-Seattle Anxiety Specialists, PLLC does not currently provide treatment for Paranoid Personality Disorder. (For treatment, please refer to this list of DBT providers.)
Paranoid Personality Disorder (PPD)
Overview
Paranoid Personality Disorder (PPD) is relatively rare affecting around 1.21- 4.4 percent of people worldwide.[1] This mental health condition is marked by a long-term pattern of unwarranted distrust and suspicion of others.[2] People with PPD tend to show signs of the disorder in their late teens or early adulthood; symptoms may diminish over time.[3,4] Since people with Paranoid Personality Disorder are reluctant to confide in others there is a limited amount of research available.
Symptoms
Symptoms of Paranoid Personality Disorder typically begin in people’s late teens or early adult years; however, Lee (2017) found that these traits tend to decline around 46% within this life span (a pattern common in personality disorders).[5,6] According to Cleveland Clinic, some common symptoms associated with PDD include:[7]
Doubting the commitment, loyalty or trustworthiness of others, believing others are exploiting or deceiving them
Being reluctant to confide in others or reveal personal information because they’re afraid the information will be used against them
Being unforgiving and holding grudges
Being hypersensitive and taking criticism poorly
Reading hidden meanings in the innocent remarks or casual looks of others
Perceiving attacks on their character that aren’t apparent to others
Having persistent suspicions, without justified reason, that their spouses or romantic partners are being unfaithful
Being cold and distant in their relationships with others and might become controlling and jealous to avoid being betrayed
Not seeing their role in problems or conflicts, believing they’re always right
Having difficulty relaxing
Being hostile, stubborn and argumentative
An important characteristic of Paranoid Personality Disorder is the absence of psychotic symptoms (e.g., paranoid delusions, hallucinations) that are characteristic of schizophrenia and psychotic states of bipolar disorder.[8]
Diagnosis
PDD is difficult to diagnose early in life due to the evolution of personality throughout child and adolescent development. As a result, healthcare providers do not typically diagnose someone until after the age of 18.[9] Paranoid Personality Disorder is also difficult to diagnose as a result of the disorder’s nature. People with personality disorders do not typically think there is a problem with their behavior or ways of thinking, which may delay seeking treatment until a different condition (e.g., anxiety, depression) develops due to problems created by the pre-existing personality disorder.[10]
Causes
There is no direct cause of Paranoid Personality Disorder, however, the Cleveland Clinic notes that childhood emotional neglect, physical neglect (e.g., lack of food, clothing, shelter), and supervisory neglect play a significant role in the development of PPD.[11]
Risk Factors
There are multiple socioeconomic factors that may make someone more at risk of developing Paranoid Personality Disorder. Some factors include living in a low-income household and being Black, Native American or Hispanic. People with a family history of schizophrenia and delusional disorder are more at risk of developing PPD, as well.[12]
Complications
Around 75% of people with Paranoid Personality Disorder have another comorbid personality disorder. Cases of PPD are often found combined with Avoidant Personality Disorder, Borderline Personality Disorder, Narcissistic Personality Disorder, and Antisocial Personality Disorder.[13] People with PPD are also more likely to have substance abuse disorder and panic disorder compared to the general population.[14] Paranoid Personality Disorder can also cause social complications. The generally unfounded beliefs and habits of blame/distrust that affect people with PPD can interfere with the ability to form close or even workable relationships.[15] People with Paranoid Personality Disorder stop working earlier than those without a personality disorder and are more likely to be divorced, separated or never married.[16,17]
Treatment
Talk therapy (e.g., cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT)) is the treatment of choice for people affected by PPD in order to increase general coping skills and improve social interaction, communication and self-esteem.[18] Medication is not typically prescribed for the disorder itself, however, antidepressants, anti-anxiety, or antipsychotic drugs may be prescribed if develope associated psychological conditions (e.g., anxiety, depression) or extreme symptoms.[19]
Those with Paranoid Personality Disorder may wonder if they can trust a mental health professional, which is ok. The mental health professional will work to build trust and help those confiding in them feel comfortable and trust following their advice.[20] If you think you may have Paranoid Personality Disorder please seek out a licensed mental health professional for help, guidance and options how to live a healthier and more-fulfilling life.
Contributed by: Maria Karla Bermudez
Editor: Jennifer (Ghahari) Smith, Ph.D.
References
1 Martel, J. (2021, April 21). What you need to know about paranoid personality disorder (PPD). Healthline. Retrieved March 18, 2023, from https://www.healthline.com/health/paranoid-personality-disorder
2 Paranoid personality disorder (PPD): Symptoms & treatment. Cleveland Clinic. (2022, April 28). Retrieved March 18, 2023, from https://my.clevelandclinic.org/health/diseases/9784-paranoid-personality-disorder#:~:text=Paranoid%20personality%20disorder%20(PPD)%20is,demean%2C%20harm%20or%20threaten%20them.
3 Ibid.
4 Lee R. (2017). Mistrustful and Misunderstood: A Review of Paranoid Personality Disorder. Current behavioral neuroscience reports, 4(2), 151–165. https://doi.org/10.1007/s40473-017-0116-7
5 Cleveland Clinic (2022)
6 Lee (2017)
7 Cleveland Clinic (2022)
8 Lee (2017)
9 Cleveland Clinic (2022)
10 Ibid.
11 Ibid.
12 Martel (2021)
13 Lee (2017)
14 Cleveland Clinic (2022)
15 Ibid.
16 Ibid.
17 Lee (2017)
18 Cleveland Clinic (2022)
19 Ibid.
20 Martel (2021)