PARANOID PERSONALITY DISORDER

Paranoid Personality Disorder or PPD is a mental condition in which a person has a long-term pattern of distrust and suspicion of others.

Individuals with PPD may feel extremely cautious of others, always on guard for signs that someone is trying to threaten, mistreat or deceit them even when they have no or insufficient justification for these feelings. They are generally difficult to get along with and often have problems with close relationships.

Paranoid personality disorder is the fourth most common personality disorder in the United States.

Having paranoid personality traits elevates the risk of developing substance use disorders and significantly impacts people’s ability to trust others and develop a stable social network.

Particularly in response to stress, individuals with this disorder may experience very brief psychotic episodes (lasting minutes to hours).

What causes Paranoid Personality Disorder (PPD)?

The exact cause of PPD is not known, but it likely involves a combination of biological and psychological factors. The fact that PPD is more common in people who have close relatives with schizophrenia suggests a genetic link between the two disorders.

There is also a strong connection between paranoid personality disorder and childhood abuse. People with the disorder often have histories of childhood trauma combined with family dynamics that were emotionally distant. People with the disorder typically experienced little to no affection growing up and were directly abused or exposed to frequent episodes of violence between their parents.

What are symptoms of Paranoid Personality Disorder (PPD)?

• Suspecting other people that they are trying to exploit, harm and deceive them without sufficient support or justification.
• Having unreasonable doubts about the loyalty or trustworthiness of friends or associates.
• Refusing to confide in others because of irrational fear that the information will be used maliciously against him or her.
• Interpreting hidden and baleful meanings in innocent gestures, events or conversations of others.
• Responding with anger and hostility to perceived attacks on his or her character or reputation that are not apparent to others.
• Holding grudges against others and unwilling to forgive the insults, injuries or slights that they assume they have received.
• Pathologically jealous, often suspecting that their spouse or sexual partner is unfaithful without any adequate justification.

How common is Paranoid Personality Disorder (PPD)?

From 2.3 to 4.4% of the general US population are estimated to have paranoid personality disorder. It is thought to be more common among men.

How is Paranoid Personality Disorder (PPD) diagnosed?

PPD is diagnosed based on a psychological evaluation. If you recognize symptoms of Paranoid Personality Disorder in someone you care about, you can encourage them to seek professional help and book an appointment with a doctor. The health care provider will consider how long and how severe the person’s symptoms are. Doctors usually diagnose personality disorders based on criteria in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), published by the American Psychiatric Association and then forms a treatment plan.

What is the treatment of Paranoid Personality Disorder (PPD)?

Treatment is quite challenging for people with PPD because they are often very suspicious of doctors. But if the treatment is accepted by an individual then medication together with psychotherapy can be effective.

• Cognitive Behavioral Therapy (CBT) is often effective in helping individuals adjust their distorted thoughts and maladaptive behaviors. During the course of treatment people will learn how to identify and change their destructive or disturbing thought patterns that have a negative influence on behavior. CBT may help people with PPD become better able to trust others and improve their relationships with friends and family. CBT can also help people with PDD in managing their responses to others. Rather than responding to comments with anger or hostility, for example, people can learn more appropriate ways of dealing with their emotions.

• Medication can be used in case if symptoms are severe or if an associated condition such as depression or anxiety is also present. Prescribed drugs include antidepressants, antipsychotics, and anti-anxiety medications.

Tips for people with PDD

• If you are experiencing any paranoid thoughts, you can try to engage in self talk. You can write about your thoughts and feelings in a diary or notebook and then answer how you feel about it. Try to answer your questions such as ‘Is it possible I am exaggerating a threat?’ or ‘Is there any evidence for my suspicions that can’t be questioned?’ etc.
• You can talk about your thoughts with your closed ones or with someone you trust. This will help you to question and challenge your paranoid thoughts and will reduce stress.
• Keep yourself connected with your family and loved ones as it will help you to feel valued, confident and more able to face difficult times.
• You can try mindfulness which will help you in becoming more self-aware, feel calmer and less stressed, cope with difficult thoughts, and feel more able to choose how to respond to your thoughts and feelings.
• Try to get enough sleep. Getting a proper sleep will provide you with the energy to cope with difficult feelings and stressful situations.
• Try to make changes in your diet. Eating healthy food and taking proper meals helps in making a difference to your mood and energy levels. Abstain from smoking and drinking.
• Exercise regularly as it will helpful for your mental wellbeing.
• Try to do something creative such as playing a musical instrument or baking or dancing. Such activities can help you to distract from difficult thoughts and feelings or help you to process them.

Tips for partners, families and carers

• Talk openly with the person experiencing paranoid thoughts. Paranoid beliefs can make people feel isolated but talking about them can help reduce stress in them and will give them a different perspective to think.
• Encourage and support them to seek professional help. It is important to reassure your loved ones that it’s ok to ask for help and that there is help out there.
• Try to use clear and unambiguous language with them to reduce the chances of misinterpreting what you are saying.
• Be more patient and considerate about their feelings. You can focus on the distress they are feeling and offer comfort. It is not necessary to validate with the reason they feel that way but just acknowledging their feelings will reduce their stress and anxiety.
• You should respect their wishes and not make decisions for them. Even if you know what is best for them, try to respect their wishes.
• It is important to look for your mental wellbeing too. It could be quite distressing seeing someone you care about experiencing paranoia. You can talk to someone if you are struggling to cope. Try to take some break and make time for yourself too.

Myths v/s Facts about Paranoid Personality Disorder (PPD)

References

• https://www.msdmanuals.com/professional/psychiatric-disorders/personality-disorders/paranoid-personality-disorder-ppd
• https://medlineplus.gov/ency/article/000938.htm
• https://www.helpguide.org/articles/mental-disorders/paranoid-personality-disorder.htm
• https://www.therecoveryvillage.com/mental-health/paranoid-personality-disorder/paranoid-personality-myths/
• American Psychiatric Association. Paranoid personality disorder. Diagnostic and Statistical Manual of Mental Disorders. 5th ed.