What is Paranoid Personal Disorder?
Paranoid personality disorder (PPD) is one of a group of conditions called “Cluster A” personality disorders which involve odd or eccentric ways of thinking. People with PPD also suffer from paranoia, an unrelenting mistrust and suspicion of others, even when there is no reason to be suspicious. This disorder usually begins by early adulthood and appears to be more common in men than in women.

What Are the Symptoms of Paranoid Personality Disorder?
People with Paranoid Personal Disorder are always on guard, believing that others are constantly trying to demean, harm, or threaten them. These generally unfounded beliefs, as well as their habits of blame and distrust, might interfere with their ability to form close relationships. People with this disorder:
– Doubt the commitment, loyalty, or trustworthiness of others, believing others are using or deceiving them
– Are reluctant to confide in others or reveal personal information due to a fear that the information will be used against them
– Are unforgiving and hold grudges
– Are hypersensitive and take criticism poorly
– Read hidden meanings in the innocent remarks or casual looks of others
– Perceive attacks on their character that are not apparent to others; they generally react with anger and are quick to retaliate
– Have recurrent suspicions, without reason, that their spouses or lovers are being unfaithful
– Are generally cold and distant in their relationships with others, and might become controlling and jealous
– Cannot see their role in problems or conflicts and believe they are always right
– Have difficulty relaxing
– Are hostile, stubborn, and argumentative

What Causes Paranoid Personality Disorder?
The exact cause of PPD is not known, but it likely involves a combination of biological and psychological factors. The fact that PPD is more common in people who have close relatives with schizophrenia suggests a genetic link between the two disorders. Early childhood experiences, including physical or emotional trauma, are also suspected to play a role in the development of PPD.

Advice for friends and family:
“The most helpful thing for me is to be taken seriously. On some level I know my beliefs can’t be real, yet to me they are utterly terrifying. Treating the fear as very real, even if you can’t go along with my reasons for the fear, is so important.”

Talk openly
Paranoid beliefs can make people feel isolated but talking about them can help reduce stress. You might find that your point of view reassures them and gives them a different perspective.

Don’t dismiss their fears
Even if you don’t agree that they are under threat or at risk, try to understand how they are feeling. It’s important to recognize that their feelings are very real, even if you feel the beliefs, they are based on are unfounded.

Focus on their feelings
Focus on the level of distress they are feeling and offer comfort. It’s possible to recognize their alarm and acknowledge their feelings without agreeing with the reason they feel that way.

Support them to seek help
You can’t force anyone to get help if they don’t want it, so it’s important to reassure your loved one that it’s ok to ask for help, and that there is help out there. See our pages on how to support someone else to seek help for their mental health for more information.

Respect their wishes
Even if you feel that you know what’s best, it’s important to respect their wishes and don’t try and take over or make decisions without them.

Know what to do in an emergency
If your loved one hasn’t been able to talk to you about their experiences, they may become very unwell before you realise they need help. If you are worried that your family member or friend is becoming very unwell or experiencing a mental health crisis, you could suggest that they use their crisis plan (if they have one). Our information on crisis services explains more about the help available to support someone in crisis.

Look after yourself
Seeing someone you care about experiencing paranoia can be distressing or even frightening. You may feel as if you have no time for yourself, but looking after your own wellbeing is important for you and for them. You may find it helpful to get support through talking therapy or peer support.