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Paranoid personality disorder symptoms

When a person has a paranoid personality disorder, they can experience a pervasive sense of suspiciousness and hypersensitivity to criticism and hostility. Paranoid personality disorder symptoms also include having a persistent mistrust of the world, misconstruing neutral or friendly actions as hostile or contemptuous; and a strong discomfort in sharing personal information, even with close family and friends, for fear of the information being used maliciously against them. People with paranoid personality disorders can also see threats and danger where they don’t exist.

Paranoid personality disorder and its symptoms can affect a person’s ability to form close relationships, which can go on to impact them in their work and home life. The person is likely to be on guard, constantly on edge and feel as though most people are trying to humiliate or harm them. They can appear cold, unemotional and aloof, when in reality, they are oversensitive, and are easily hurt by any minor comments or questioning.

Common paranoid personality disorder symptoms

Common paranoid personality disorder symptoms include the following:

  • Doubting the motives, loyalty or trustworthiness of others
  • Believing, without evidence, that others are manipulating or deceiving them
  • Being reluctant to confide in family and friends due to the belief that the person will use any personal information against them
  • Misreading non-threatening statements and behaviour as hostile or contemptuous
  • Bearing grudges and being unwilling to forgive
  • Being quick to anger and retaliate to perceived incidents
  • Suspicious of family and friends, including pathological jealousy

Someone with a paranoid personality disorder is also likely to have the following characteristics:

  • Prefers solitude and isolates themselves from others
  • Reluctance to confide in others
  • Intense interpersonal difficulties including close peer relationships
  • Irritable and hostile mood
  • Experiences social anxiety
  • Underachieves in education
  • Hypersensitivity
  • Eccentric fantasies

Paranoid personality disorder can become apparent in childhood or adolescence, where a person starts to show hypersensitivity, social anxiety or poor relationships with peers. It is thought that a number of psychological and biological factors are involved in someone developing the disorder. It is also understood that early childhood trauma – either emotional or physical – can lead to paranoid personality disorder.

Treatment for paranoid personality disorder and its symptoms

It is common for people with paranoid personality disorder to be mistrusting of healthcare professionals, as suspicion and paranoia are symptoms of the condition. This can result in people living with the disorder without receiving a diagnosis or treatment.

While personality disorders are considered to be long-term mental health conditions that need ongoing management, treatment can help to reduce the impact of the symptoms so that the person is able to live as fulfilling a life as possible. With the right help and support, a person can learn new techniques and coping strategies so that they can begin to manage their paranoid personality disorder symptoms effectively in their daily life.

Various medical treatments are available to reduce the distress associated with paranoid responses to stressful situations. Occasionally, low dose antipsychotics are indicated, if any brief psychotic episodes emerge. Long term management for paranoid personality disorder symptoms will typically include psychotherapy. The goals of this type of treatment include the following:

  • Helping the person to recognise and accept their feelings of vulnerability
  • Increasing the person’s self-worth
  • Encouraging the development of more trust in others
  • Supporting the person to find ways to verbalise their distress as opposed to shunning or intimidating others

At Priory, our psychiatrists and therapists are highly capable of diagnosing paranoid personality disorders, and engaging with and supporting people through the treatment process. When working with people, Priory specialists can help to enhance their sense of self-control while improving their social skills such as communication and empathy.

Over time, our therapists can help the person to begin to challenge and modify their persistent attribution of blame to others, so that they can move beyond the belief that all people are manipulative and that there is a constant need to look out for threats.

Treatment can help to free a person from seeing the world through a filter of paranoia and suspicion, giving them the opportunity to start viewing things in a more positive and helpful way.

Blog reviewed by Dr Tanushree Sarma (MBBS, MRCPsych, MSc), Consultant Psychiatrist at Priory Hospital Chelmsford

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