Treatment For Paranoid Personality Disorder

Paranoid personality disorder, also known as PPD, is characterized by suspiciousness and distrust of other people. A person with PPD thinks that other people are intent on humiliating or harming him. People with this disorder think that everyone is out to get them and often suspect romantic partners of infidelity.

Because they tend to view everyone as a threat, people with PPD often exhibit hostile or aggresive behavior. This distrust of others makes paranoid personality disorder treatment particularly challenging. Even if a person with paranoid personality disorder enters treatment, he may discontinue therapy because he does not trust the therapist or the medical establishment.

Paranoid Personality Disorder Medication

Medication is not usually recommended for people with paranoid personality disorder. Research indicates that while selective serotonin reuptake inhibitor (SSRI) antidepressants may curb suspiciousness and hostility, in some people these antidepressants could actually intensify other symptoms. In addition, people with paranoid personality disorder are often resistant to taking medication as prescribed because of their feelings of distrust. Some see medication as a method of controlling them, and they may discontinue treatment or refuse it entirely.

However, with certain symptoms of paranoid personality disorder, medication can be useful. For example, if the person is experiencing severe anxiety to the point where it interferes with daily life, anti-anxiety medications may be helpful. Extremely agitated patients may be prescribed anti-psychotic drugs.

Paranoid Personality Disorder Therapy

The preferred paranoid personality disorder treatment is therapy, although the condtion poses a set of unique challenges for a psychiatrist. Personality disorders such as PPD are difficult to diagnose and treat because the patient rarely seeks help on his own. Often, he only seeks treatment because of the interventions of the legal system or a concerned friend or relative.

Treatment for paranoid personality disorder is especially difficult because the patient’s inherent mistrust of others extends to the therapist. Therapy must be handled delicately to gain and keep the patient’s trust. The psychiatrist must be open and honest at all times. In addition, the therapist must strike a balance between being objective about the patient’s paranoid beliefs and directly challenging them. If the patient feels threatened, he’s likely to terminate treatment.

Because of the level of mistrust involved in paranoid personality disorder, therapy in a group setting is generally not effective. Neither is family therapy or self-treatment typically useful. Symptoms are chronic, so once treatment for paranoid personality disorder begins, the patient generally needs to continue treatment for the rest of his life. But a good therapist who gains and maintains the patient’s trust can help him get his symptoms under control to improve daily functioning.


Encyclopedia of Mental Disorders (2010). Paranoid personality disorder. Retrieved October 13, 2010, from

Grohol, J.M. (2010). Paranoid personality disorder treatment. Retrieved October 13, 2010, from