranoid personality disorder (PPD) doubt commitments of other people at all times and questions their loyalty even when there seems to be no reason for it. They tend to end up believing that their loved ones or their love interest are using them or their bond is deceiving them.

  1. They are meticulous and usually reluctant when it comes to confiding in others about personal thoughts and experiences, and often, fear that the information that they share with other people will be eventually used against them in some harmful way.
  2. People who have a paranoid personality disorder (PPD) are usually very unforgiving nature and are quick to taunt and be mean at any chance they get since they get moody at all times. They hold grudges for long intervals, for no apparent reason.
  3. They are very hypersensitive and feel everything extremely deeply. They tend to overanalyze their feelings and think themselves into a bad mood. They take criticism very badly and aren’t always open to feedback about their work from others.
  4. Paranoid people try to look for hidden meanings in normal talks and remarks given by other people and can over-analyze casual conversations and looks.
  5. When someone talks about their character in a critique way, they are quick to get angry and retaliate in their defence quickly.
  6. They have suspicions that develop without any reason that their loved ones are being unfaithful.
  7. They are cold and distant in their relationships and often end up being possessive, controlling and jealous when it comes to sharing the attention of their loved one.
  8. Paranoid people are unable to see their role in problems they create and firmly believe that they are always right no matter how irrational they may sound in the arguments presented.
  9. They are a tough time trying to relax. Paranoid people are hostile, stubborn, and have a very argumentative behaviour even in standard situations.


The exact causes of paranoid personality disorder are unknown. Still, it most likely involves factors relating to psychology and the biological coordination of an individual and neurological problems they may have developed over time. PPD may also cause other psychological disorders like obsessive-compulsive disorder (OCD).

PPD is extremely common in people who have schizophrenia, and its pathophysiology suggests a strong bridge with genetics involved in those two. A paranoid personality disorder may also be caused by rough experiences in one’s childhood years, during the age of 7-13, which may be a trigger for a paranoid personality in the individual.

Physical and emotional trauma over the years is also a prevalent and robust factor as people who are betrayed, or their loved ones have been unfaithful, develop a strongly paranoid personality for themselves and even do not confide in people anymore.

Personal and social interactions become very hard for people with paranoia and contribute to the development of paranoid personality disorder in people who have some minor cases of insanity. These causes of paranoid personality disorder are catalogued by DSM 5 and are strongly suggested to seek therapy if found so. (Vyas, 2016)


 A paranoid personality disorder is a well-recognized disorder by the diagnostic and statistical manual of mental disorders (DSM 5) and is strongly suggested to be evaluated and treated. The physician or psychiatrist usually starts by performing a full evaluation with a medical history of the patient and asking about personal life.

Paranoid people typically show signs of earlier abuse, heartbreak, or any other historical trauma in their life that may have been the primary source for them to develop such a psychological disorder. If such circumstances arise and paranoia is evident in these evaluations, a full physical examination for the patient is done, despite there being no apparent test for the diagnosis of paranoia in patients.

A physical analysis is therefore used to rule out any other illnesses that the patient has, may have had, or carries, which may be an additional or root cause of paranoia. If the doctors are not able to find any psychological or physical reason, history or trauma in any form, or any other root causes, they may refer the patient to a psychologist or other health care professionals.

As a psychologist or mental health professional is a more suitable choice to treat psychological conditions and treat mental illnesses by therapy. They use precise assessments and interviews specially designed for patients of all types for evaluating a person with paranoia, or any other disorder that related to abnormal brain functioning and treats the individual is whatever possible ways therapy may be suited for the best (Lee, 2015).


Patients who have paranoid personality disorder suffer from delusions that there is nothing wrong with them, and they are seemingly just fine. They do not consider their paranoid personality as a mental disorder since the denial of rational things can often be a symptom if those reasons are not beneficial to them.

Treatment is sought by them in the form of psychotherapy and they have several sessions of counselling with a healthcare professional who has specifically designed assessments and interviews in which they ask about their childhood, any trauma they had in the past, different moods, discuss any possible situations they may have, and check the patients reflex actions to certain questions and scenarios.

These treatments most likely and majorly focus on improving their social interactions with people they work with and interact with on a weekly or daily basis as well as improving their communication and public speaking skills to boost up their self-esteem in life (Bateman,2015).

People seeking treatment for paranoid personality disorder (PPD) do not majorly receive medications for their illness as paranoia is not necessarily controlled by pills. However, sometimes doctors may recommend medications to manage the symptoms and effects by prescribing anti-anxiety, anti-depressant, and antipsychotic drugs so that some extreme symptoms can be controlled. 

If the patients are suffering from any associated psychological problem, then the psychiatrist also suggests medical checkups and performs exams on schedule basis. 

A paranoid personality disorder is different from other disorders like schizophrenia, delusional disorder, OCD, etc. and there seems to be no perceptual distortions in the person’s behaviour as well as non-bizarre delusional thinking which have no chances of being true at all.

Some individuals may also harbour suspicious thoughts about the health care professionals treating them, and that can cause problems and hurt the treatment of the disorder in a very bad way. They may move on to chronic paranoia if they are left untreated for long periods, but medications, in any case, are suggested to be prescribed for the shortest period possible.


The complications associated with paranoid personality disorder have a disrupted social life. Their thinking and behaviour get in the way of everything they do or may try to be a part of since their paranoid personality can be very off-putting to certain people on many platforms, whether it is a job or a social gathering.

Their thoughts interfere in the way of their ability to maintain healthy relationships as well as their ability to function in daily life. Their stubborn nature can sometimes land them in legal situations in which they may sue companies and people whom they think are trying to target them.

The prevalence of such attributes is an important factor that contributes to society’s views being extremely negative about the individual since they seem to always be in some kind of argumentative situation with other people.

Some Helpful Resources

  1. Paranoid Personality Disorder: The Ultimate Guide to Symptoms, Treatment, and Prevention (Personality Disorders)
  2. Cognitive Therapy of Personality Disorders
  3. The Cognitive Behavioral Therapy Workbook for Personality Disorders: A Step-by-Step Program
  4. Paranoid Personality Disorder – When Anxiety and Jealousy Hijack Your Life
  5. I Am Not Sick, I Don’t Need Help! How to Help Someone with Mental Illness Accept Treatment


A paranoid personality disorder is a chronic disorder, and the outlook of the people who have it may vary from person to person and usually last throughout a person’s life. Some people are either able to overcome their disorder or continue to function normally despite their thoughts and can get the simple joys of life like getting married and having children.

They are also able to communicate well and hold a job and excel in their fields while others are socially disabled and have no proper life when it comes to the basic human interactions needed to overcome anxiety, paranoia, and other compulsive disorders one might have. The people who resist treatment for paranoid personality disorder face poor outcomes.

Frequently Asked Questions

Does paranoid personality disorder get worse with age?

No, according to recent studies, like many personality disorders, paranoid personality disorder symptoms lessen with age.

Can paranoia go away?

There is no complete cure paranoid personality disorder, but therapy and coping with one’s symptoms can cause a person to lead a better life without any major occurrences of paranoia.

Who is a paranoid person?

A paranoid personality disorder is a condition in which people develop odd ways of thinking and suffer from delusions and suspicions about scenarios that don’t exist.

How do you know if you have paranoia?

If you are constantly finding yourself indulged in paranoid thoughts that include delusional scenarios and are quick to react to small things then there is a probability of you having paranoia.

Is being paranoid a sign of depression?

Not necessarily. Paranoia can develop in people that suffer from all kinds of mental illnesses, depression being one of them.

How do I deal with a paranoid person?

Don’t argue with them and let them get their way as arguing and indulging is a competitive conversation can only lead to a worse outcome.


  1. Paranoia Symptoms, Causes, and Treatments
  2. Paranoid Personality Disorder (PPD) Test & Self-Assessment
  3. What is paranoid personality disorder?
  4. Does paranoid personality disorder get worse with age?
  5. How is paranoid personality disorder treated?
  6. What drugs cause paranoia?

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