Paranoid Personality Disorder: Causes, Symptoms, And Treatment

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Written by , MSc Shaheen Naser MSc Experience: 3 years
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Paranoid personality disorder is when an individual may develop unreasonable suspicion of others. As estimated, 10% of the global population is affected by a personality disorder (1).

People with this disorder are hypersensitive to criticism and suspect others constantly.

Read on to know more about this disorder in detail, diagnosis, symptoms, treatment options, complications, and ways to manage it effectively. Continue reading further.

What Is Paranoid Personality Disorder?

Paranoid personality disorder (PPD) is a type of personality disorder that causes the affected person to behave oddly or eccentrically. This disorder falls under a group of personality disorders called “Cluster A” (2).

Individuals who have PPD usually also have paranoia. This may lead to unrelenting mistrust and suspicion of others even when there is no reason to do so.

Another hallmark of this disorder is being reluctant to confide in others and bearing grudges. PPD usually surfaces by early adulthood and is more common in men than in women.

The main signs and symptoms associated with paranoid personality disorder are discussed below.

Symptoms Of Paranoid Personality Disorder

Individuals with PPD are constantly on guard as they believe that others out there are trying to demean, threaten, or harm them. Such unfounded beliefs can interfere with the affected person’s ability to form close relationships.

The symptoms exhibited by a person who has PPD are (3):

  • Believing that others are trying to harm or demean them
  • Doubting the loyalty, commitment, or trustworthiness of others
  • Reluctance in confiding in others
  • Being hypersensitive when it comes to criticism
  • Getting angry/hostile quickly
  • Recurring suspicions when it comes to their spouse/partner, without reason
  • Being cold and distant in relationships
  • Difficulty in relaxing

These are some common traits seen in those who have PPD. Let’s now look at the factors responsible for triggering paranoid personality disorder.

What Causes Paranoid Personality Disorder?

While the exact cause of PPD is not yet found, it is believed to be triggered by a combination of biological, environmental, and psychological factors.

Paranoid personality disorder is often seen in individuals who have close family members with a history of schizophrenia and other delusional disorders (4).

Emotional or physical trauma during early childhood is another contributing factor to the development of PPD.

If you think that you (or someone close to you) are exhibiting symptoms of paranoid personality disorder, it is best to see a doctor.

How To Diagnose Paranoid Personality Disorder

Once you visit a doctor, they may begin by asking you questions about the symptoms you exhibit and your family and medical history.

They might carry out a physical examination to look for any other possible conditions you may be affected with. If the examination or the symptoms you exhibit indicate PPD, you will be sent to a psychologist, psychiatrist, or a mental healthcare provider for further testing.

The mental healthcare provider will do a comprehensive or detailed assessment that may include asking you about your childhood, work, school, and relationships. You may also be asked how you deal with or respond to an imaginary situation. They gauge your reaction to various situations and then make a diagnosis.

If you are found to have paranoid personality disorder, your doctor will discuss and create a treatment plan for you.

How To Treat Paranoid Personality Disorder

The main drawback of treating PPD is that most affected individuals have difficulty in accepting treatment. However, in general, treatment for this disorder can be very successful.

Individuals who are willing to go ahead with treatment for PPD can avail talk therapy or psychotherapy (5). These therapies aim at:

  • Helping the individual cope with the disorder
  • Teaching how to communicate with others in social situations
  • Helping reduce the feelings of paranoia

Certain medications can also help in the treatment of paranoid personality disorder. Some medications work especially well if the patient has other related conditions like depression and anxiety disorder. Such medications include (3):

  • Benzodiazepines
  • Antidepressants
  • Antipsychotics

Combining these medications with talk therapy/psychotherapy can help in managing PPD successfully.

It is important to avail treatment for paranoid personality disorder to avoid the complications discussed below.

[ Read: 5 Simple Tips To Build Your Mental Stamina ]

What Are The Complications Of Paranoid Personality Disorder?

People with this disorder live less functional lives. The unusual and suspicious behavior associated with PPD can interfere with the affected individual’s relationships as well as their ability to function socially and at work.

You must know that there is no cure or prevention for paranoid personality disorder. Treatment aims at improving the symptoms, and affected individuals may have to continue with the treatment throughout their lives. PPD causes a lot of emotional turmoil. Hence, support and care have a great role to play in managing its symptoms.

Paranoid personality disorder (PPD) is a mental illness in which an individual may get angry quickly and mistrust the motives of others. People with this eccentric personality disorder are hypersensitive to criticism and are reluctant to confide in others. Emotional or physical trauma during early ages and a history of schizophrenia are the main reasons for this condition. They also have difficulty accepting the treatment for this disorder. Consult your health care provider and use the medications and psychotherapy to help manage PPD effectively.

Frequently Asked Questions

Does paranoid personality disorder get worse with age?

Yes, paranoid personality disorder falls on the list of personality disorders that worsen with age.

Is paranoia a form of narcissism?

While paranoia is not exactly a form of narcissism, it may arise from pathological narcissism in some cases (7).

Is paranoia a symptom of bipolar?

Paranoia in all individuals may not indicate bipolar disorder. However, individuals with bipolar disorder may experience psychosis which may present paranoia as a symptom.

Can a person with paranoid personality disorder become violent?

Yes, there is a possibility that an individual with a paranoid personality disorder may become violent under certain conditions. However, although there is some link between delusions and violence, it does not necessarily mean that all individuals with paranoid delusions are prone to violence (8).

What is the difference between paranoid personality disorder and paranoid schizophrenia?

An important difference between PPD and paranoid schizophrenia is the absence of hallucinations in the case of the former.

Key Takeaways

  • People with paranoid personality disorder (PPD) are hypersensitive to criticism, get angry quickly, and are reluctant to confide in others.
  • PPD is often seen in individuals with a family history of schizophrenia and other delusional disorders.
  • Individuals with this disorder have difficulty accepting the treatment as they don’t trust anyone easily.
  • However, by combining the medications with psychotherapy, one can manage PPD effectively.


  1. Personality Disorders, Functioning and Health” Psychopathology, Karger.
  2. Paranoid personality disorder.” Journal of Personality Disorders, US National Library of Medicine.
  3. Pharmacological interventions for paranoid personality disorder” The Cochrane database of Systematic Reviews, US National Library of Medicine.
  4. Schizotypal and paranoid personality disorder in the relatives of patients with schizophrenia and affective disorders: a review.” Schizophrenia Research, US National Library of Medicine.
  5. Psychotherapy of Personality Disorders” The Journal Of Psychotherapy Practice and Research, US National Library of Medicine.
  6. Mistrustful and Misunderstood: A Review of Paranoid Personality Disorder” Current Behavioral Neuroscience Reports, US National Library of Medicine.
  7. Paranoid phenomena and pathological narcissism” American Journal of Psychotherapy, US National Library of Medicine.
  8. Violence and delusions: Data from the MacArthur Violence Risk Assessment Study” The American Journal of Psychiatry, American Psychology Association.
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Dr Perpetua Neo
Dr Perpetua NeoDClinPsy, MPhil
With over 8 years of experience, Dr. Perpetua Neo accelerates Type-A High Achievers’ performance and leadership by teaching them to master their time, mind, and sleep in a way that’s tailored to their personality. She specializes in sorting out The Big 3 that most mistakenly believe they can tolerate— perfectionism/anxiety, abusive relationships, and panic attacks— quickly and thoroughly.

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