What is paranoid personality disorder?

Paranoid personality disorder is classed as a Cluster A personality disorder, which is defined as having odd or eccentric thoughts and behaviours. 

PPD is a serious and debilitating mental health condition, usually starting in early adulthood.  It’s generally more common in men than women and is believed to affect between one to four percent of the population.  About 75% of people with PPD will also suffer from another personality disorder, most commonly antisocial, avoidant or borderline personality disorder. 

It is characterised by feelings of deep mistrust, suspicion and paranoia, unlike other mental health conditions involving paranoia they do not suffer from hallucinations or delusions.  Because of their symptoms it can be very difficult for people with PPD to make and maintain relationships. 

It can affect their school or work lives, due to their mistrust and suspicion of other people.  It is often more upsetting for the people closest to them as they can see how unreasonable their behaviours are, as they can appear hostile, cold and suspicious for seemingly no reason.


As with many mental health conditions the exact cause of PPD is not known, although it is believed that both genetics and psychological reasons play a part.  A family history of schizophrenia can be a high-risk factor, and childhood trauma or neglect is also believed to be a contributing factor.  People from poorer backgrounds, or who live alone or have never been married can also be at higher risk of developing PPD.

Physical Symptoms

  • Being cold and distant with people
  • Finding it difficult to relax
  • Being very stubborn
  • Coming across as being hostile
  • Being very argumentative
  • Prone to being sarcastic
  • Being defensive and not taking criticism well
  • Having difficulty working with other people
  • Suffer from mood swings
  • Not being very sociable and becoming detached from people

Psychological Symptoms

  • Feelings of paranoia
  • Depression
  • Anxiety
  • Lacking trust in others
  • Feeling other people are out to harm you
  • Distrusting the loyalty and commitment of other people
  • An inability to confide in others
  • Holding a grudge and not being able to forgive people


Professional Help

You should always consult your doctor if you are struggling with your mental health, however this can be challenging for people with PPD as they believe there is nothing wrong with them and the problem lies with everyone else. 

Whilst there is no specific medication for PPD, they can prescribe medication if appropriate, for related symptoms such as antidepressants or mood stabilisers for anxiety or depression. In extreme cases of paranoia they might prescribe anti-psychotics.

However because of the nature of PPD they are often reluctant to take prescribed medicines, as they are mistrustful even when they are able to see a marked improvement in their symptoms after taking them.

Psychotherapy remains the main treatment for PPD, to help them build relationships, and to learn trust and empathy. Therapies such as CBT (cognitive behavioural therapy), help them to recognise and change their negative and destructive thought patterns, as well as control their emotions.  Written by Jan, Jeana and Wendy at Barnsley Hypnosis and Counselling (UK).  For more free information click above link.