Paranoid Personality Disorder

What is paranoid personality disorder?

  • Paranoid personality disorder is a long-term mental health problem. When you think that other people want to hurt or take advantage of you, these are paranoid thoughts. With paranoid personality disorder, you have these thoughts often, and they cause problems in your daily life. You may not know that you are being paranoid because you truly believe that other people are trying to harm you. This may make it hard for you to know if you are in real danger, or if you just think that you are.

  • These paranoid thoughts may stop you from trusting others. You may have trouble getting along with others that you live or work with. You may think you do not need help with your thoughts and behaviors, but that everybody else needs help. Treatment for paranoid personality disorder may decrease your anxiety (worry). You may also be able to have better relationships with your family and friends.

What may cause or put me at a higher risk of getting paranoid personality disorder?

  • One of your parents died, or your parents went through a divorce when you were a child.

  • Someone in your family has paranoid personality disorder, or another personality disorder.

  • You saw one parent cheating on the other parent when you were a child.

  • You have drank too much alcohol, or drank alcohol too often, or you have abused drugs in the past. Alcohol is found in adult drinks such as beer, wine, and whiskey.

  • You were physically or sexually abused as a child.

How is paranoid personality disorder diagnosed?

  • Psychiatric assessment: Caregivers will ask if you have a history of psychological trauma, such as physical, sexual, or mental abuse. They will ask if you were given the care that you needed. Caregivers will ask you if you have been a victim of a crime or natural disaster, or if you have a serious injury or disease. They will ask you if you have seen other people being harmed, such as in combat. You will be asked if you drink alcohol or use drugs at present or in the past. Caregivers will ask you if you want to hurt or kill yourself or others. How you answer these questions can help caregivers decide on treatment. To help during treatment, caregivers will ask you about such things as how you feel about it and your hobbies and goals. Caregivers will also ask you about the people in your life who support you.

  • Signs and symptoms: Paranoid personality disorder usually begins when you are a young adult. The signs and symptoms are not caused by another personality disorder, or by a medical problem. With this disorder, you have trouble trusting other people. You also have at least four of the following:

    • You think that other people will harm, trick, or take advantage of you. You think this with little or no proof that it is true.

    • You think that your friends might not be loyal. You may think about how they have let you down. You may search for proof that they cannot be trusted.

    • You are nervous about talking to other people, because you are afraid they will use the information against you.

    • You think that others are trying to insult you. You think this even though what others say or do seems harmless. You may think that kind words or actions are being used to trick you. You may hear a person say one thing, but you think that they mean something else.

    • You often hold grudges against people who you believe have done something bad to you. You believe that the actions were done to hurt you, and you cannot forgive the people who did them. You may see people as your enemies, and want to get back at them (revenge).

    • You think that certain people are trying to make you look bad to other people. You may react by getting angry, or attacking them back. You may also believe that your reputation (what people think of you) is being threatened.

    • You may suspect your spouse or sexual partner of being unfaithful, even though there is little proof. You may search for signs of proof that your partner has been with a woman or man other than you. You may ask your partner questions to learn if he is lying to you. Your partner may tell you that you are trying to control him.

How may the beliefs and behavior of paranoid personality disorder affect other people?

  • It may be hard for you to have close relationships with people. It may be hard to accept feedback from other people. You may think that you are always right. You may feel angry or tense when you are around other people. You may argue with, or withdraw from other people. You may not accept that you have made a mistake, and you may blame other people for your mistakes.

  • People may see you as being angry, unfriendly, jealous or very sensitive. This can make it hard for you to get along with others at your job. It can make friendships and family relationships hard to keep. You may end up hurting yourself or others, or you may make others want to hurt you. Being treated for paranoid personality disorder may improve relationships with your friends and loved ones. With paranoid personality disorder, it is common to have other mental problems, such as depression, anxiety, or drug abuse. Ask you caregiver for more information about these problems.

What therapies may be used to treat paranoid personality disorder?

It may be hard for you to believe that you have a problem. It also may be hard for you to trust a caregiver to help you. Your treatment may include:

  • Behavioral therapy: Your caregiver may help your spouse or partner understand your behavior. He may help your partner change to decrease your jealousy. Your caregiver may teach you and your partner ways to avoid arguments.

  • Counseling: Your caregiver may ask how are you are feeling. He may ask you to explain your fears and beliefs. Your caregiver may ask you to tell him who you are angry with, and why you are angry with that person. He may talk to you about other ways to think about things that have happened to you. Your caregiver may help you cope with stress at work and at home. He may teach you ways to get along better with your spouse, friends and other people.

  • Psychoanalysis: Your caregiver may want to learn how your personality problem began. He may ask you to tell him about your past and your childhood. By learning about your past, your caregiver may help you understand your actions. By understanding your behavior, you may be able to decrease paranoid thoughts.

  • Psychotherapy: Your caregiver may teach you ways to cope with your symptoms. He may help you change your behavior, so that you can work and get along with other people better.

What medicine may be used to treat paranoid personality disorder?

The following types of medicine may be used to decrease your symptoms:

  • Antianxiety medicine: This medicine may be given to decrease anxiety and help you feel calm and relaxed.

  • Antidepressants: This medicine helps keep you from feeling deeply sad.

  • Mood stabilizer: This medicine helps control your impulsive mood swings.

Where can I find more information about paranoid personality disorder?

  • American Psychiatric Association
    1000 Wilson Boulevard, Suite 1825
    Arlington , VA 22209
    Phone: 1- 703 - 907-7300
    Phone: 1- 888 - 357-7924
    Web Address:
  • National Mental Health Association
    2001 N. Beauregard Street
    Alexandria , VA 22311
    Phone: 1- 703 - 684-7722
    Web Address:

When should I call my caregiver?

Call your caregiver if:

  • You feel depressed (very sad).

  • You feel very anxious or worried.

When should I seek immediate help?

See care immediately or call 911 if:

  • You think that you may harm yourself or someone else.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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