Written by: THE BALANCE
Medically reviewed by Dr. Sarah Boss, MD
Last updated: January 20, 2026
Fact checked
Quick Summary
  • Have you ever come across someone who is always sceptical about others and the world in general; looking at the world through glasses tainted with doubt and paranoia?
  • Individuals with this condition experience paranoia, which is a state of unbending mistrust and reservations about others, in the absence of any reason for suspicion.
  • Their distrust and suspicion are so great that it heavily influences their thought pattern and their behavior negatively.

Have you ever come across someone who is always sceptical about others and the world in general; looking at the world through glasses tainted with doubt and paranoia? People with paranoid personality disorder are always guarded since they believe others are trying to ridicule them or harm them. 

It’s definitely not easy to see your loved one suffering from Paranoid Personality Disorder and it’s even more challenging if you are unaware of this condition. Hence, recognizing Paranoid Personality Disorder and helping your loved one seek treatment for this condition is the surest way to make life better for them. 

Paranoid Personality Disorder is a mental health condition seen in individuals who have a ‘Cluster A’ personality, also known as an ‘eccentric’ personality. Individuals with this condition experience paranoia, which is a state of unbending mistrust and reservations about others, in the absence of any reason for suspicion. Their distrust and suspicion are so great that it heavily influences their thought pattern and their behavior negatively. Moreover, it significantly impairs their day-to-day functioning and this can have a drastic impact on their quality of life. 

In this personality disorder, individuals behave in a guarded manner because they perceive that others are on the lookout for them, and intend to harm, demean, or threaten them. Their beliefs are groundless and hold no true significance but these individuals are unable to see past their scepticism. 

Due to their general lack of trust and their habit of judging and blaming others, their ability to make close relationships is hindered and even if they have one, the relationship is usually strained due to constant accusations from their end. Individuals with paranoid personality disorder repeatedly doubt the trustworthiness, faithfulness, and honesty of people associated with them and this results in the deterioration of a relationship. 

In addition, when met with suspicion and feelings of being threatened or rejected these individuals are quick to respond with anger outbursts and shift the blame on others making it difficult for people associated with them to satisfy them and earn their trust. 

Individuals with paranoid personality disorder are prone to developing other mental health disorders such as depression, anxiety, obsessive-compulsive disorder, and agoraphobia along with developing a substance use disorder. According to research, individuals with a family history of schizophrenia are more likely to have a paranoid personality disorder. 

Paranoid Personality Disorder often surfaces early in adulthood and is more common in men as compared to women. According to statistics, 1 in 10 people in the UK suffer from a personality disorder like paranoid personality disorder but exact figures remain largely unknown since these people do not seek treatment. 

Even though it may seem like you are completely powerless in matters of dealing with your loved one, there are ways that you can convince them to seek treatment and your support and compassion can pave the way for them to live an improved life.

Unfortunately, the cause of paranoid personality disorder is still not known but it is believed that various psychological, biological, and environmental factors contribute significantly to the development of this condition. 

Individuals who have dealt with trauma in the early years of life such as emotional or physical abuse and neglect in childhood are at an increased risk of having a paranoid personality disorder.

A genetic link between schizophrenia and paranoid personality disorder was perceived by scientists, however, the connection between the two mental health disorders is not as strong as was previously believed. 

Individuals with paranoid personality disorder have a skewed view of the world and they believe that others wish to cause them harm for unknown reasons. Due to the relentless mistrust and doubt, these individuals are not able to develop and maintain life-long relationships. 

It can be difficult to spot paranoid personality disorder in a loved one because initially the signs and symptoms of this disorder may be subtle and there are times when we too become aggressive and blame others under the influence of a bad mood, however, individuals with paranoid personality disorder have an underlying fear due to which they regularly behave in a guarded and rough way. 

Following are the signs and symptoms observed in individuals with paranoid personality disorder:

  • They are hesitant to reveal information about themselves out of fear that it would be used against them.
  • They are hypersensitive and cannot take criticism well, rather they become furious when someone points out their wrongs. 
  •  They are always doubting the honesty, trustworthiness, and loyalty of others and believe that they are being deceived. 
  • These individuals hold grudges and do not forgive easily.
  • They believe that they are always right and are unwary of their attitude and mistreatment of others. 
  • They perceive innocent remarks of others as having a hidden message to insult them.
  • They are always controlling in a relationship and believe that their partner is unfaithful to them. 
  • They can become hostile and aggressive at minor events. 
  • They find it difficult to calm their nerves because they are constantly preoccupied with thoughts of others hurting them. 

A mental health provider will look into the condition of your loved one and will look for at least four signs and symptoms as mentioned above. Your doctor will further evaluate to rule out other possible mental health conditions that overlap with paranoid personality disorder in presentation such as schizophrenia, bipolar disorder, or depression along with psychosis. 

Having a loved one suffering from Paranoid Personality Disorder can be nerve-racking and it leaves you annoyed and exhausted to the core. The stubbornness of your loved ones about their baseless beliefs and their unrelenting negative thoughts of being demeaned and rejected by others can take a toll on you. 

Regardless of how invested and cooperative you are in the relationship these individuals are not appreciative and this can leave you flustered, making it a very hard task to cope with them.

To make it less challenging to deal with your loved one with paranoid personality disorder, here is a list of strategies that you can implement. 

  • Acknowledge their pain

You don’t necessarily have to agree with their baseless beliefs in order to support them. Simply providing them your support and listening to them compassionately as they address their fear can help a great deal in diffusing the tension that has built up in your relationship. Dealing with a paranoid personality disorder is very exhausting for the individual himself or herself since they can’t get their minds off the constant worry. 

  • Don’t dismiss their beliefs or argue about them 

If you try to dismiss their paranoid beliefs about others, chances are they will become aggressive and any effort made from your end in helping them address the issue will simply backfire. Hence learning the right tactic to deal with this situation is key. You should not talk them out of their sceptical views because this will simply reinforce their belief that you are judging them and are set to demean them. Let them talk openly and this will help to reduce their anxiety. 

  • Set boundaries 

It is very crucial to set your boundaries and make it clear to them what you will not tolerate. While they may be in pain, it doesn’t give them the liberty to take out their exhaustion and anger at you. Once you make it clear that their behavior is damaging and it can no longer work if they continue to devalue you, then there is a chance that they will consider their actions and think about getting treatment upon realising the detrimental effects of their condition. 

  • Be clear while communicating with them

It takes nothing for an individual with a paranoid personality disorder to twist your words and paint them in a negative light. Even when your words have no hidden meaning, these individuals can dig out something against them, and in order to avoid this situation always communicate in a clear and simplified language. If they try to misinterpret your words, make it clear that you did not mean so and that they are giving the conversation a wrong turn. 

  • Promote physical activity 

You should encourage your loved ones to do physical activity like working out since it is known to release endorphins in the blood which improves mood. Research has proven that involvement in such activities is linked with reduced anxiety and depression helping these individuals to cope with their condition. 

  • Encourage yoga and meditation

Individuals with paranoid personality disorder find it difficult to unwind so encouraging them to do yoga, and other mindfulness activities such as meditation can help boost their energy levels and improve their outlook on life.

  • Encourage them to seek professional help

You should talk to your loved one dealing with a paranoid personality disorder to seek professional help. If you are unable to convince them, take a therapist on board who can explain their mental health condition to them. Therapists can also guide you on how to deal with an acute attack of paranoia of your loved one. 

There is no denying that living with an individual with paranoid personality disorder can have a great impact on your mental and physical well-being and not in a positive way. Dealing with an individual with PPD leaves you frustrated and agitated as you feel that no matter how hard you try things just simply don’t work in your favor to make things better between you and your loved ones. 

It can be very disturbing to constantly prove your truthfulness and loyalty to someone who is not ready to accept your contributions to the relationship. There are times when you might be asking yourself, ‘how to respond to paranoid accusations?’ because truth be told, you feel tired after continuously proving that you mean no harm to them. 

Your loved one’s condition may make you feel as if the world is gloomy and there is pessimism all around but once you step out from the bubble of your strained relationship to take care of yourself, you will find healing a rewarding feeling and it will help you regain your mental and physical health. So in order to achieve these milestones, you need to practice a few strategies for building your self-esteem. 

Here is how you can do it:

  • Establish other relationships 

Living with someone who has a paranoid personality disorder can be tough since they try to control most aspects of your life and at times they even ask you to isolate yourself from your friends and family, leaving you with no one to socialise with. 

However, it is completely normal and a need of an individual to find like-minded people to share experiences and enjoy life in general. So the first step to helping yourself is to make new friends if you are not connected with the old ones as a support group that embraces you for who you are and gives you full freedom to be yourself. 

  • Do exercise 

Engage yourself in physical activities like exercising as it will help you reconnect with yourself and will improve your self-esteem. By exercising alongside your loved one you will develop a bond and will develop into a healthy relationship. 

  • Get yourself adequate sleep 

It is necessary to have a good night’s sleep because when you are well rested you are better able to deal with your loved one struggling with a paranoid personality disorder. Moreover, it helps you to stay calm and control your emotions while dealing with them.

  • Eat properly

It is easy to neglect yourself and your diet while you take care of your loved one but this can negatively affect your physical health leaving you exhausted and it is not the best state to help. Take proper and healthy meals to keep yourself well-nourished. 

  • Take a break from your routine to unwind

Taking care of a loved one with paranoid personality disorder can take a toll on you and you may feel like your world has come to an end. In order to eliminate this feeling, you need to take a break every once in a while to recharge yourself. 

It is not wrong to say that relationships are the most severely affected in the life of an individual with a paranoid personality disorder. If you are dealing with someone who has a paranoid personality disorder whether it is your partner, spouse, parent, sibling, or child you know how emotionally challenging it is. From dealing with their accusation and false beliefs to them ridiculing you for your seamlessly innocent remark, it can all leave a mark on you and make you feel broken and helpless. 

Since individuals with paranoid personality disorder are very controlling in a relationship, they may often control who you socialise with and can even ask you to cut ties with your circle, leaving you isolated. They harbour feelings of jealousy and are always doubting that you are being unfaithful to them and it can be very heart-breaking to receive comments on disloyalty when you have given your full in the relationship. 

It is a sign of a healthy relationship that as it progresses, partners develop trust, and mutual respect and the relationship deepens over time. It is quite the contrary with individuals who have paranoid personality disorder since relations with such individuals grow weaker over time due to the increase in suspicion and lack of trust by their partner. 

While you may have lost all hopes for improvement in your relationship but once you convince your loved one to seek treatment for this disorder, things can turn out for the better.  

Individuals with a paranoid personality disorder do not consider their suspicions and paranoia as a matter of concern. To them, it is rational to act the way they do since they believe they are always under threat or likely to be harmed by someone. 

Since these individuals find themselves to be completely normal and their behavior non-problematic it is highly unlikely that they will go and seek treatment for themselves. Moreover, since these individuals have a general lack of trust for everyone, it is hard to establish a rapport with their therapist because they find it very difficult to trust someone but through psychotherapy (talk therapy) a bond can be established between the therapist and the individual with PPD. 

In addition, Cognitive Behavior Therapy (CBT) and Dialectical Behavioral Therapy (DBT) are effective treatment options for individuals with a paranoid personality disorder. Therapy focuses on generating coping skills and integrating values such as empathy, kindness, and trust along with improving communication skills. It also improves the self-esteem of these individuals and helps them learn social interaction. 

Medications are not generally prescribed in the setting of paranoid personality disorder but to treat depression or anxiety, medications such as anti-anxiety and antidepressants can be given. 

If you are looking for an extensive, inpatient treatment for your loved one then a luxury rehabilitation facility is an excellent option to consider since enrolling your loved one in a high-end luxury rehab program will provide them with all the top-notch services, unparalleled level of care, and a team of highly esteemed medical professional providing them round-the-clock-care in a premium setting away from the hustle of city life. It will provide your loved one with the perfect opportunity to reflect and recover. 

FAQs

Is paranoia linked with ADHD?
It is not typical to observe psychotic symptoms such as paranoia in individuals with ADHD, however, 10% of individuals with ADHD may exhibit symptoms of psychosis. In addition, stimulant drugs used to treat ADHD can also trigger symptoms of psychosis. 
Is paranoia a mental illness?
Paranoia is not a mental illness per se, rather it is a symptom of some mental health disorders such as paranoid personality disorder, schizophrenia, and delusional disorder. 

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