Feeling suspicious and withdrawing socially are symptoms of paranoid personality disorder. They can be managed with professional support.
If you live with a paranoid personality disorder, seeking help can seem difficult.
However, your symptoms can be managed, and treatment can help you cope with many situations that cause you distress and fear.
There is no cure for this personality disorder, but treatment can help a lot.
One of the 10 personality disorders is paranoid personality disorder. This is a chronic mental health problem that often develops during your teenage years or young adulthood.
When you receive professional support, you can find relief for many of your symptoms and experience more positive social interactions. It could also improve other areas of your life, such as your job.
For treatment to work, a healthcare professional first needs an accurate diagnosis.
Sometimes two or more conditions occur together. When this happens, these conditions are called comorbid.
For example, you might get diagnosed with paranoid personality disorder and also diagnosed with depression.
An accurate diagnosis that also identifies overlapping symptoms can increase the chances of successful management. This way all of your symptoms are addressed in the treatment plan.
To diagnose paranoid personality disorder, a healthcare professional may want to perform a physical exam. This will rule out any medical cause for your symptoms.
If they think you might have a personality disorder like Paranoid Personality Disorder, they might refer you to a specialist, like a psychologist or psychiatrist.
These mental health professionals may want to speak with you and gather details about your background, concerns and goals, as well as other relevant information.
Once they have this information, they can compare your symptoms with the diagnostic criteria set out in the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5). It is a reference manual for mental health clinicians to diagnose, classify and identify mental health problems.
Based on their findings, they can make a diagnosis and then discuss a treatment plan with you, which may consist of psychotherapy sessions, medication, or both. You can actively participate in this process so that you feel that you are doing what is best for your situation.
Psychotherapy is the first line of treatment for paranoid personality disorder.
Establishing a relationship with someone you don’t know can be difficult if you are living with this condition. However, it is important that you try to connect with your therapist. They are trained and experienced in mental health and can guide you to improve your quality of life.
The goal of psychotherapy for paranoid personality disorder is to identify your thought patterns and help you weigh actual threats against perceived ones. It can help you learn that you don’t have to worry about as many things as you could now.
Since paranoid personality disorder is a lifelong condition, you may need to continue treatment indefinitely. The frequency of your treatment visits can depend on many factors, including the intensity of your symptoms and your progress.
Cognitive Behavioral Therapy (CBT)
Cognitive behavioral therapy (CBT) is considered the first option for personality disorders. A 2018 case study suggests it’s effective for paranoid personality disorder.
CBT is talk therapy and it helps you change negative or harmful thought patterns.
CBT can help you build trust in others. It can also increase your ability to regulate emotions and improve social interactions.
As part of CBT, your therapist may invite you to participate in a behavioral experiment. You may be asked to interact with other people and then rate how you are feeling. You and your therapist can work through challenges like not trusting others.
You can go at your own pace and don’t have to participate in situations you don’t agree with. However, it is important that you try to trust your therapist to guide you.
This therapy focuses on a concept called locus of control. There are two: internal and external.
If you have an internal locus of control, you think you are in control of the outcome of every situation that arises. You may think it’s up to your effort and determination to accomplish something.
If you have an external locus of control, you may believe that how you feel or what happens to you is entirely dependent on external factors like fate, luck, or what other people are doing.
Most people have a combination of internal and external locus of control.
Psychodynamic therapy helps you switch to an internal locus of control if that is not where you are. It can help you feel more in control of your own safety so that you worry less about whether you can trust others.
The reality test involves examining the differences between what you believe or perceive and the reality around you.
Your therapist can help you assess your thoughts, examine the evidence to support them, and consider alternatives if they don’t coincide.
The purpose of reality testing therapy is to help you explore the multiple reasons for someone’s behavior.
For example, if your spouse doesn’t tell you where they’ve been, you might assume they’re cheating. However, they may plan a surprise party for you, or they may face a private challenge that they aren’t ready to share.
There are no medications specifically for the symptoms of paranoid personality disorder.
It is possible, however, that if you are living with symptoms of other conditions, your healthcare professional may suggest medications to help you manage.
For example, if you are also living with symptoms of anxiety or depression, medication can help you deal with them specifically.
Medications sometimes used with symptoms of paranoid personality disorder or co-morbid conditions include:
Atypical antipsychotics block chemical receptors in the brain to improve certain symptoms.
Some antipsychotics include:
- risperidone (Risperdal)
- quetiapine (Seroquel)
- olanzapine (Zyprexa)
- clozapine (Clozaril)
- ziprasidone (Geodon)
Antidepressants work by balancing the neurotransmitters in your brain. Examples include:
- sertraline (Zoloft)
- fluoxetine (Prozac)
- paroxetine (Paxil)
- duloxetine (Cymbalta)
- venlafaxine (Effexor XR)
Mood stabilizers are typically used for bipolar disorder, but they can work for other mood disorders as well. They help restore neurochemical balance to help reduce disruptive emotional changes.
- gabapentin (Horizant)
- lamotrigine (Lamictal)
- topiramate (Qudexy)
Atypical antipsychotic drugs also stabilize mood and may be prescribed for this alone or with another mood stabilizing drug.
There is no cure for paranoid personality disorder, but you may see improvement in your symptoms when you seek professional support.
Psychotherapy can be extremely effective in helping you change negative thoughts and develop coping skills to improve your relationships.
Medication can also help if you are living with other conditions like anxiety or depression.
Even if you don’t feel like it right now, there is support available and there are safe spaces for you to heal.