Read on to learn more about PPD, its symptoms, treatment, and how to cope.
Definition of Paranoid Personality Disorder
PPD has a set of criteria outlined in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the American Psychiatric Association handbook for diagnosing mental health conditions. These diagnostic criteria include:
Suspicious that others are exploiting, harming, or deceiving them without evidence to support this beliefPreoccupied with thoughts about the trustworthiness of friendsLess likely to confide in others because they fear what they say may be used against themFind it difficult to trust othersMay interpret remarks or the behavior of others as being demeaning or threateningWill often hold a grudge and be unforgivingMay perceive that others are attacking their character or reputationMay have ongoing suspicions that a spouse or partner is unfaithfulMay react angrily or counterattack if they feel their reputation has been attacked
Symptoms
People with PPD are frequently suspicious of others’ beliefs and behaviors, which may create problems in their daily functioning.
Some other symptoms of PPD include:
Rigid and critical of othersDifficulty accepting criticism themselvesDifficulty working with others and being collaborativeMay blame others for the shortcomings they haveMay frequently use the court system for legal disputes and excessive litigationMay have grandiose fantasiesFocused on issues of power and rankMay experience psychotic episodes in response to stress
Causes
PPD first presents in childhood and adolescence. Some research indicates there may be genetic causes for PPD, including an association with family members who have schizophrenia or delusional disorder.
Other researchers indicate that childhood trauma consistently presents as a risk factor for PPD. Specifically, childhood emotional neglect, physical neglect, supervision neglect, and physical abuse are all risk factors for PPD.
In addition, people with post-traumatic stress disorder (PTSD) are more likely to have PPD.
Brain trauma is often connected to PPD. Up to 26% of people with brain injuries meet the diagnostic criteria for PPD.
Treatment
Treatments for PPD vary depending on symptoms and other conditions the person may have. Medication and therapy typically work best when used together to treat any personality disorder.
Medication
There is no medication that can treat a personality disorder, and there are no medications approved by the Food and Drug Administration (FDA) specifically for PPD. However, medications are sometimes used to reduce symptoms or intensity.
Medications to treat PPD may include antipsychotics, antidepressants, and mood stabilizers.
Therapy
The three types of therapy that researchers believe may be effective in treating PPD are:
Cognitive behavioral therapy (CBT): CBT is considered an effective therapy for PPD. CBT explores how our thoughts influence our beliefs and behavior. Dialectical behavioral therapy (DBT): DBT is also an effective therapy for PPD because it offers validation for the client, encourages emotional regulation, and builds coping skills. Mentalization-based treatment (MBT): This combines psychodynamic therapy, CBT, and interpersonal psychotherapy. It is considered effective because it increases the skill of mentalization, which is a process of understanding one’s own emotions, thoughts, and behaviors.
Coping
Coping with PPD can be challenging. While medication and psychotherapy may be the most effective way to treat PPD, there are a few other ways to cope that may be helpful.
Sleep well: Getting consistent quality sleep may help with symptoms of PPD. Yoga: Yoga breath work, poses, and stretches have been shown to reduce anxiety and calm the nervous system, which may be helpful for those with PPD. Journaling: Journaling is often helpful for externalizing thoughts that are circulating in the mind. Meditation: Multiple evidence-based studies indicate that meditation can reduce stress and improve mental well-being.
Summary
Paranoid personality disorder (PPD) includes ongoing patterns of distrust, suspicion, hostility, and jealousy toward others. It involves a belief that people are behaving maliciously toward the person with PPD.
Childhood trauma is the most likely cause for PPD, though there may be a genetic predisposition. People with PPD can benefit from both therapy and medications.
A Word From Verywell
PPD poses unique challenges. If you or a loved one is struggling with PPD, help is available. Contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline online or call 800-662-4357 for more information on how to find support and treatment options.
