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Paranoid personality disorder (PPD) is a type of eccentric personality disorder. An eccentric personality disorder means that the person’s behavior may seem odd or unusual to others. An individual with paranoid personality behavior is very suspicious of other people. They mistrust the motives of others and believe that others want to harm them. Additional hallmarks of this condition include being reluctant to confide in others, bearing grudges, and finding demeaning or threatening subtext in even the most innocent of comments or events. A person with PPD can be quick to feel anger and feel hostile toward others.
PPD usually appears in early adulthood. According to the Cleveland Clinic, PPD appears to be more common in men than women.
Treatment for PPD can be challenging, because people with PPD have intense suspicion and mistrust of others. A mental health professional must establish trust with the patient. This trust enables the patient to confide in the professional and believe that they have a disorder.
The cause of paranoid personality disorder is unknown. However, researchers believe that a combination of biological and environmental factors can lead to paranoid personality disorder.
The disorder is present more often in families with a history of schizophrenia and delusional disorders. Early childhood trauma may be a contributing factor.
Often, people with paranoid personality disorder don’t believe that their behavior is abnormal. It may seem completely rational to a person with PPD to be suspicious of others. However, those around them may believe this distrust is unwarranted and offensive. The person with PPD may behave in a hostile or stubborn manner. They may be sarcastic, which often elicits a hostile response from others, which may seem to confirm their original suspicions.
Someone with PPD may have other conditions that can feed into their PPD. For example, depression and anxiety can affect a person’s mood. Mood changes can make someone with PPD more likely to feel paranoid and isolated.
Other symptoms include:
Some symptoms of PPD can be similar to symptoms of other disorders. Schizophrenia and borderline personality disorder are two disorders with symptoms similar to PPD. It can be difficult to clearly diagnose these disorders.
Your primary care provider will ask you about your symptoms and history. They’ll also do a physical evaluation to look for any other medical conditions you may have. Your primary care provider may send you to a psychiatrist, psychologist, or other mental health professional for further testing.
The mental health professional will perform a comprehensive assessment. They may ask about your childhood, school, work, and relationships. They may also ask you how you would respond to an imagined situation. This is to gauge how you might react to certain situations. The mental health professional will then make a diagnosis and form a treatment plan.
Treatment for PPD can be very successful. However, most individuals with this condition have trouble accepting treatment. Someone with PPD doesn’t see their symptoms as unwarranted. If an individual is willing to accept treatment, talk therapy or psychotherapy are helpful. These methods will:
Medications can also be helpful, especially if the person with PPD has other related conditions such as depression or anxiety disorder. Medications may include:
Combining medication with talk therapy or psychotherapy can be very successful.
The outlook depends on whether the individual is willing to accept treatment. Individuals who accept treatment can hold down a job and maintain healthy relationships. However, they must continue treatment throughout their lifetime, because there’s no cure for PPD. Symptoms of PPD will continue, but can be managed with care and support.
People with PPD who resist treatment may lead less functional lives. PPD may interfere with their ability to hold down a job or have positive social interactions.
Written by: Janelle Martel
Medically reviewed on: May 17, 2017: Timothy J. Legg, PhD, CRNP
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