When a person has a pattern of distrust with persistent suspicion of others, it can feel uncomfortable. What’s more, this can be perceived by others as odd thinking and behavior. As a result, a person who has symptoms of paranoia may become completely isolated from others. This isolation may not only be a result of rejection from others but also result from a fear of hidden threats or malicious intentions. Further compounding the problem is that an individual may refuse to confide in others for fear the other party will use that information against them. Because of this, it can be difficult to treat paranoid personality disorder (PPD). However, choosing professional mental health treatment can significantly improve the quality of life of those with PPD.
What Is Paranoid Personality Disorder?
According to the journal Current Behavioral Neuroscience Reports, in the past, PPD was thought to be associated with a separate mental health condition called schizophrenia. This assumption was due to the astonishing similarity of paranoia and suspicious thought patterns. After continued research, PPD became another diagnosis that is considered milder than schizophrenia.
Over time, the medical community has also acquired a greater understanding of the possible causes of these symptoms. The journal mentioned above reports that based on four cross-sectional studies, childhood trauma such as neglect and physical abuse may be a risk factor for developing PPD. Additionally, genetics play a major role in the development of the condition. Brain trauma is yet another risk factor.
PPD is often linked with other personality disorders such as borderline personality disorder (BPD). Therefore, individuals with PPD are at an increased risk for developing symptoms of BPD such as suicidal thoughts and attempts.
Paranoid Personality Disorder Symptoms
According to the aforementioned journal article, individuals diagnosed with PPD may present with varying characteristics. However, a majority of individuals experience symptoms such as:
- Hypervigilance
- Intense paranoia
- Negative emotionality
- Aggression
- Cognitive rigidity
- Hostile disposition
- Unjustified suspicion of others
- Grudge holding
- Impaired social cognition
Can Someone with Paranoid Personality Disorder Be Dangerous?
While most individuals with Paranoid Personality Disorder (PPD) are not inherently dangerous, their heightened mistrust and suspicion of others can sometimes lead to conflict or aggression—especially in stressful or emotionally charged situations. People with PPD may misinterpret benign actions as malicious, leading them to act defensively or confrontationally in an attempt to protect themselves. In rare cases, this hypervigilance and tendency toward hostility may escalate into verbal or physical aggression, particularly if the individual feels cornered or betrayed. It’s also important to note that co-occurring conditions such as Borderline Personality Disorder (BPD) or substance abuse may increase the risk of harmful behavior. However, with proper treatment—including psychotherapy and, in some cases, medication—most individuals with PPD can manage their symptoms effectively and reduce the likelihood of volatile reactions.
How to Communicate with Someone with Paranoid Personality Disorder
Communicating with someone who has Paranoid Personality Disorder (PPD) requires patience, empathy, and a thoughtful approach. Because individuals with PPD often struggle with deep mistrust and may view others’ intentions with suspicion, it’s important to remain calm, consistent, and non-confrontational. Avoid arguing or trying to challenge their beliefs directly, as this can increase defensiveness and escalate tension. Instead, focus on listening actively and validating their feelings without necessarily agreeing with their interpretations. Keep communication clear, respectful, and predictable, which can help reduce misunderstandings and build a sense of safety. Establishing boundaries is also crucial—maintaining respectful space while showing that you are reliable and supportive. If possible, encourage professional support and reassure them that seeking help is not a sign of weakness, but a step toward better understanding and improving their relationships.
How to Treat Paranoid Personality Disorder
Treating Paranoid Personality Disorder (PPD) requires a thoughtful, patient-centered approach, as individuals with PPD often have difficulty trusting others—including mental health professionals. Psychotherapy remains the most effective treatment, with Cognitive Behavioral Therapy (CBT) commonly used to help individuals recognize and reframe paranoid thoughts, reduce defensiveness, and improve interpersonal skills. Another valuable therapeutic option is Dialectical Behavior Therapy (DBT), which focuses on building emotional regulation, distress tolerance, and mindfulness—skills that can be especially helpful for those struggling with intense suspicion or emotional reactivity. In cases where symptoms are more severe, such as significant agitation or anxiety, medication may also be prescribed, including antipsychotics or anti-anxiety medications. Establishing a trusting therapeutic relationship is key, as is creating a safe, nonjudgmental environment. With consistent care and the right support, individuals with PPD can learn to manage their symptoms and lead more balanced, fulfilling lives.
How Can Dialectical Behavior Therapy Help Treat Paranoid Personality Disorder?
According to the Minnesota Department of Human Services (MDHS), dialectical behavior therapy (DBT) has been clinically proven to assist individuals facing challenges with PPD. This type of therapy is one of the best and most effective evidence-based treatments for individuals with PPD. Through this therapy, individuals can learn safe strategies to cope with the stress associated with this mental illness. DBT can also help individuals develop mental stability and healthy connections with others.
DBT is based on effective cognitive-behavioral principles, which means that it involves challenging distorted thought processes. Depending on the facility chosen, a person may attend a DBT intensive outpatient program every week. Someone can usually attend group skills training or take on a more individualized treatment approach if they prefer. Regardless of the route taken, DBT can help individuals with PPD appropriately manage past trauma and effectively respond to life-threatening behaviors or paranoid thoughts without self-medicating.
Treating Paranoid Personality Disorder at 12 South Recovery
A person with PPD may feel hesitant to surrender to professional mental health treatment. This can be especially true because of their persistent feelings of mistrust and paranoid thoughts related to others. Although this is common, individuals with PPD have found DBT with 12 South Recovery to be effective in developing problem-solving skills and helpful strategies to better cope with their condition.
At 12 South Recovery, clients learn new life skills and find relief from problematic behaviors with each session. They may find that their emotions are more regulated and their relationships are improved. Another benefit can be that clients learn appropriate coping mechanisms they can use when met with certain triggers associated with PPD.
Call 12 South Recovery Today
When personality disorders are involved, seeking support is imperative. If you are facing problems with past trauma, substance abuse, or PPD, call 12 South Recovery at (888) 830-8374. We can help you manage your condition and create a healthy, worthwhile life.
