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Paranoid Personality Disorder

Medically reviewed by Last updated on May 1, 2023.

What is paranoid personality disorder (PPD)?

PPD is a long-term mental health condition. PPD causes you to be suspicious, distrusting, and hostile toward others. These thoughts and behaviors can cause problems with your relationships and daily activities.

What causes PPD?

The cause may not be known. Your risk is higher if you have a family history of PPD, delusions, or schizophrenia. You are also at risk if you were abused or neglected as a child.

What are the symptoms of PPD?

You may have PPD if at least 5 of the following are true:

  • You do not easily feel empathy (know how someone else feels). You often show no emotion when someone is upset. It is hard for you to have close relationships. You have trouble creating direction in your life. You do not have a sense of your own identity.
  • You think other people will harm, trick, or take advantage of you. You think your friends are not loyal or have let you down. You suspect your partner has been unfaithful. You search for proof that your friends or partner cannot be trusted.
  • You are nervous about talking to others. You are afraid they will use the information against you. You think certain people are trying to insult you, make you look bad, or threaten your reputation. You hear a person say one thing, but you think he or she means something else. You are defensive when others make comments. You argue, pick fights, or get angry.
  • You often hold grudges. You cannot forgive people you think tried to hurt you. You may see certain people as your enemies. You may try to take legal action against them.

What other behaviors might I have with PPD?

  • Depression
  • Obsessive-compulsive disorder (OCD)
  • Agoraphobia (fear of open spaces)
  • Alcohol or substance abuse

How is PPD diagnosed?

Your healthcare provider will ask about your history and if you want to hurt yourself or others. He or she will ask about your behaviors, feelings, and relationships with others.

How is PPD treated?

  • Medicines can help decrease anxiety or depression and make you feel more stable.
  • Individual or group therapy can help you create healthy, positive relationships. The following are common types of therapy:
    • Supportive psychotherapy helps you understand your behaviors and actions. This can help you build positive relationships.
    • Family therapy helps you and your family communicate and teaches your family how they can best support you.

Treatment options

The following list of medications are in some way related to or used in the treatment of this condition.

Call your local emergency number (911 in the US) if:

  • You want to hurt yourself or others.

When should I seek immediate care?

  • You have severe depression.

When should I call my doctor or therapist?

  • You feel depressed, anxious, or worried.
  • You do not want to leave your house.
  • You begin to drink alcohol, or you drink more than usual.
  • You take illegal drugs.
  • You take medicines that are not prescribed to you.
  • You have questions or concerns about your condition or care.

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 healthcare providers 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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Learn more about Paranoid Personality Disorder

Treatment options

Symptoms and treatments

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.