Paranoid personality disorder (PPD) is a mental disorder whose name is derived from the Greek word for ‘madness’.  It is a psychiatric illness characterized by individuals having a pervasive suspicion that others are hostile or threatening.  A person afflicted with this disorder is, however, always in touch with reality and occasionally delusional. This disorder cannot be diagnosed with laboratory tests or imaging methods. The doctor usually interviews the patient, and also may give a diagnostic questionnaire to the patient that is specially designed to perform a psychological evaluation of the case.

Causes of Paranoid Personality Disorder

The exact causes of PPD are unknown though some experts suspect genetic predisposition. Some familial factors are thought to influence the growth of the disorder. There have been instances of the presence of PPD in families that have had one or more members suffering from schizophrenia and other delusional disorders. Early childhood experiences including instances of physical and emotional trauma are suspected to play a role in the development of the condition. This disorder is seen to occur more commonly in males. It is initially apparent during childhood or the adolescent years.

paranoid personality disorder

Symptoms of Paranoid Personality Disorder

•    The most prominent symptom of paranoid personality disorder is a pervasive distrust of other people and any act of theirs is interpreted as deceiving or harmful.
•    The individual is preoccupied with perceived threats from others. Harmless statements from others are misinterpreted as insults.
•    They bear grudges and hold them for a long time. They are unforgiving.
•    They are socially isolated, do not share intimacies, are aloof, defensive, and unfriendly.
•    They are overtly suspicious of their partner’s faithfulness.
•    The expectation that they will be exploited by others can lead to hostility and anger, and in rare cases, PPD victims are capable of becoming violent.
•    They cannot collaborate with others and are incapable of working in a team.
•    They are highly observant, always scanning their immediate environment for acts or words that confirm their suspicions that others are out to get them.
•    They have a strong sense of autonomy and try to exert control over others close to them.
•    They have a tendency to argue and pre-emptively attack those they perceive as harmful. They also vigorously counter-attack at the slightest provocation and are habitually prone to making defensive statements.
•    They are critical of others’ acts and words, are sarcastic, and they cannot accept criticism of any sort.
•    They have difficulty in relaxing and are tense most of the time.
•    They believe they are always right.
•    They may appear to be rational and objective, but are stubborn and demanding.
•    They guarded, secretive, do not share personal information, are emotionally cold and do not possess tender feelings.
•    They often get tussled in issues involving power and rank and legal disputes.
•    They sometimes show grandiose and make-believe fantasies.
•    They are prone to making negative generalizations about people belonging to specific ethic groups, populations that are different from their own, nationalities, etc.
•    Severely affected individuals form tightly knit associations with others holding the same kind of beliefs.
•    Under extreme stress, those severely affected also exhibit transient delusions and psychotic behavior.

Substance abuse, alcoholism, obsessive compulsive disorder, depression, etc., are some disorders among many others that may co-exist with PPD, with some more common than others.

Treatment of Paranoid Personality Disorder

It is generally seen as difficult to treat patients with paranoid personality disorder as they are often suspicious of the doctor. If the treatment is accepted, long-term psychotherapy and counseling are usually resorted to. The treatment primarily focuses on improvement of general coping skills and improvement of self esteem and communication with others. A therapist with experience in this line is seen to be more effective in treating patients with the condition. It is a good idea to call a health-care provider or a mental health professional if suspicions in the mind rise to the point of interfering with daily work.

The treatment is sometimes coupled with anti-depressant and anti-anxiety medications. Self-help groups do not provide significant help to the victims because of the very nature of the disorder.

Prognosis

Paranoid personality disorder is a chronic and lifelong condition. The outcome, though frequently seen as poor, is also dependent on whether the affected individual is ready to accept help. Prevention of the disorder is not possible.