Do you know the myths and facts about paranoid personality disorder? Learn what paranoid personality disorder is, what it is not, and how to treat it.

Paranoia is the intense fear or anxiety that others are harmful or dangerous. Many people have had a paranoid thought at some point in their lives. However, a person with constant paranoia may have paranoid personality disorder (PPD). There are many myths about PPD. Knowing the facts about paranoid personality disorder may help a person seek treatment. Keep reading to learn the truth about some common paranoid personality disorder myths.

Myth #1: Paranoid personality disorder consists of false beliefs.

Fact: Paranoid personality disorder consists of fear.

Paranoid personality disorder does not consist of false beliefs. False beliefs are characteristic of schizophrenia. People with PPD live with the constant fear that others are plotting to harm or threaten them. Paranoid personality disorder also includes the following symptoms:

  • Always shifts blame or points finger at others
  • Extremely private
  • High strung
  • Holds grudges
  • Hypersensitive toward criticism
  • Misinterprets social interactions
  • Mistrusts others
  • Prejudice and xenophobic
  • Suspicious of lovers
  • Self-righteous

Myth #2: Hallucinations are a symptom of paranoid personality disorder.

Fact: Hallucinations are a symptom of schizophrenia.

A hallucination is the perception of things that are not present. Hallucinations are more than just seeing things or hearing voices. They can involve any of the senses. Hallucinations are one of the differences between paranoid personality disorder and schizophrenia. Schizophrenia involves warped thoughts, behavior, emotions, sense of self, language and perception. Individuals with both disorders experience loneliness and isolation. However, a person with PPD does not have distorted perceptions. Interestingly, people with PPD often have a relative with schizophrenia.

Myth #3: People with paranoid personality disorder are just socially awkward.

Fact: People with PPD have trouble with relationships because they mistrust others.

A person with PPD is more than just socially awkward. Relationships are difficult for people with a paranoid personality disorder because of their paranoia. People with PPD are often extremely suspicious. They also have a hard time trusting, and believe the worst of other people. This leads to the person with PPD becoming withdrawn or isolated. 

Myth #4: The cause of paranoid personality disorder is known.

Fact: We do not know what causes paranoid personality disorder.

The exact cause of paranoid personality disorder is still unknown. A person’s personality is made up of their typical thoughts, feelings, and behaviors. It develops during childhood and is shaped by both genetics and the environment they grow up in. Scientists suspect that a person’s genetic makeup can make them more likely to develop a personality disorder. Then their childhood environment, or what happens to them as a child, affects whether they actually develop a personality disorder. It is unknown which circumstances trigger the development of PPD. Scientists suspect that emotional or physical trauma during childhood is the culprit.

Myth #5: Paranoid personality disorder is easily treated.

Fact: Unfortunately, paranoid personality disorder can be difficult to treat.

Effective treatment for PPD involves consistent medication and therapy. Paranoid personality disorder treatments include:

  • Cognitive-behavioral therapy
  • Psychotherapy
  • Family therapy
  • Individual therapy
  • Group therapy
  • Medication

Unfortunately, distrust is a major roadblock for therapists and medical care providers. Patients with PPD worry that professionals are trying to harm them. So, these patients refuse to cooperate with their doctors. They are also suspicious that medications are prescribed to hurt them. So, it is difficult to get these patients to take their medications consistently enough to benefit them.

Substance and alcohol use also complicate treatment for PPD. A person with PPD may choose to self-medicate because depressant substances like alcohol help relieve their symptoms. But, the relief is temporary and can be addictive. Thus, alcohol and substance use often co-occurs with PPD and complicates treatment.

If you or someone you know is concerned that they may have paranoid personality disorder co-occurring with alcohol or substance abuse, The Recovery Village can help. Contact us today to learn more about treatment options for paranoid personality disorder co-occurring with alcohol or substance use.

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Editor – Renee Deveney
As a contributor for Advanced Recovery Systems, Renee Deveney is passionate about helping people struggling with substance use disorder. With a family history of addiction, Renee is committed to opening up a proactive dialogue about substance use and mental health. Read more
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Medically Reviewed By – Dr. Aleishia Harris-Arnold, PhD
Aleishia Harris-Arnold earned her PhD in Immunology in 2014 from Stanford University School of Medicine. Read more

Better Health Channel. “Paranoia.” November 2016. Accessed June 1, 2019.

Chang, Ching-Jui, et al. “Morbidity Risk of Psychiatric Disorders […]a Patients in Taiwan.” Schizophrenia Bulletin, January 1, 2002. Accessed June 1, 2019.

Live Science. “Don’t Freak Out: Paranoia Quite Common.” November 12, 2008. Accessed June 1, 2019.

Mandal, Ananya. “Differences between Paranoid Personality[…]ranoid Schizophrenia.”, February 27, 2019. Accessed June 1, 2019.

Prywes, Michael. “Things To Remember When You Love Someone[…]Personality Disorder.” Accessed June 1, 2019.

World Health Organization. “Schizophrenia.” April 9, 2018. Accessed June 1, 2019.

Medical Disclaimer

The Recovery Village aims to improve the quality of life for people struggling with substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare providers.