Paranoid Personality Disorder (PPD): Symptoms, Causes and Treatment


Medically reviewed by

Bajaj Finserv Health

Mental Wellness

4 min read


A key characteristic of people with a paranoid personality disorder is that they are suspicious and distrustful which can make them hesitant to ask for help. To know more about PPD, read on.

Key Takeaways

  • Paranoid personality disorder is a difficult to diagnose type of paranoia
  • Suspicion and distrust are common symptoms of paranoid personality disorder
  • Treatment for paranoid personality disorder includes therapy and medication

A paranoid personality disorder is a type of paranoia that can affect people at any stage in life. It falls under a group of conditions known as Cluster A personality disorders. Paranoid personality disorder (PPD) often leads to feelings of suspicions and distrust of others, making it quite tricky to address. Moreover, people with PPD also don't believe that their behavior is problematic in any way. A constant state of fear, suspicion, and distrust can also make it difficult for them to ask for help.

It is difficult to help people with PPD, but professional care is an option. If you notice signs of PPD in someone, you should encourage them to get treatment and not force them into it. This is because, to them, their fears and suspicions are not unwarranted. Read on to know more about paranoid personality disorder.

Common Paranoid Personality Disorder Symptoms 

Suspicion and distrust are among the common signs of paranoid personality disorder. But, people with PPD do not see their suspicion or distrust as unusual. To them, this is a justified defensive mechanism against people they distrust. These two symptoms of paranoid personality disorder may present in the form of: 

  • Misinterpreting conversations or gestures 
  • Having the thought others might harm or use them 
  • Hostile towards others, including family, relatives, partners 
  • Detached or social isolation 
  • Sensitive towards criticism 
  • Negative perception about others 
  • Controlling nature to protect themselves from manipulation or exploitation 
  • Cannot relax

These signs of paranoid personality disorder overlap with other mental illnesses. This includes conditions such as schizophrenia, depressive disorder, or bipolar disorder. As a result, your doctor needs to ensure that these conditions are not the cause of your symptoms.

This disorder test you undergo is strictly for assessment purposes. Doctors will likely ask questions about your past and conduct a physical examination to check for other issues. Do note that a paranoid personality disorder test taken online isn't a conclusive diagnosis.

Additional Read: Schizotypal Personality Disorderhow to help person with Paranoid Personality Disorder infographics

Causes of Paranoid Personality Disorder 

Hereditary factors and gender can lead to paranoid personality disorder. Research shows that men are more often diagnosed with PPD than women [1]. And in the case of genetics, a family history of schizophrenia increases one's risk of PPD. The factors given below may also increase one's risk:

  • Emotional or physical neglect in childhood 
  • Childhood trauma 
  • Unfounded and extreme parental rage 
  • Chaotic or abusive household 
  • Isolation or stress

Research also shows that race can increase the risk of PPD [2]. But more research is needed to find the exact link between race and PPD.

Diagnosis of Paranoid Personality Disorder 

Diagnosing paranoid personality disorder is tricky. This is because people with PPD often think that their behavior does not warrant change or attention. This makes them hesitant to ask for help or visit the doctor. Moreover, the overlapping symptoms make it difficult to diagnose this disorder. This often leads to people consulting a doctor for other conditions that are actually PPD.

In such cases, the doctors generally do not ask confronting questions. This is to avoid getting defensive or hostile responses. They may ask questions that are general and give more information about the patient. These questions are usually asked to know the following things about a person with PPD: 

  • Family history 
  • Impulsiveness 
  • Work and personal history 
  • Medical history 
  • Reality testing

A doctor generally gives a diagnosis of PPD based on the criteria set in DSM. This manual also lists and describes the symptoms of a person with a PPD. One can also find information about other mental health conditions in the manual.

Paranoid Personality Disorder Treatment Options 

For people with PPD, treatment can be difficult. This is because of their generally guarded, suspicious, and distrustful nature. Thankfully, continuous treatment helps people with PPD keep their condition in check. This can also help them be more effective and functional. Some common treatment options are specific medications and psychotherapy.

In psychotherapy, one may get dialectical behavior therapy or cognitive behavior therapy. Both of these therapies focus on helping patients develop more empathy, trust, and self-esteem. This can also help them be more communicative and interactive in social situations. Medication is generally given in case the patient has extreme symptoms. It can also be an option if the patient has other mental illnesses.

Additional Read: Multiple Personality Disorder

Now that you know more about paranoid personality disorder take the required measures to get treatment. If you notice any early signs of mental health conditions, reach out to a doctor. Talking to a doctor can help you understand and manage your condition better. To get an online appointment with top doctors, visit the Bajaj Finserv Health portal. Here, you can book an appointment in minutes and get advice from the best in the field. You can also know more about how to reduce stress and anxiety or deal with relapse of mental illness. This way, you can pay attention to mental health and focus on it for better wellbeing.

Published on 13 Jul 2022Last updated on 29 Dec 2022

Please note that this article is solely meant for informational purposes and Bajaj Finserv Health Limited (“BFHL”) does not shoulder any responsibility of the views/advice/information expressed/given by the writer/reviewer/originator. This article should not be considered as a substitute for any medical advice, diagnosis or treatment. Always consult with your trusted physician/qualified healthcare professional to evaluate your medical condition. The above article has been reviewed by a qualified doctor and BFHL is not responsible for any damages for any information or services provided by any third party.

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