Treatment options and dealing with a person who has PPD

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What is Paranoid Personality Disorder?

Paranoid personality disorder (PPD) is also referred to as eccentric personality disorders. People with this disorder are often observed to be unusual or bizarre in their actions. They exhibit extreme signs of paranoia, with apprehension and distrust toward others even when they have no reason for wariness. The lack of communication skills can often be perceived as an insult or threat. The disorder usually onsets in early adulthood and is more prevalent among men than women.

A person with PPD is in touch with reality and not suffering from psychosis, meaning they are not delusional or having hallucinations. They often isolate themselves due to their mistrust in people and their fear that others may exploit or harm them. Often avoiding social interaction as a coping method, innocent comments or jokes may be perceived as insults to them sometimes causing them to react with violence.

Paranoid Personality Disorder Treatments

Most people with PPD do not seek treatment because they do not see that they have any issues. Treatment options are often explored during high stress times in their lives or when social demands are placed on them by family, partner/spouse and co-workers.

A person with PPD should not be in a relationship until they are cured or actively participating in psychotherapy. There is no way to deal with paranoid personality disorder unless they are willing to seek therapy and recognize there is a problem. Paranoia is a constant battle that tears apart relationships and ultimately leads down a path of self-destructive behavior.

The paranoia also causes paranoid personality disorder treatments to sometimes stop because the person doesn’t follow the health plan set forth due to lack of trust of the therapist. Building therapist-client faith depends upon considerable care and is difficult to maintain even after a confidence level has been made. Psychotherapy is the preferred method of treatment and is given on a long term basis.

While in psychotherapy the treatment will consist of

  • How to better cope with situations
  • Finding pleasure in social interaction
  • Improving intercommunication
  • Increasing self respect

Medication is not used to treat paranoid personality disorder. Medication such as anti-anxiety, antidepressant or anti-psychotic drugs may be prescribed to treat other underlying problems but not specially for the treatment of paranoid personality disorder.

An anti-anxiety agent, such as diazepam, is applicable to select as an option if the person is impaired from serious anxiety and is distressed and their daily life function is compromised. An anti-psychotic medication, such as thioridazine or haloperidol, may be suitable if the person has delusional thinking which may in turn cause the person to react by harming themselves or by harming another person. In most instances psychosis is not indicated.

The social aftereffect of this mental disorders could be family disruption, loss of job and home so the benefit of seeking treatment is favorable so the consequences of their actions do not occur again.

How to deal with paranoid personality disorder?

If you are close with a person who has PPD it is very important to remember to take care of yourself first and foremost. You can become emotionally drained from the constant threats and feelings of guilt for things that you have not done. Realize that you are not the reason they act this way, they have a disorder and need professional help. Find a good support system in your area.

Try to turn each conflict situation into a positive experience and rethink how you could possibly turn it around. Make sure that your actions are not reinforcing their paranoid behavior by stepping back and taking a look at the big picture as a whole. Stay calm, try not to be impulsive and react immediately to what is said or done to you. Always be aware of what is going on around you.

Realize that you cannot make them change their mind: instead, engage as much as possible in loving and supportive behavior.


1. Paranoid Personality Disorder, Cleveland Clinic

2. Paranoid Personality Disorder, WebMD

3. Paul J. Hannig, Ph.D., MFT Paranoia Truths

4. Paranoid Personality Disorder, PsychNet-UK