How to Deal with Paranoid Personality Disorder

Learn about the symptoms, causes, and treatment methods of paranoid personality disorder.

Paranoid Personality Disorder

Table of Contents

What Is Paranoid Personality Disorder?

Paranoid personality disorder (PPD) is a unique personality disorder characterized by intense paranoia and distrust of other people. It goes far beyond regular paranoia or hesitancy in forming new social connections; in many cases, paranoid personality disorder can make it hard for a person to maintain close relationships, negatively affecting their quality of life.

PPD is an eccentric personality disorder, also called a Cluster A disorder. Like other disorders in this cluster, PPD is seen in those who act oddly and primarily have a pattern of suspicion or distrust of others.

Paranoid personality disorder does not merely mean that someone has difficulty trusting others. Instead, it means that a person is unable to trust the motivations or loyalty of other people as seen with their long-term pattern behaviors.

Some studies estimate that between 2.3% and 4.4% of the population in the US suffers from paranoid personality disorder to some degree.1 Because of its primary symptoms, PPD can be difficult to deal with and may lead to decreased relationship quality, difficulty forming new relationships, and severe isolation.

Symptoms of Paranoid Personality Disorder

The primary symptom of paranoid personality disorder is a generalized distrust or anxiety about the intentions of others. Frequently, this distrust is unfounded (i.e., it is not based on fact or observed behavior of other people). Instead, it’s an inherent inability to trust others.

Other symptoms of PPD include but are not limited to:

  • A tendency to be unforgiving of others and hold grudges
  • A reluctance to confide in others or reveal any important information
  • Constant doubt of the trustworthiness or loyalty of other people
  • A tendency to read hidden meanings in the remarks, looks, or behaviors of other people
  • A tendency to see attacks on one’s character that aren’t true or apparent in others
  • Persistent suspicions that significant others, such as lovers or spouses, are being unfaithful
  • Generally cold or distant relationships with others
  • Difficulty seeing one’s own role in conflicts or interpersonal problems
  • Difficulty relaxing
  • A stubborn or argumentative nature or behavior pattern
  • A tendency to form and keep negative opinions or stereotypes of others, particularly from other cultural, social, or ethnic groups

Results from Symptoms

Nonetheless, paranoid personality disorder may lead to the formation of ancillary symptoms. It can be difficult for individuals with PPD to form long-term friendships or other social connections. This can make them more likely to suffer from mental health conditions like depression or anxiety.

Furthermore, PPD could lead some individuals with the condition to begin abusing substances or to become addicted to substances. These coping mechanisms take the place of healthier alternatives like therapy.

Causes of Paranoid Personality Disorder

The root causes of paranoid personality disorder are not fully understood or identified; however, medical and mental health professionals believe that PPD is primarily caused by two factors: genetics and the environment.


Genetics may increase the risk of developing PPD or a similar personality disorder. For example, if someone has a family member with PPD, they may be more likely to develop paranoid personality disorder themself.

Mental health or behavioral disorders are frequently linked to one or more genetic combinations. For example, puberty may trigger the development of PPD or other personality disorder symptoms, as the unique combination of hormone changes and brain shifts may trigger these and other conditions.

Environmental Factors

Environmental factors may also lead to the development or triggering of PPD symptoms. “Environmental” in this sense means any nonbiological or nongenetic factors, such as any chemicals a fetus is exposed to in the womb, physical or emotional trauma and childhood, and so on.

In fact, there’s lots of evidence suggesting that negative, shocking, or traumatic experiences during early childhood could lead to the development of PPD.2

Regardless, PPD is frequently diagnosed after a doctor’s complete medical and physical examination. A mental health professional may also do an in-depth examination and compare reported or observed symptoms against those recorded in the DSM-5.

Treatment of Paranoid Personality Disorder

Paranoid personality disorder can be difficult to tackle alone and may lead to lasting negative effects on one’s quality of life. Fortunately, there are multiple treatment pathways to consider and pursue with the help of a therapist and family.3


Psychotherapy has been proven useful for treating the symptoms of paranoid personality disorder, especially cognitive behavioral therapy (CBT). CBT relies on intense one-on-one sessions with mental health professionals like therapists or psychoanalysts.

During CBT sessions, patients break down why they think the way they do and can identify negative thought patterns. With time and practice, CBT could lead to persistent and positive changes in behavior and thinking. While psychotherapy cannot fully treat paranoid personality disorder or “cure” it, CBT could help individuals lead long, fulfilling lives and minimize the negative symptoms they experience.


Therapists or mental health professionals may also recommend one or several medications, often used in conjunction with therapy. Potential medications include:

Antidepressants can help treat any depressive symptoms a patient experiences because of their PPD while potentially helping their paranoia or discomfort in social situations.

Benzodiazepines are frequently used to treat the symptoms of anxiety, which are common among those suffering from PPD.

Mood Stabilizers
Individuals with paranoid personality disorder may find that their mood frequently fluctuates, making it difficult to concentrate or receive treatment. Mood stabilizing drugs could help alleviate these symptoms or make it easier for patients to attend regular therapy sessions.

Paranoia Treatment - Taking Care of youself

Taking Care of Yourself

Aside from psychotherapy and medication, patients with PPD should also take care of themselves as best as possible. Paranoid personality disorder and other personality disorders are frequently improved if one’s surrounding life attributes are positive. Here are some examples of self-care people can practice if they have PPD.

Maintain Relationships

First, individuals with paranoid personality disorder should not let close relationships falter or wither. In fact, it’s vital to maintain close relationships, particularly with good friends and family members. If individuals lose their close relationships, they may feel increasingly justified in their paranoid thought patterns. This will make it difficult for them to unlearn these thought patterns and overcome the symptoms of their PPD.

Relax and Unwind

Furthermore, people must give themselves time to relax and unwind at the end of each day. Stress and anxiety, especially if the feelings are related to work or other people, can make individuals more likely to be paranoid or mistrusting of others.

Relaxing and unwinding alleviates stress and may make people more likely to think of others charitably or practice behavioral thought patterns as recommended by a therapist.


Exercise is also crucial, especially for those who have any personality disorder. Regular exercise burns off cortisol and other stress hormones, making one feel more optimistic about everything, including interpersonal relationships.

Furthermore, exercise is a positive outlet and habit for overall health and wellness. When it comes to treating paranoid personality disorder, taking care of the body is just as important as the mind itself.

Eat Well and Get Enough Sleep

People need to eat a well-rounded diet with plenty of vegetables and nutrients. Eating junk food is more likely to cause tiredness, crabbiness, and irritability—all factors that can make dealing with PPD more stressful.

In addition, regular sleep is crucial for treating any mental health condition, including PPD. The brain needs plenty of sleep to recharge and regenerate itself and dump harmful waste chemicals. Therefore, those with PPD should prioritize going to sleep at the same time each night and getting a good eight hours of rest each evening.

Getting Help for Paranoid Personality Disorder

Fortunately, dealing with paranoid personality disorder is far from impossible–it’s more than manageable, especially when seeking help from Bi-Bett. As licensed addiction treatment professionals, we help manage the symptoms of comorbid addiction or substance abuse and paranoid personality disorder, whether it’s by engaging in a detoxification program or seeking out a sober living space.

Contact us today for more information and let us help you or a loved one overcome the challenges of paranoid personality disorder.


If you or a loved one needs help, please call us at
623-523-4748 and our team at Blueprints For Recovery in Arizona will help.

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