In Syndromes & Disorders

What You Need to Know About Paranoid Personality Disorder

Paranoid personality disorder is also known as PPD. It is grouped under the quaintly named category of eccentric personality disorders. This definition tends to make one think of doddering Victorian gentlemen in dusty libraries. However, paranoid personality disorder is a real condition in these modern times that can often be helped by treatment as long as the patient wants treatment.

Getting a diagnosis of PPD is not the end of the world. The condition is often more stressful for anyone living with the sufferer than for the sufferer himself. Never try to self-diagnose a mental health condition. If you cannot get to a mental health professional, at least get to a general practitioner or family doctor for a diagnosis. You or your loved one may be diagnosed with other mental conditions in addition to PPD.

What Is Paranoid Personality Disorder?

Paranoid personality disorder is when a person mistrusts everybody for no reason at all. They are in a constant state of vigilance and believe everyone in the world is out to get them. They rarely trust anyone, follow anyone’s directions, believes what anyone tells them or take medications prescribed to them. They prefer to make their own way in the world even when others clearly want to help them or befriend them.

The latest edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders lists PPD as a Cluster A disorder, which means the same thing as an eccentric personality disorder. Paranoid personality disorder DSM fifth edition describes the sufferer as being victim to his distorted thoughts, moving through the world with hostility and fear.

IS PPD a Serious Mental Illness?

All mental illnesses should be taken seriously. It is a common misconception that personality disorders are not-so-serious mental illnesses. People with PPD can often hold down jobs and pay their bills. Their illness makes it incredibly difficult to deal with people, keep friendships or have long-lasting romantic relationships. It is possible to define a PPD pateint as successful.

There is a stigma associated with having a PPD diagnosis. Famous people with PPD include leaders like Joseph Stalin, Saddam Hussein and President Richard M. Nixon. Because of this stigma, all celebrities with PPD keep the diagnosis a well-guarded secret. There are not many statistics available for how common PPD is among the general population.

What Are the Causes of PPD?

It is unknown what causes any mental illnesses, including paranoid personality disorder. For some reason, men are far more affected than women. The Cleveland Clinic explains that many patients with PPD also have relatives with schizophrenia or schizophrenic disorders. There is also a theory that severe childhood traumas can also cause mental illnesses like PPD.

The Cleveland Clinic also notes that it is nearly impossible to prevent. Symptoms often begin by the early 20s, although sometimes they may appear earlier.

Are There Any Tests for PPD?

There is no medical test like a blood test in order to diagnose PPD. Diagnosis is usually based on observation of the patient’s behavior and past medical history. The patient is also watched for symptoms of other personality disorders, such as having hallucinations. The doctor or mental health professional will also do a physical examination to rule out causes like tumors. Some patients with PPD will balk at a physical examination.

Patients are then interviewed and asked questions about their lives. Diagnosis is then determined by how the patient answers these questions. Doctors or mental health professionals may also interview anyone living with the patient to get another point of view as to how the patient behaves. If a patient is violent, then the patient may have to be sent to a hospital or asylum in order to calm down.

Symptoms of PPD

The main symptoms of PPD are not merely that they do not like people, but that they do not trust anyone They do not trust facts. They do not confide in anyone. They dwell abnormally long on past problems with people and may plot revenge. They do not accept what anyone tells them. They are incredibly jealous and easily hurt. They do not accept any form of criticism. They are always in the right and woe betide anyone who tells them otherwise.

Sometimes people with PPD can turn violent. They think they are just protecting themselves, but this is small comfort to anyone at the receiving end of such an attack. Anyone living with a person suffering from PPD must be able to defend themselves, have a place to run to if necessary and be vigilant for signs of impending violence, advises Dr. Stuart C. Yudovsky, author of Fatal Flaws: Navigating Destructive Relationships With People With Disorders of Personality and Character (American Psychiatric Association; 2007.)

Examples of PPD

The late President Richard M. Nixon was a textbook example of PPD. His distrust in others eventually cost him the White House. However, he was a two-term President, Governor of California and leader of the Republican Party. He also helped instigate good relations with China.

He also was incredibly paranoid. He would expend countless hours of manpower to investigating innocuous people like John Lennon. He taped everything that went on in the White House and authorized the break-in at the Watergate Hotel. However, he was reportedly a doting parent and adored his mother.

Treatment for PPD

Treatment usually consists of talk therapy. Patients are shown how to more properly interpret the information they get. Unfortunately, patients rarely trust their therapists. Patients can be quite verbally abusive or dismissive of any suggestions, which can tax even the most experienced of therapists. Therapy is usually one-on-one as opposed to group therapy. Violent patients may have to be committee, whether they want to or not. points out that there are no support groups for PPD patients. This is because of the total distrust PPD patients often have for other people, including other PPD patients. If you were convinced that a certain group of people supposedly showing the same symptoms you have were really just out to get you, would you go to that support group? Chances are you wouldn’t. This is what a mental health professional is up against when trying to treat a PPD patient.

Are There Any Medications for PPD?

Sadly, there are no drugs made specifically for PPD patients. The big problem is getting a patient to take any medication since they are convinced that the medication will somehow harm them. Anti-psychotic medications like thorazine may be administered if the patient is violent to himself or to others. Patients who can no longer function, such as those who refuse to leave their homes, are often prescribed anti-anxiety medications like diazepam. Again, there is a problem of making a person take medication.

Many patients with PPD also have other mental illnesses like generalized anxiety disorder or major depression. Medications like anti-depressants are used to treat those problems, which may or may not impact PPD symptoms. Every person reacts differently to medications or combinations of medicines.

Long-term Prognosis

PPD is incurable. The patient has to be willing to change in order for any drugs or therapy to be effective. Unfortunately, many patients with PPD are unwilling to change. They still may be able to get a job and function outside of the home, but they never can relax their guard against others. Marriage is often impossible because the PPD patient is convinced that the partners are stealing, having affairs and lying about it all.

Although they may not seem totally human, they are still human beings with very human needs and desires. Imagine longing to talk to someone and yet torn by suspicions about that person. If they develop an incredible loneliness, they may self-medicate with drugs or alcohol in order to tolerate the presence of others. This can lead to substance abuse and addiction, which presents a whole other set of problems.

Do I Have PPD?

If you are seriously asking yourself if you have PPD, the chances are that you do not. This is because most PPD patients are suspicious not only of others but information of others. Some PPD patients may firmly believe that they are not suffering from any mental illness and that PPD is just a myth.

However, if you have any doubt that you have PPD, talk to your doctor as soon as possible. You may not have PPD, but you may have something else that needs attention. The sooner you can learn how to treat your problems and start treatment, the better it is for your long-term prognosis.


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