A man sulks while his worried friends stare at him.Paranoid personality (PPD) is a diagnosis characterized by extreme suspicion of others. This distrust often extends across a range of settings, from romantic relationships to workplaces. An individual may fear others will harm them even when there are no grounds for such suspicions.

The National Epidemiologic Survey on Alcohol and Related Conditions estimates roughly 4% of individuals have paranoid personality. This condition typically develops by early adulthood. Men are more likely to be diagnosed with it than women are. 

Someone with PPD may struggle to maintain close relationships due to their paranoia. Being constantly on alert for threats can create excessive stress. A licensed therapist can help someone with PPD address these and other symptoms.

Symptoms of Paranoid Personality

Someone with paranoid personality constantly assumes others are “out to get them.” The person may lack any evidence for these fears but strongly believe in them anyway. The individual may be unaware that others find their beliefs irrational.

To qualify for a diagnosis of PPD, a person must show at least four of the following symptoms:

  1. Suspects others are exploiting, deceiving, or otherwise hurting them (without evidence).
  2. Has recurring, unfounded suspicions that their lover is having an affair.
  3. Constantly worries about whether their friends or colleagues are loyal.
  4. Has difficulty telling others anything but the most basic information for fear it will be used against them.
  5. Interprets innocent actions as attempts to belittle or threaten them.
  6. Reacts angrily or aggressively to perceived attacks on their character (attacks which they alone notice). 
  7. Holds persistent grudges.

Someone with PPD will likely see hostility where there is none. For example, if a coworker hands them the wrong paperwork, they may interpret this as an act of sabotage rather than an honest mistake. Positive actions may be met with suspicion as well. For instance, an individual may see a compliment on their clothes as a passive-aggressive jab at their appearance. 

When someone with PPD feels attacked, they are often quick to fight back. They may accuse the target openly, or they could use sarcasm or complaints to let their displeasure known. This behavior may provoke hostility from others, which the person with PPD sees as validation for their initial suspicion. In this way, paranoid personality can become a self-fulfilling prophecy.

What Does Paranoid Personality Look Like?

Like other personality disorders, paranoid personality can hurt one’s ability to form healthy relationships. People with PPD often believe they are under attack. As such, they can be reluctant to show vulnerability or communicate openly (both of which can be necessary for social bonding.).

Some individuals cope with distrust by keeping social interaction to a minimum. They may put on a stoic, aloof exterior and deflect attempts at conversation. Others may act on their paranoia by becoming overly confrontational and stubborn. People in this second group can find themselves in lots of arguments.

No matter where a person falls on the above spectrum, they are likely to have issues with control. People with paranoid personality often have an excessive need for independence. Teamwork may be difficult for them, especially if the project requires stages of revision. People with PPD can be extremely sensitive to criticism. 

Although people with PPD value their own autonomy, they may not appreciate it in others. Paranoid personality can cause someone to become possessive of loved ones. In a romantic relationship, a person may demand to know their lover’s location at all times. These controlling behaviors are often intended to prevent betrayal, but typically they end up driving people away.

Paranoid personality can cause problems with one’s workplace, social network, and overall well-being. Yet due to their mistrust of others, people with PPD are often reluctant to admit they have an issue, choosing to blame others for their concerns. Paranoid personality symptoms are unlikely to improve unless a person seeks treatment.

Paranoid Personality and Related Conditions

The symptoms of PPD can resemble paranoid schizophrenia or delusional disorder, but these conditions are diagnosed separately. The paranoia in PPD is present throughout one’s daily life, rather than restricted to specific delusions.  

In general, paranoid personality does not involve psychosis. While a person may suspect their lover of cheating on them, they are unlikely to suspect their lover of being a government spy. However, a person may develop paranoid schizophrenia or delusional disorder later in their life, at which point they may have psychotic symptoms. 

Paranoid personality can occur alongside other mental health diagnoses too. An estimated 75% of people with PPD have a comorbid personality diagnosis. The most common comorbid issues are avoidant personality and borderline personality. Other common comorbid conditions include:

When someone with paranoid personality has comorbid diagnoses, treatment can be even more essential for their mental health. If you are seeking help for yourself or a loved one, you can find a therapist here.

References:

  1. Carroll, A. Are you looking at me? Understanding and managing paranoid personality disorder. Advances in Psychiatric Treatment, 20, 40-48. Retrieved from http://apt.rcpsych.org/content/15/1/40.full
  2. Lee, R. J. (2017). Mistrustful and misunderstood: A review of paranoid personality disorder. Current Behavioral Neuroscience Reports, 4(2), 151-165. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5793931
  3. Martel, J. (2012, July 10). Paranoid Personality Disorder. Retrieved from http://www.healthline.com/health/paranoid-personality-disorder