Understanding Paranoid Personality Disorder (PPD)
Before we examine some of the treatment options that are used on patients suffering from this disorder, it’s important to be aware of some paranoid personality disorder symptoms that are exhibited by most patients.
Patients suffering from PPD are always suspicious of those around them. They tend to misinterpret comments made by others. They’re of the opinion that people are hostile and out to hurt them. They find it difficult to have healthy relationships (even with their spouses) because they constantly doubt the intentions of their friends, family members and coworkers. They do things to retaliate for perceived slights and this is why people tend to distance themselves from someone who has this disorder.
Treatment for Paranoid Personality Disorder
Patients generally come in for psychiatric treatment when their loved ones force them to. Some patients may also visit the doctor on their own particularly when the disorder progresses and they can’t cope with the pressures of life. The aim of treatment is to help the person to get rid of feelings of mistrust, resentment, jealousy and anxiety. This can also be achieved through group counseling sessions.
Medications such as selective serotonin reuptake inhibitors (SSRIs) and neuroleptic drugs may also be prescribed. Even though medications will help the patient to a certain extent, psychotherapy is essential to undo the negative thought patterns and perceptions.
Psychotherapy for Patients with Paranoid Personality Disorder
Group therapy sessions along with individual therapy are the best treatment options for people with paranoid personality disorder symptoms. The counselor will help the patient make a few interpersonal changes that will in turn affect his or her interaction with others. Group sessions are equally important because members of the family and close relatives can play an important role during treatment. They can dispel wrong notions that are present in the patient’s mind and build trusting relations with him or her.
Most therapists incorporate Transference Focused Psychotherapy during counseling sessions to help the patient recover. Since patients suffering from personality disorders have experienced faulty relationships in the past (sometimes from infancy), the therapist uses the patient-therapist relationship as a tool to correct the patient's personality structure. The interactions, feelings and emotions that the patient expresses to the therapist are always based on his or her previous relationships with others.
This helps the therapist understand and pinpoint the various negative representations the patient has experienced in the past. The therapist will attempt to build an empathic relationship with the patient so that he or she can express negative feelings and learn to deal with distressing emotions that arise.
The psychotherapist plays an active role in the treatment by asking pointed questions and discouraging abusive or destructive behaviors. In most cases the patient will refuse to attend psychotherapy sessions. The therapist aims to build a trusting relationship with the patient to enable a return to psychotherapy sessions in the future.
Using Psychotherapy to Help Patients
After the therapist builds a trusting relationship with the patient, members of the family may be called for group therapy sessions. The therapist will help the patient confront the good and bad representations he or she sees in others so that any given member of the family is not considered as 'all bad' or 'all good'. Once the patient learns to deal with opposite feelings towards the same person, a better model of relationships can be built in the mind. This will help the patient overcome feelings of distrust towards others.
Although transference focused psychotherapy is very effective for most types of personality disorders, patients should be willing to participate in these counseling sessions for a long period of time. In some cases, the patient may opt out of therapy and the treatment may fail on the whole. If the patient gets back to therapy, the reasons for the failure of previous treatments should be investigated.
Medications for Patients with Paranoid Personality Disorder
There is no specific medication that can treat all patients suffering from paranoid personality disorder. While a particular drug may work effectively on one patient, it may intensify the symptoms of another. Selective serotonin reuptake inhibitors are generally prescribed to control symptoms of anger, anxiousness and irritability. Prozac is the preferred drug as it works quite effectively on patients suffering from these symptoms. Even though the doctor may prescribe medications to aid a speedy recovery, patients may refuse to take their drugs due to their suspicious nature.
If your loved one is suffering from paranoid personality disorder, you must try to help them take their medications on time. Follow the dosage instructions that are given by the doctor and seek medical intervention if the patient becomes highly anxious or stressed out. Anti-anxiety medications may be helpful in such situations but only when they’re prescribed by the doctor.
Is the Treatment Effective?
The treatment is effective but only to a certain extent. Paranoid personality disorder is a chronic mental health problem. Patients are better able to cope with life if they continue with psychotherapy sessions and medications.
NB: The content of this article is for information purposes only and is not intended to replace sound medical advice and opinion.
Merck Manuels, MERCK