What’s Paranoid Personality Disorder

Paranoid personality disorder is a personality disorder which falls under the sub-grouping of “Suspicious”. There are three sub-groupings for personality disorders. Suspicious, emotional and compulsive and last but not least, anxious. 

What is Paranoid Personality Disorder?

Paranoid personality disorder is a personality disorder that causes people to behave in a very paranoid and mistrusting way.

People suffering from PPD assume that everyone is “out to get them”. This inhibits close personal relationships from being formed. At least to the level of trust and intimacy that many of us typically experience.

Usually people feel untrusting or leery of others when something has happened to them in the past. People with PPD may assume that something else could happen again.

It’s common to want to give someone the benefit of the doubt in a uncertain situation. However, someone with PPD will never do this. They will avoid people for the smallest actions that they perceive to be harmful toward them.

Those with PPD do not need to experience deceptive behavior or harm from someone in order to have feelings of extreme mistrust.

They will assume that people are always trying to harm them in some way. It can be very hard for them to trust even their closest relatives.

People with PPD will always be on the lookout for signs that people are being unfaithful or harmful to them. Their thoughts and behaviors are so tuned into this notion that they assume incorrectly and misinterpret other’s behavior often.

Most people do not have ill intent. However, they will be blamed or accused of trying to hurt or deceive the person with PPD.

Of course, this makes it hard to be around someone with PPD and can cause serious relationship problems.

Symptoms of Paranoid Personality Disorder

Below are several common symptoms and signs of paranoid personality disorder. Those suffering with PPD may show some, all or a combination of these signs.

Refusal to Share Personal Information

Sharing personal information about what part of town you live in or what pizza place you prefer might seem harmless to the average person who is not suffering from PPD.

However, if someone is diagnosed with PPD, they will overthink everything. They will be over cautious with sharing personal information even as general as those examples.

They will most likely suggest meeting at a mutual location and will not give out much information about themselves until you “check certain boxes” in their minds.

Even then, they will still be on the lookout for the smallest signs of harm.

They’re Stubborn and Cause Confrontation

Since people with PPD feel uneasy and want security, they will stay in their comfort zone in many areas of life. Opinions, beliefs and preferences included.

If someone has an opposing view on something, they may try to control the situation. They will often refuse to see another person’s side.

what's paranoid personality disorder

If there is an argument, even if the paranoid person is wrong, it will be very difficult to get them to apologize. Someone with PPD will most likely feel attacked in some way.

Those with PPD do not typically shy away from confrontation.

They are set in their ways and want others to feel and think the same way.

Basically, since they’re experiencing a lack of control in their own minds, they want to try to control situations and actions of others. This makes them feel safe and that they’re all on the same page.

When someone does not conform to their ideas, suggestions or opinions, they may write them off as not having their best interests. This can be in any situation whether it is a close friend, or someone they barely know. 

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Over Analyze Body Language

It is common for those with PPD to take innocent words or the smallest physical gestures and make them mean something else.

For example, if they’re talking to someone and they think that person looks at them a little funny, their paranoid behavior will interpret that as a sign that the person they are talking to shouldn’t be trusted.

Or, they could see the same person in a store a couple times they may think they are being followed.

They will assume that the “follower” intends to harm them and they will act accordingly by either finishing up and leaving quickly or even confronting them (depending on the individual).

Needless to say, general interactions are not as simple to those with PPD. 

They Strictly Stereotype People

Since people with PPD are so mistrusting, it is difficult for them to see past typical stereotypes of races or cultural groups.

Often stereotypes have some truth to the premise of them, but generally, rational people know to look at the individual instead of a group as a whole.

The average, intelligent person is aware that stereotypes are not true of everyone in a certain group. They can look beyond that to establish their own thoughts, beliefs and relationships.

Those with PPD are usually the opposite. They may believe negative stereotypes to be true of everyone in a certain group. They will then avoid people of those groups. This is because they’re assuming the worst and want to avoid them.

Hold Grudges out of Fear

Another common symptom is that people with PPD hold grudges and seldom forgive people. While this is frustrating and petty, it is coming from a place of fear.

Their past experiences or issues that  caused them to develop paranoid personality disorder, is trying to protect them going forward.

what's paranoid personality disorder

This is why they are so distrusting. Their mind is pretty much tells them “Well this person can’t be trusted, therefore, we need to protect ourselves and not let it happen again.”

They may come off as heartless and cold when it comes to their unforgiving behavior.

They Assume Incorrectly

Those with PPD will take other’s opposing opposition as a sign that they should not be trusted.

People with PPD have an overwhelming feeling of always being correct. When someone disagrees with them, they feel they cannot trust them.

Basically, the moment someone says or does something that equates to distrust in the mind of the paranoid person, they write them off as not being able to trust them.

It is very difficult if not impossible to have successful friendships or romantic relationships with someone who is paranoid. They will take the smallest thing out of proportion and will most likely not believe the truth.

This also goes for jealousy in a relationship. When the person with PPD feels something such as jealousy or mistrust, they will look for reasons that they are correct instead of trying to see both sides or disprove it.

Causes of Paranoid Personality Disorder

There is not one specific cause that is known. Typically, we know that personality disorders are caused from a variety of factors. This includes genetics, environment and past traumatic experiences.

Here are a handful of possible causes of PPD.

Genetic Factors

Personality traits such as anxiety can be passed down from parents to children. Other traits and poor conditions are inherited as well.

Also, it is not uncommon for someone with PPD to have a relative who is suffering from schizophrenia.

While a disorder like schizophrenia is not something that can be directly passed down from parents, the combination of characteristics and other traits (anxiety, depression, etc.) can be genetically received.

Unfortunately, it is up to the child to become aware of their tendencies and act accordingly to reverse any harmful personality traits.

The beauty of that is that if they’re aware of it and seek treatment, they can reverse the pattern and create a healthier life for future generations.

Personally, I inherited OCD tendencies and anxiety and am working toward eliminating those behaviors/thought patterns. This is for my own peace and well-being and also so don’t pass them down to my children one day. 


Any traumatic event can cause an individual to develop PPD depending on the makeup of their brain and other preexisting factors.

Examples of trauma that could cause the development of PPD could be abuse or witnessing/experiencing something else that results in trauma.

what's paranoid personality disorder

A Brain Injury

When a brain injury occurs, the individual is left with lasting effects that can result in developing a disorder.

This is due to the brain’s inability to properly function since the injury. In this case, the brain won’t be able to produce a healthy balance of chemicals.

As described in the earlier article “What is Obsessive Compulsive Personality Disorder?”, when the brain is experiencing a chemical imbalance, this is because certain neurotransmitters are not functioning properly.

This results with improper emotional responses, depression and anxiety. This can all lead to developing PPD if other factors come into play.

Environment Factors

Children and teens especially are so susceptible to environmental influences. Poor living conditions can also contribute.

Things that typically accompany that such as poor mindsets, neglect and unhealthy habits can contribute to the development of PPD.

This can occur if the individual is susceptible to anxiety and/or depression and if they do nothing to get help.

Using my childhood as an example, while there were many good times, there were also many stressful times which lead to extreme anxiety.

It may be hard to recognize that you’re suffering from anxiety if you don’t know any differently.

Also if those around you are anxious and high strung, you likely won’t be able to identify that you’re being conditioned that way until you are living on your own.

Disorders can also be induced by what a child is exposed to in their early childhood.

Development Issues

The health of the mother during pregnancy determines so much about the future health of the child.

If poor lifestyle choices are at play there is a huge risk that the child’s brain will not develop properly.

So aside from personality genetics contributing to developing PPD, poor health during the baby’s development could also be a contributing factor.

It depends on how well the brain develops and what that particular child is able to handle given the circumstances.

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Facts and Statistics

PPD is yet another personality disorder that is more commonly developed among men than women. This could be for a number of reasons including how information is processed during previous traumatic events. 

It is known that about 2.5% – 4.5% of people in the U.S. suffer from paranoid personality disorder.

There are a few common treatment options that someone with paranoid personality disorder can turn to.

As is typical for a variety of personality disorders, various therapy methods and sometimes medication is suggested.

Antidepressants are only prescribed if conditions such as anxiety and/or depression are present in the particular case

Psychodynamic psychotherapy and Cognitive-behavioral therapy are the two most common forms of “talk therapy”. Both that have been known to treat personality disorders – PPD included.

Here’s a little more about each type of therapy option…

Psychodynamic psychotherapy

Psychotherapy is used for a variety of disorders and emotional support. Psychotherapy is great for working through the daily struggles that individuals with PPD may face.

Depending on the severity of the individual’s disorder, psychotherapy can be a short process or can last for years. According to research, the majority of people in psychotherapy typically see helpful results.

The professional skills and knowledge a therapist has can help rewrite destructive patterns of behavior.

This will lead to better outcomes in every area of the patient’s life such as relationships, their job, and even their relationship with themselves. 

Cognitive-behavioral therapy

CBT is also a form of psychotherapy (“talk therapy”), although its focus is slightly different. CBT specifically targets eliminating negative thought patterns.

This can help someone with PPD as they suffer from constantly wondering and suspecting that people always mean them harm.

In turn, this could lead to loneliness although they may not know how to do something about it.

Talking to a therapist and working through self-sabotaging behaviors can help them overcome issues like this that they may not have been able to before.

The Diagnosis for PPD

In order to be diagnosed with paranoid personality disorder a certain number of specific criteria need to be met.

According to this article by Merck Manual, four or more of the below symptoms/characteristics need to be present with the individual in order to be diagnosed.

  • Incessancy grudge holding.
  • They’re always paranoid that their spouse is being unfaithful
  • Irrationally reacting angrily as if they’ve been attacked when they haven’t.
  • They’re a hard “nut to crack” and rarely confide in others
  • They’re always overthinking what other do and say because they believe other’s always mean them harm

Paranoid personality disorder affects those living with it as well as those who love and care about them.

If you or someone you know is struggling with PPD and would like help, therapy is always a great way to start! Being open to talking to a professional can help treat areas that significantly impact your life.

Building trust and working through destructive thought patterns can change your life!

As previously mentioned, here is the discount link to sign up for online therapy (plus the “extras” toolbox) at 20% off your first month! START ONLINE COUNSELING 20% OFF

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Hi, I'm Marissa! I'm passionate about mental and emotional health and want to share what I've learned over the years with others! I've seen first hand how mental health struggles can cause serious issues within relationships, work life, daily productivity, self-worth and more! I truly believe that we owe it to ourselves to bring more awareness to these life changing topics. Start your mental/emotional health journey by learning more today!

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