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Paranoid Personality Disorder: What You Need to Know

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Have you ever encountered someone that is oddly cautious and weird and just doesn’t trust people at all? Maybe you have met someone that believes someone is stalking them and would hurt them anytime. Perhaps, you know someone who just doesn’t like to be with people because he or she doesn’t feel safe and would only be comforted by their solitude. 

Well, they may not know it, but there’s a good chance that they’re suffering from a personality disorder called Paranoid Personality Disorder (PPD). While you’re wondering what PPD is, here are the things you need to know about it.


Paranoid Personality Disorder (PPD) is under the category of Personality Disorders under the Diagnostic and Statistical Manual of Disorders 5th Edition (DSM-5). Personality disorders are long-term patterns of behaviour and experiences that differ significantly from what’s expected or normal. The behaviour patterns often begin during teenage years or early adulthood and cause distress or problems in functioning. Without treatment, personality disorders can be long-lasting. A personality disorder affects your way of thinking about yourself or other people, your way of responding emotionally, your way of relating to other people, and your way of controlling your behaviour.

There are many kinds of personality disorders, and given the above definition; Paranoid Personality Disorder is a pattern of being suspicious of others and seeing them as mean or spiteful. People with paranoid personality disorder believe that people will harm or deceive them and don’t confide in others or become close to them. They have a massive distrust of everybody and only trust themselves. 

Diagnosis and symptoms

If you’re wondering if you know someone who might be suffering from this kind of disorder, here are the symptoms according to DSM-5:

  • Doubting other people’s commitment, loyalty, or trustworthiness, believing others are deceiving them.
  • They are reluctant to confide in others or reveal personal information because they are afraid the information might be used against them.
  • People with this kind of disorder are unforgiving and hold grudges.
  • Are hypersensitive and take criticism poorly.
  • Often thinks that the looks and actions of other people have hidden meanings.
  • They perceive others attacking their character, and they generally react with anger and are quick to retaliate.
  • Have persistent suspicions, without reason, that their spouses or lovers are unfaithful.
  • They are generally cold and distant in their relationships with others and might become controlling and jealous to avoid being betrayed.
  • They cannot see their role in problems or conflicts, believing they are always right.
  • Have difficulty relaxing.
  • Are hostile, stubborn, and argumentative.
  • They have the tendency to develop negative stereotypes of others, especially if the person is from a different cultural group.

The DSM-5 also said that, in addition to having symptoms of pervasive suspicion and distrust, a diagnosis of PPD requires that the above symptoms should not be related to a psychotic episode associated with other mental disorders such as schizophrenia, bipolar disorder, or depressive disorder with psychotic features.

Diagnosis of a personality disorder, as well as other mental disorders, requires a mental health professional such as a psychologist or a psychiatrist looking at long-term patterns of functioning, behaviours, and symptoms. Diagnosis is made in individuals of age 18 or older. People under age 18 generally are not diagnosed with personality disorders because their personalities are still developing, and most of the people with personality disorders don’t recognise that they have a problem.


Paranoid personality disorder, like almost all personality disorders, can be treated with psychotherapy. With continuous treatment and appropriate social support, people with this disorder can manage their symptoms and function more effectively in everyday life.

However, people who have PPD often don’t seek treatment for their condition, usually because they do not know that they have a problem. To people with PPD, it is the other people who are the problem because of their suspicions and beliefs of others are either true, justified, or both. It is difficult for people with this kind of condition to trust their doctors and therapists because of the extreme distrust and paranoia that primarily characterises this condition. Good thing that there is now HIPAA, which is an act that protects confidential information of patients in the healthcare system.

Cognitive-behavioural therapy  (CBT) is proven effective in helping individuals adjust distorted, irrational thought patterns and maladaptive behaviours; that’s why it is the most used psychotherapy in disorders like these. CBT is a psychotherapeutic treatment that helps patients understand the feelings and thoughts that influence their behaviours. During treatment, people with PPD learn how to identify and change destructive, irrational, and disturbing thought patterns that have a negative influence on behaviour.

Dealing with paranoid personality disorder

After reading this, someone may come to your mind, and you might want to be able to help them. You might also think that it is you who might be suffering from PPD. Here are some ways on how to help or deal with someone with PPD:

  • Help the person avoid things that they fear. Move that person away from the cause of the fear, or noise and activity, if possible. Ask the person to tell you what is causing their fear. For example, if the person is afraid of cats or dogs or any animals, avoid them.
  • Offer to talk about the person’s fears when they are in a normal state. Consider making a plan on how he or she should handle their fears and anxieties.
  • Consider also asking the person to make a list of his or her fears. You can offer to help him or her in making the list if it is too much for them to handle. You should also consider asking the person to write things like, ‘These things are not going to hurt me. These fears are symptoms of my illness. I should seek help for them to go away.’ But don’t insist that the person should do this because this may make the person include you as part of their paranoid belief. Remember, you are trying to help them not to make them worse.
  • Don’t argue with the person regarding their condition. If you made that person want to listen to you, you can ask questions about their fears and paranoia to understand better what they’re going through. Build trust with this person because that’s what they lack in relating to other people – trust.
  • Remind the person that asking for professional help or medicines can make a big difference and bring relief, not shame. At the end of the day, they’re the ones who can give them big help regarding their condition.

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