What personality disorder is characterized by someone who believes everyone is out to get them?

Paranoid personality disorder (PPD) is classified as a type of eccentric personality disorder. People with eccentric personality disorders display behaviors that may seem odd or unusual to others.

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) also uses the term cluster A personality disorders to describe eccentric personality disorders like PPD.

An individual with PPD is very suspicious of other people, which may interfere with their daily life and activities. They mistrust the motives of others and believe that others want to harm them.

Additional hallmarks of this condition include:

• being reluctant to confide in others
• bearing grudges
• finding demeaning or threatening subtext in even the most innocent of comments or events
• quickly feeling anger and hostility toward others

According to a 2017 literature review, PPD affects between 1.21 and 4.4 percent of people worldwide.

Treatment can be a challenge because people with PPD have intense suspicion and mistrust of others.

If you have PPD, you might wonder whether you can trust a mental health professional and feel suspicious of their motives in trying to help you — and that’s OK.

A mental health professional will work with you to build trust so that you’ll feel comfortable confiding in them and following their advice for better managing your mental health condition.

The cause of PPD is unknown. However, researchers believe that a combination of biological and environmental factors can lead to it.

The disorder is present more often in families with a history of schizophrenia and delusional disorder. Early childhood trauma may be a contributing factor as well.

Other contributing factors include:

• living in a low-income household
• being separated or divorced
• being widowed
• never marrying

African Americans, Native Americans, and Hispanic Americans are more likely to be diagnosed with PPD, according to the 2017 research review mentioned earlier.

However, more research is needed on how — and why — prevalence varies across racial groups.

Trauma and stress may help explain the higher rates in African Americans.

Research, including a 2014 study, suggests that there’s actually little difference between Black individuals and white individuals when it comes to pathological paranoia symptoms, such as delusions. However, Black individuals are more likely to exhibit nonpathological paranoia symptoms, such as a lack of trust.

People with PPD often don’t believe that their behavior is anything out of the ordinary.

It may seem completely rational to them to be suspicious of others. However, those around them may believe this distrust is unwarranted.

A person with PPD may also behave in a hostile or stubborn manner. They may be sarcastic, which may often elicit a hostile response from others. That hostile response, in turn, may seem to confirm their original suspicions.

Someone with PPD may have other conditions that can compound their PPD symptoms. For example, depression and anxiety can affect a person’s mood. Shifts in mood can make someone with PPD more likely to feel paranoid and isolated.

Other symptoms of PPD include:

• believing that others have hidden motives or are out to harm them (in other words, experiencing persecutory delusions)
• doubting the loyalty of others
• having trouble working with others
• being hypersensitive to criticism
• quickly becoming angry or hostile
• becoming detached or socially isolated
• being argumentative and defensive
• having trouble seeing why their behavior might be a cause for concern
• having trouble relaxing

Symptoms of PPD can overlap with symptoms of other mental health disorders.

Schizophrenia and borderline personality disorder (BPD) are two conditions with symptoms similar to PPD. As a result, it can be difficult to accurately diagnose these conditions.

In order to diagnose PPD, a primary care physician will first ask you about your symptoms and medical history. They’ll also perform a physical examination to look for any other medical conditions.

The primary care physician may send you to a psychologist, a psychiatrist, or another mental health professional for further testing.

The mental health professional will perform a comprehensive assessment. They may ask you about your childhood, school, work life, and relationships.

In addition, the mental health professional may try to gauge your behavior by asking you how you would respond to an imagined situation.

The mental health professional will then make a diagnosis and form a treatment plan.

Did you know?

People with personality disorders are more likely to have substance use disorder than the general population. This is especially true for people with PPD, as well as those who have the following conditions:

PPD can be treated successfully. However, most people with the condition have trouble accepting treatment. Someone with PPD doesn’t see their symptoms as unwarranted.

Talk therapy or psychotherapy are helpful for people willing to accept treatment. These methods will:

• help you learn how to cope with the disorder
• help you learn how to communicate with others in social situations
• help reduce feelings of paranoia

Medications can also be useful, especially if you have other related conditions, such as depression or an anxiety disorder. Medications that may be prescribed include:

• antidepressants
• benzodiazepines
• mood stabilizers

Combining medication with talk therapy or psychotherapy can be very effective.

The outlook for paranoid personality disorder depends on whether an individual is willing to accept treatment.

People with PPD who resist treatment may lead less functional lives. PPD may interfere with your ability to hold down a job or have positive social interactions.

In comparison, individuals who accept treatment may have less trouble keeping a job and maintaining healthy relationships. However, you must continue treatment throughout your lifetime, because there’s no cure for PPD.

Symptoms of PPD will continue, but they can be managed with care and support.

Personality disorders are a group of mental health conditions that are characterized by inflexible and atypical patterns of thinking, feeling, and behaving. These inner experiences and behaviors often differ from the expectations of the culture in which someone lives.

If you have a personality disorder, you may have a difficult time relating to others and dealing with everyday problems in the ways that are expected by your cultural group. You may not be fully aware of this discrepancy between your thoughts and behaviors and those accepted by society.

You may have a view of the world that’s quite different than that of others. As a result, you could find it difficult to participate in social, educational, and family activities.

These behaviors and attitudes often cause problems and limitations in relationships, social encounters, and work or school settings. They may also make people you feel isolated, which can contribute to depression and anxiety.

Personality disorders are treatable, however. Often a combination of talk therapy and medication can go a long way in helping you live with one of these conditions.

The cause of personality disorders isn’t known. However, it’s believed that they may be triggered by genetic and environmental influences, most prominently childhood trauma.

Personality disorders tend to emerge in the teenage years or early adulthood. The symptoms vary depending on the specific type of personality disorder. For all of them, treatment typically includes talk therapy and medication.

There are numerous types of personality disorders. They’re grouped into three clusters based on similar characteristics and symptoms. Some people may have signs and symptoms of multiple personality disorders.

Cluster A: Suspicious

• Paranoid personality disorder. People with paranoid personality disorder may be distrustful of others and suspicious of their motives.
• Schizoid personality disorder. People with schizoid personality disorder can display little interest in forming personal relationships or partaking in social interactions. They can have trouble interpreting social cues, causing them to seem emotionally distant.
• Schizotypal personality disorder. People with schizotypal personality disorder often believe that they can influence other people or events with their thoughts. They may misinterpret behaviors, leading to inappropriate emotional responses. They may also avoid having intimate relationships.

Cluster B: Emotional and impulsive

• Antisocial personality disorder. People with antisocial personality disorder tend to manipulate or treat others without expressing remorse for their actions. They may engage in dishonest behavior like lying and stealing, and they may be prone to heavy alcohol and drug use.
• Borderline personality disorder. People with borderline personality disorder often feel empty and abandoned, regardless of family or community support. They may have difficulty dealing with stressful events and have episodes of paranoia. They also tend to engage in risky and impulsive behavior, such as binge drinking and gambling.
• Histrionic personality disorder. People with histrionic personality disorder frequently try to gain more attention by being dramatic or provocative. They may be easily influenced by other people and are sensitive to criticism or disapproval.
• Narcissistic personality disorder. People with narcissistic personality disorder often believe that they’re more important than others. They tend to exaggerate their achievements and may brag about their attractiveness or success. Other symptoms include a deep need for admiration but lack empathy for other people.

Cluster C: Anxious

• Avoidant personality disorder. People with avoidant personality disorder often experience feelings of inadequacy, inferiority, or unattractiveness. They may dwell on criticism from others and avoid participating in new activities or making new friends.
• Dependent personality disorder. People with dependent personality disorder depend on other people to meet their emotional and physical needs. They usually avoid being alone and regularly need reassurance when making decisions. They may also be more likely to tolerate physical and verbal abuse.
• Obsessive-compulsive personality disorder. People with obsessive-compulsive personality disorder have an overwhelming need for order. They strongly adhere to rules and regulations, and they feel extremely uncomfortable when perfection isn’t achieved. They may even neglect personal relationships to focus on making a project perfect.

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), is a reference that doctors and mental health professionals use to help diagnose mental health conditions. Each personality disorder has criteria that must be met for a diagnosis.

A primary care doctor or mental health professional will ask you questions based on these criteria to determine the type of personality disorder. In order for a diagnosis to be made, the behaviors and feelings must be consistent across many life circumstances.

They should also cause significant distress and impairment in at least two of the following areas:

• the way you perceive or interpret yourself and other people
• the way you act when dealing with other people
• the appropriateness of your emotional responses
• how well you can control your impulses

In some cases, your primary care doctor or mental health professional may perform blood tests to determine whether a medical problem is causing your symptoms. In some cases, they may order a screening test for alcohol or drugs if they think substances are causing your symptoms.

Treatment can vary depending on the type and severity of your personality disorder. It may include psychotherapy and medications.

Psychotherapy

Psychotherapy, or talk therapy, may help in managing personality disorders. During psychotherapy, you and a therapist can discuss your condition, as well as your feelings and thoughts. This can provide you with insight on how to manage your symptoms and behaviors that interfere with your daily life.

There are many types of psychotherapy. Dialectical behavior therapy can include group and individual sessions where people learn how to tolerate stress and improve relationships. Cognitive behavioral therapy aims to teach people how to change negative thinking patterns so they can better cope with everyday challenges.

Medication

There aren’t any medications approved for the treatment of personality disorders. However, certain types of prescription medications might be helpful in reducing various personality disorder symptoms, such as:

If you think someone may have symptoms of a personality disorder, or if they tell you that they think they do, encourage them to talk with a mental health professional. While voicing your concerns may cause tension, emphasize that your first priority is their well-being.

Call 911 or local emergency services if you ever feel that the other person intends to cause harm to themselves or others.

You can also provide your loved one with a list of crisis resources for when they need immediate support. Below are some hotlines and text lines that they can reach 24/7.

The most important aspect of treating a personality disorder is determining the condition in the first place. When you recognize that you have a mental health condition, it will be easier for you to seek and stick with treatment.

Once you find a treatment that works for you, you should see an improvement in your symptoms.

You may have to try a few different types of treatment to find what works best. That’s OK. What matters is that you find a good fit.