Are You Overly Cautious Or Suffering From Paranoid Personality Disorder?

By Sarah Fader

Updated December 07, 2018

Reviewer Avia James

In today's world, caution is encouraged.

We teach our kids to be wary of strangers, we have learnt from experience to read every document twice and pay close to attention to the fine print. Crime sprees show us the devil can lurk behind a handsome face and not every person of authority will necessary be looking out to serve and protect. It's therefore no wonder that people set up cameras in their homes, feel askance at the idea of allowing a stranger the use of their phone or watch unknown cars on their street with intense suspicion.

But at what point does being cautious spill into something more? It can be a tricky question to answer but ask yourself the following:

Is your cautious personality ruining friendships and chipping away at your relationships?

Do you mistrust people who have never given you a reason to do so?

Is the quality of your life being affected because you always feel paranoid?

Are you preoccupied with conspiracy theories?


If you've answered yes to these questions, your cautious nature might be a sign of something more serious…you might be suffering from paranoid personality disorder (PPD).

You might be wondering if PPD is a real thing. Yes it is.

PPD is categorized as an eccentric personality disorder because the individual behaves in a manner that other people find abnormal or odd. People who suffer from paranoid personality disorder basically have severe and irrational trust issues. They suffer from paranoia and are continually suspicious of other people and their motives, with or without a cause. They are fearful that people around them are trying to hurt them, physically or emotionally.


It falls under a group of mental disorders referred to as Cluster A personality disorders. The two other disorders, which make up Cluster A are:

Schizoid Personality Disorder: when the individual has no interest in social relationships, feel very apathetic towards others and displays limited emotions.

Schizotypal Personality Disorder: the individual experiences a distorted perception of reality i.e. may see hidden messages in things and believe they're meant for them, they are acutely anxious in social settings and interactions and express very flat emotions.


Patients who suffer from a Cluster A disorder tend to be paranoid about people and events, they have a hard time building and maintaining meaningful relationships and in general behave in an atypical, odd manner. Their behavior, mannerisms and personality are not easily understood by other people.

The disorders under Cluster A (especially schizotypal personality disorder) are usually linked to schizophrenia as they share similar traits (for example, displaying eccentric behavior, having a distorted view of reality) and research suggests some people (a small percentage) with a Cluster A disorder may go on to develop schizophrenia or another psychotic disorder.

Symptoms of the disorder first appear in early adulthood and men are more likely to suffer from the illness than women.


Research has suggested that people who have family members with schizophrenia are more likely to develop PPD. This means there may be a genetic link between schizophrenia and PPD, however not enough data is available to conclusively confirm this link. Other theorists suggest that the disorder stems from an early belief that people are unfriendly and cannot be trusted, watching parents behave in a paranoid, distrustful manner or as a projection of one's own negative feelings. However, the exact cause is unknown and these are simply theories.

A physically or emotionally traumatic childhood (i.e. being the victim of abuse or witnessing acts of violence as a child) can also play a role in why someone develops PPD.

How is paranoid personality disorder diagnosed & are you suffering from it?

If you're reading this and wondering whether you or someone you know may be suffering from paranoid personality disorder you may have a lot of questions. Consider taking an online quiz or test on PPD as a starting point to getting help. Depending on the site, some quizzes are longer or shorter than others but they all require simple yes or no answers. The great thing about online tests, is that, you can take as many of them as you want!

The tests will ask you to answer questions like:

Do you often think that others are trying to hurt you?

Do you handle criticism badly?

Are you suspicious of other people?

Although online tests should never be used to get an official diagnosis, the results you get can help you start a conversation about your symptoms and push you to get the help you need.

Individuals who suffer from paranoid personality disorder may exhibit some of the following symptoms:

  • Hold on to anger and grudges against people who they feel have mistreated them and won't accept apologies or attempts to mend things;
  • Tendency to misinterpret neutral or even friendly interactions or advances from others as negative, hostile ones;
  • Being continually suspicious of spouse, thinking they may be cheating on them even when there is no proof to justify those feelings;
  • Display extreme sensitivity when they experience any kind of rebuff or criticism or rejection;
  • Belief in and preoccupation with conspiracy theories about the world and their life;
  • Reluctant to share personal details and things about self to others out of fear the information will be used against them;
  • Display hostility to others without justification;
  • Experience difficulty in working with others, i.e. working in a team setting at work or at school;
  • Doubt loyalty in others;
  • Socially detached;
  • Anxious


Diagnosis for PPD can be a little tricky since several personality disorders share some symptoms and traits. But with time and with accurate information provided by the patient, a diagnosis is possible.

A Physical Examination: Doctors typically begin the diagnostic process with a physical check-up to make sure there are no health issues (including substance abuse) to account for the symptoms the patient is experiencing. The exam may include blood and screening tests. In addition, the doctor will ask many questions about the patient's health to get a full picture.

A Psychological Evaluation: Once the physical check-up is complete, the doctor will sit down with the patient to evaluate their psychological well being. This includes in depth discussions about the patient's emotions, thoughts, behavior etc. The doctor may ask the patient to complete a questionnaire and also have conversations with family members or people who know the patient well in order to better understand the issue at hand. When it comes to mental disorders or addictions, the patient is sometimes ill equipped to fully understand the severity of their condition.

DSM-5: Once the doctor has a full picture of physical and psychological symptoms, they will compare them against the criteria set out in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and render a diagnosis.

Once the diagnosis is in place, the patient can begin treatment.

Treating Paranoid Personality Disorder:


While PPD is an illness that can be treated with very high rates of success, it can also be a challenging disorder to treat given the particularities of the illness. When an individual goes to see a doctor or health professional for treatment, trust plays a big role. Since patients of PPD are naturally distrustful and suspicious and they do not believe their behavior is unusual or unwarranted, doctors have a harder time implementing a treatment plan.

It can take considerable time and effort for the mental health professional to gain the patient's trust and make them believe they are only trying to help them. If and when it gets to that point, the best treatment method for PPD is psychotherapy. A team of doctors, psychiatrists, social workers, nurses etc. may be involved in one patient's treatment.

By using various Talking Therapy methods (individual and group counseling), the patient will be armed with coping skills and taught how to handle their disorder. They will receive training on how to conduct themselves in social situations and most importantly will learn how to get rid of or decrease the feelings of mistrust and paranoia. Couple and family therapy may also be suggested in order to help bridge communication gaps and help the family deal with and understand the effects of the illness. In treating the patient, it's also important to treat the family because coping with a disorder can be very stressful for family members.


In some cases, medication like anti-depressants and anti-psychotics are also provided to the patient; especially when other conditions such as anxiety, depression or another mental disorder are present. No two treatment plans are alike, the doctor will work out a specific treatment plan based on the patient's history, type of disorder, and severity of illness. When the treatment plan is followed, the individual can go on to lead a very healthy and 'normal' life. However, the key is to maintain and continue the treatment because while PPD can be successfully contained and managed, it is chronic disorder, which unfortunately has no cure.

When people choose to not be treated for PPD, the quality of their life is dramatically reduced as they will have difficulty keeping jobs or engaging within society in a positive manner. They may become reclusive and isolated and suffer from other issues like depression and anxiety. So if you are an individual who is reading this and you think you might be suffering from PPD, you are strongly encouraged to get help.

It can be a daunting prospect to place your trust in complete strangers and you don't have to trust them from the get go, but you might consider making an appointment and simply having a chat with your doctor. That can make all the difference between an enjoyable life and one filled with suspicion and mistrust.

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