What is paranoid personality disorder?

Paranoid personality disorder (PPD) is a condition that causes extreme distrust of other people. If you have this disorder, you think that everyone is out to get you. You are always afraid that others are trying to cheat, hurt, or fool you.

What is the cause?

The exact cause of this disorder is not known. Possible causes include:

• The brain makes chemicals that affect thoughts, emotions, and actions. Without the right balance of these chemicals, there may be problems with the way you think, feel, or act. People with this disorder may have too little or too much of some of these chemicals.
• Stress plays a part. You may be at higher risk due to problems such as abuse, financial stresses, or the death of loved ones.
• Problems in your family when you were growing up may increase your risk. For example, if you were often rejected or abused as a child, you might have learned to distrust people. Your risk is higher if someone in your family has schizophrenia.

This disorder usually starts in childhood or in the teen years. Men are more likely than women to be diagnosed with PPD.

What are the symptoms?

Symptoms may include:

• Thinking that others are trying to cheat, hurt, or fool you
• Worrying that friends or family are not loyal or that your significant other is cheating on you
• Not talking about things for fear the information will be used against you
• Getting easily insulted and not having a sense of humor
• Holding grudges
• Having a poor self-image

How is it diagnosed?

Paranoia is a possible result of abusing alcohol and drugs such as marijuana, amphetamines, cocaine, and PCP. Your healthcare provider or a mental health therapist will ask about your symptoms and any drug or alcohol use. He or she may also:

• Ask about your relationships with family, friends, and coworkers
• Give you a personality test
• Make sure medicines are not causing or increasing your symptoms

You may have lab tests to rule out medical problems.

How is it treated?

This disorder changes the way you relate to others and the way you think about everyday activities. It may be treated with therapy or medicine.

• Talk therapy involves talking with a therapist about your problems and issues, and working toward solutions.
• Behavior therapy helps you recognize that the way you act affects others. This can help you change problem behaviors.
• Cognitive behavior therapy (CBT) is a way to help you identify and change views you have of yourself, the world, and the future. CBT can make you aware of unhealthy ways of thinking. It can also help you learn new thought and behavior patterns.

Medicine is not used to treat this disorder, but may help if you also have problems with anxiety or depression.

For more information, contact:

• The National Alliance on Mental Illness (NAMI)
  800-950-6264
  http://www.nami.org
• Mental Health America
  800-969-6642
  http://www.mentalhealthamerica.net/