Paranoid Personality Disorder is categorized as a cluster A (odd) personality disorder that is characterized by a pervasive distrust and suspiciousness of others such that their motives are interpreted as being malevolent, beginning by early adulthood and being present in many different contexts.

People suffering from paranoid personality disorder will likely have a very difficult time with maintaining and creating new healthy relationships with others. This is due to the fact that people with this disorder will often find it very hard to trust others and will often be very cynical as well. Such cynicism creates a type of barrier which greatly limits the amount of people they will become close with, if any.

Also, there may in fact be some comorbidities with schizophrenia. This has to do with both of these disorders sharing the common symptom of paranoia. There may also be other comorbidities of paranoid personality disorder, such as schizoid, narcissistic, and avoidant personality disorder, among others.

Someone suffering with paranoid personality disorder can expect each day to be filled with stress and uncertainty as their paranoia will extend much further than merely being fearful of people they know. They may also be easily insulted, very sensitive, and may diligently look for reassuring evidence to confirm their biases, even though such evidence is not grounded in reality.

Symptoms of Paranoid Personality Disorder

People suffering from paranoid personality disorder will have an overall distrust for most people. They may believe that strangers or even people they love are trying to harm or deceive them. They will often display behavior that is out of touch with reality as they will likely be unable to ward off their paranoid fear thoughts.

They will also have a very difficult time with interpreting social cues correctly, as well as common everyday happenstances. For example, a woman suffering from paranoid personality disorder may make eye contact with a man at a grocery store. They man may say hi to her and then wink. His motives for doing so was out of his attraction for her, but in her mind, he has something to hide by winking and may be plotting against her.

Below, you will see some more common symptoms of paranoid personality disorder:

  • Distrust of most people, even loved ones
  • Difficulty having healthy relationships with others
  • Belief they are being stalked when they are not
  • Belief they are being persecuted when they are not
  • Looking for clues merely to validate their false beliefs
  • Stress and anxiety due to their paranoia

Causes of Paranoid Personality Disorder

There is no known cause of paranoid personality disorder. However, genetics and environmental factors may play very significant roles in the development of this condition. For instance, someone with a family history of mental illness, especially with personality disorders, may have a higher chance of developing this disorder. This will likely be due to them also having a higher chance of having a genetic predisposition to developing mental illness.

If they were to have such a genetic predisposition, then all that may be required for them to develop paranoid personality disorder may be them experiencing some sort of traumatic event. A traumatic event that may cause someone to develop this condition could be that perhaps they were actually stalked once before for many months or years which instilled a great amount of fear and distrust in most people.

Though we do not know exactly what causes paranoid personality disorder to develop, there is a consensus among most mental health professionals that both genetics and one’s environment play very significant roles in the development of virtually any given mental disorder. Taking a closer look at these different parameters may shed some light as to whether or not you are at risk for developing paranoid personality disorder.

Diagnosis according to the DSM-5

To qualify for being diagnosed with paranoid personality disorder, the patient must meet at least 4 out of the following criteria:

  • Suspects, without sufficient basis, that others are exploiting, harming, or deceiving him or her.

  • Is preoccupied with unjustified doubts about the loyalty or trustworthiness of friend or associates.
  • Is reluctant to confide in others because of unwarranted fear that the information will be used maliciously against him or her.
  • Reads hidden demeaning or threatening meanings into benign remarks or events.
  • Persistently bears grudges (i.e., is unforgiving of insults, injuries, or slights).
  • Perceives attacks on his or her character or reputation that are not apparent to others and is quick to react angrily or to counterattack.
  • Has recurrent suspicions, without justification, regarding fidelity of spouse or sexual partner.

Paranoid Personality Disorder Treatment

Talk therapy and medications such as antidepressants, anti-anxiety, or antipsychotic medication may be able to help treat the symptoms of paranoid personality disorder. Talk therapy, such as cognitive behavioral therapy (CBT) may be very beneficial for someone suffering from this condition as it can help them to have a better understanding of why and when their thinking patterns become distorted. They will also learn effective ways to cope with their intense emotions.

Besides talk therapy, psychiatric medication may also be very advantageous for someone suffering from paranoid personality disorder. However, the type of medication prescribed, as well as the dose will greatly depend on many different factors, such as if their are the presence of comorbidities. For example, someone suffering from this personality disorder, as well as having intense depressive episodes may be prescribed an antidepressant like Sertraline to help treat their symptoms.

Antipsychotics and anti-anxiety medication may also be very effective as well, but this will depend on whether or not they are experiencing symptoms of psychosis and/or intense anxiety. This is why it is very important to first discuss all of your symptoms with your doctor to ensure that the best measures are taken.

If you think you may have this condition or if you are suffering from some of the symptoms outlined in this article, then you should talk to your doctor as soon as you can so that you can be properly diagnosed and treated for your symptoms.