Paranoid Personality Disorder

What is "Paranoid Personality Disorder"?

Paranoid personality disorder is one of several psychiatric disorders that come under the "umbrella" of personality disorders.

Psychiatric disorders are broken down into categories that include:

• Anxiety Disorders
• Dissociative Disorders
• Eating Disorders
• Mood Disorders
• Personality Disorders
• Psychosis
• Sexuality and Sexual Disorders
• Somatoform and Factitious Disorders
• Suicidal Behavior
• Substance Abuse

We often hear the term, "paranoid-schizophrenic", which is a disorder that comes under the category of "psychosis" and a type of schizophrenia, but which is a different condition that paranoid personality disorder is.

One difference between any form of psychosis and personality disorders (or any of the other categories of disorders) is that psychosis (which can include symptoms like hearing voices and having bizarre delusions that aren't related to anything that could happen in "real life") is that personality disorders in general, and psychotic personality disorder specifically, have "everything to do with "real life". People with personality disorders are not psychotic. Those with personality disorders can have trouble dealing with, and functioning in, life. With psychosis people can suffer with delusions, disorganized speech, grossly disorganized or catatonic behavior, and hallucinations. The individual with paranoid personality disorder may be working in the cubicle next to yours and doing his job well enough, but in all likelihood he's the person just about everyone has run-ins with from time to time; and he's the person about whom just about everyone has said, "I don't know what his problem is, but he's got some issue." Those with this disorder have trouble working with others, whether or not it's within an employment setting or other situation.

With paranoid personality disorder people generally have trouble getting along with others in day-to-day life. Forming long-term relationships is difficult for them. They're suspicious of people and don't trust others without there being any real reason for such thinking; but unlike with the bizarre delusions in psychosis, the false beliefs of someone with paranoid personality disorder are related to things that could actually be real in real life.

With paranoid personality disorder people may believe that others have ulterior motives they just don't really have. In addition, they may believe these "ulterior motives" have roots in malevolence and hostility. An example of this might be a situation where a bank makes a mistake in a person's account, and that individual believes the bank if "out to get him. An example of how this inappropriate belief could be feasible in "real life" might be that the individual could anger a customer-service rep enough to make that individual decide not to fix the mistake as soon as he otherwise would have. The "delusion aspect" of the belief would be that in reality the "whole bank" would not likely be "out to get" this individual.

Coldness and distancing in relationships are associated with paranoid personality disorder, and if those with the disorder do form attachments they tend to be jealous and have a need for control. A tendency to suspect that partners or spouses are unfaithful when they're not is also associated with this disorder.

Being suspicious of changes and believing that hostility or malevolence are behind other people's acts can be the foundation on which other inappropriate beliefs may be formed. The individual with paranoid personality disorder may perceive attacks on his reputation and/or character that are not apparent to others (although it may be worth noting here that just because others may not see real attacks on someone's character or reputation there is the chance they haven't seen something that, in fact, may be real). (This brings to mind the well known joke-line, "Just because someone is after me it doesn't mean I'm not paranoid.") People with paranoid personality disorder may be quick to react angrily.

Something that occur with people with the disorder is that their inappropriate responses to others can cause others not to like them; and when others begin to show their dislike toward the person with the disorder it can serve to confirm, in his mind, that others don't like him and can't be trusted.

People with this disorder are often known for having righteous indignation and for seeking out legal help on matters on which they feel they've been wronged. They tend to be unforgiving or perceived insults, slights, or other instances of feeling wronged. They may also, however, perceive absolutely innocent or kind remarks as "insults" or other reasons to believe the person who made them is being hostile. The individual with paranoid personality disorder tends to be a bearer of grudges. (Worth noting here is the difference between the normal individual who doesn't tend to bear grudges but who bears a grudge in an isolated situation in which bearing a grudge would be considered reasonable; and the person with paranoid personality disorder who tends to bear grudges against any number of people for any number of otherwise incorrect/unreasonable reasons.)

Inappropriate suspicions about others trying to exploit, deceive, or harm are associated with this disorder. People with it may keep questioning, and have unwarranted doubt about, the loyalty of friends or associates. Separate from beliefs about what others are doing at the present time, the expectation that others will try to exploit, deceive, or harm them is also a part of this disorder. Friends, family, co-workers, or strangers -the person with this disorder may be suspicious of any of them.

Not comfortable confiding in others (out of unwarranted fear shared information may be used against them), people with this disorder tend to be secretive. He may read hidden messages of either a threatening or demeaning nature in "innocent" remarks or gestures.

Detachment, hostility, poor self-image, and social isolation are also common among people with the disorder. A tendency toward violent behavior can add to the serious difficulties this disorder can bring to the life of someone who has it. People who have this disorder seem to never let down their defenses. They may always be looking for proof that what they suspect is real.

Men are said to have it more than women are, and this personality disorder often shows up in early adulthood.

Paranoid personality disorder is a disorder that must be diagnosed by a qualified, capable, psychiatrist; and one problem can be that the person suffering from it may not trust doctors enough to seek help, even when the disorder creates real and serious difficulties in his life.

The cause of paranoid personality disorder is not known, although it can, at times, appear to "run in families" in which one or more others suffer from psychotic disorders. Studies of identical twins suggest genetics may play some role, while some experts suspect childhood experiences as possibly having some role in contributing to, causing, the disorder.

Although treating paranoid personality disorder can be challenging, it is a disorder with which some people can live reasonably comfortably as compared to many other psychiatric disorders. Although, of course, it has the potential of causing serious difficulties in one's life paranoid personality disorder is not considered one of the most extremely debilitating of mental illnesses.

Summary of Behaviors

Counselling Resource.com (http://counsellingresource.com/distress/personality-disorders/foundation/summary.html) cites The Diagnostic and Statistical Manual of Mental Disorders (DSM IV, American Psychiatric Association, 1994) in a summary of all personality disorders points out that a person with paranoid personality disorder " generally tends to interpret the actions of others as threatening." Also noted is that "This distrust and suspiciousness is indicated by four (or more) of the following:

1. suspects, without sufficient basis, that others are exploiting, harming, or deceiving him or her

2. is preoccupied with unjustified doubts about the loyalty or trustworthiness of friends or associates

3. is reluctant to confide in others because of unwarranted fear that the information will be used against him or her

4. reads hurtful or threatening meanings into kind remarks or events

5. is unforgiving of insults or injuries

6. perceives attacks on his or her character or reputation that are not apparent to others and is quick to react angrily

7. has recurrent suspicions, without justification, regarding faithfulness of spouse or sexual partner "

What Is Not Necessarily Paranoid Personality Disorder

Throughout any number of resources addressing this disorder one remark appears over and over again, and that is that anyone diagnosing (or suspecting) paranoid personality disorder should be careful not to misinterpret cultural beliefs/differences. Some cultures have beliefs that would be viewed as "paranoid" by people in other cultures. It's important not to mistake differences in cultural beliefs (bizarre as they may seem to those of another culture) as mental illness.

The term, "paranoid," may be one of the most over-used and misunderstood psychiatric terms among the general public population (as opposed to trained, competent, mental-health professionals); and while the term is often used in jest, it's also used by people who don't know what they're talking about who are, for one reason or another, "diagnosing" other people. While saying, "I'm so paranoid," may be funny when it's said in jest, it isn't funny when people who don't understand what "paranoid personality disorder" really means start to think others who don't have anything close to that have this form of mental illness.

This type of ignorance can prove disastrous for its victims; and perhaps more than understanding what the disorder is, may be understanding what it is not.

Besides cultural differences, there can be differences between individuals that don't necessarily indicate paranoid personality disorder. Here are some examples of situations in which one person may cause another one (or more than one) to wonder if he has the disorder:

In the workplace, one person may not be liked by someone else; so every time that person tries to deal with the co-worker who just doesn't like him for one reason or another he may start to talk about how "Susie in accounting seems to have it in for me". Just because "Susie" is friendly and nice to most everybody else, the fact that one individual thinks she has it in for him doesn't necessarily mean he's got a personality disorder.

In the family, one sibling may be experience some mistreatment, abuse, or just more "coldness" by a parent when none of the others have experienced it. If other siblings haven't experienced it, and the one expresses that he has, he may be seen as "being paranoid". He isn't. He has just had his own (real) and individual experience.

A person who is mistreated or abused by a spouse or partner who only shows that nasty side of himself to his spouse/partner isn't paranoid just because nobody outside the closed doors of the home have seen this side to the individual.

The mother who walks her five-year-old to the kindergarten bus stop is not "paranoid" because her neighbor is less cautious than she is.

The parent who sets rules about a teen's use of the car is not "paranoid" because he has matured enough to have seen some of the dangers to teen drivers (or any drivers); and he is not "paranoid" because he "doesn't trust his own son or daughter". He may completely trust his own son or daughter but may remember how he, even if generally trustworthy, had very different judgment as a teen.

The person who doesn't want to ski because he knows he's not "the athletic type" and worries he'll get hurt because of that is not "paranoid".

The person who has reservations about one doctor or another, or about one hospital or another, isn't necessarily "paranoid". He may have heard something about a doctor or medical facility, have had some experience, or generally have very high standards when it comes to being convinced medical professionals are among the most skilled. In other words, not everyone who says he "doesn't trust the doctor" doesn't trust the doctor's motives. It may be skill, character, or judgment he doesn't trust.

A similar situation may be the person who says he doesn't like eating in restaurants, or at least in certain ones. Again, this person isn't necessarily "paranoid". He may just know something about the practices of some restaurants, or he may have particularly high standards regarding food handling or quality. Again, if such a person says he "doesn't trust" restaurants it isn't necessarily saying he thinks restaurant owners and workers are "out to get him", personally.

Neither is necessarily a sign of "paranoia" when a person with a legitimate complaint plans to sue someone or even many people. The real issue is whether the person has a history of wanting to sue "everybody" (or almost everybody) he believes has wronged him.

The person who is fearful of one person or of a situation for good reason (or his own reasons) is not necessarily suffering from paranoid personality disorder.

It's not "paranoid" if a person has, in reality, been mistreated but an individual, company, or government agency and develops a contempt for, and lack of trust of, any of these. The person who seeks some kind of help or protection from something like government agencies or courts, only to be shocked and angered when one or more of these fail him, or even cause unnecessary and disastrous consequences in his life, is not "paranoid" when he no longer trusts whoever/whatever failed him (or someone he knows).

The person with personal, real-life, knowledge of something like crime, cover-up, or corruption that really do go on is not "paranoid" because he's not among the people who remain unfamiliar with some of these nasty aspects of real life.

These are just examples of situations in which people often call a person "paranoid" and may suspect or believe he actually is. One other situation worth noting is this: There are times when a person whose family or friends, out of ignorance, incorrectly believe may show signs of "being paranoid" is as mentally healthy as anyone else (or may even be more mentally healthy than those who question his "cautious, sensible" personality; high standards, or even inability to trust the judgment (NOT the motives) of people who know less than he does about one thing or another.

Also, something like being aggressive or exhibiting violent behavior may not necessarily be signs of something other than paranoid personality disorder, or any personality disorder for that matter. As with any illness or disorder, exhibiting a behavior or two, or a symptom or two, doesn't always mean the illness or disorder is present.

In other words, regardless of the situation, it is important people not jump to the conclusion that someone else has this disorder because the person making the judgment is not aware of what the person in question has experienced or knows.

Perhaps a good guideline for anyone who is not a psychiatric professional, and who wonders whether he, himself, or someone he knows may have paranoid personality disorder, is this: Ask if the person in question has a generally sunny disposition, gets along well with most people, has no trouble forming long-term relationships, is warm and loving toward family, and shows no signs of being an aggressive, confrontational, individual. These are all signs of good mental health. If you or the person whose mental health you're questioning generally exhibits these signs it's unlikely paranoid personality disorder is present.

The following link is to a quiz that offers a general, non-professional, "reading" on whether or not someone taking it may have reason for concern with regard to personality disorders in general:

http://www.4degreez.com/misc/personality_disorder_test.mv