How to Cope with Paranoid Personality Disorder

June 11, 2021

Someone who struggles with paranoid personality disorder suffers from paranoia and overwhelming distrust and suspicion of other people. These feelings occur even if there is no reason to be suspicious. A paranoid personality disorder is characterized by unrelenting mistrust of others even if they have done nothing worthy of suspicion. Teens (and most adults) with paranoid personality disorder typically experience challenges maintaining and fostering relationships with friends, family, coworkers, and other important people in their lives

A paranoid personality disorder is part of a group of conditions called eccentric personality disorders. It is one of the most common personality disorders affecting up to four and a half percent of the population. Someone who struggles with paranoid personality disorder feels threatened by others, so they are usually reluctant to seek medical attention or mental health treatment at a mental health facility like Hillcrest. Consequently, this means primary care providers and many mental health providers have minimal experience diagnosing and treating paranoid personality disorder. Additionally, there are no clinical studies or treatment guidelines available to assist with diagnosis and treatment.

Understanding Paranoid Personality Disorder

If your teen struggles with paranoid personality disorder, they may experience sensitivity to criticisms, increased alertness, and emotional rigidity. For many, this disorder begins in childhood or early adolescence. It also appears to be more common in men than in women. Paranoid personality disorder has been included in the Diagnostic and Statistical Manual of Mental Disorders since the third edition was published in 1980. Although paranoid personality disorder is listed as a standalone, diagnosable mental illness, it is not uncommon for people with other common mental health conditions to exhibit symptoms related to paranoid personality disorder. 

Paranoid personality disorder frequently co-occurs with well-known illnesses such as schizophrenia, Alzheimer’s disease, schizoaffective disorder, psychotic states of bipolar disorder, and some traumatic brain injuries. Unfortunately, aside from the diagnostic criteria listed in the Diagnostic and Statistical Manual of Mental Disorders or the DSM, little else is available regarding knowledge around the risk factors and causes of paranoid personality disorder. Due to the intense distrust of other people in feelings of paranoia experienced by teens struggling with this illness, teens, and adults with PPD tend to be very reluctant to volunteer for clinical trials, which would further knowledge in this area.

Common Paranoid Personality Disorder Triggers

As previously mentioned, mental health professionals are still learning about paranoid personality disorder, its causes, and its risk factors. Most studies investigating the cause of psychological disorders tend to group personality disorders together. Therefore, it can be challenging to identify the root causes of a specific personality disorder such as PPD. The exact cause of PPD remains unknown, adding to the difficulties in determining a trigger or “cause” for the illness. However, the limited available research points to a few potential causes. 

Several studies have consistently suggested that childhood trauma is a risk factor for paranoid personality disorder. Also, a paranoid personality disorder is thought to be more common in those who have a close relative with schizophrenia or delusional disorders. This relationship suggests there could be a genetic link between the two conditions and that heredity and biology may play a role. Research has identified a few other factors that may predict paranoid personality in children and teens. These include various environmental factors such as emotional neglect, physical neglect, parental neglect, experiencing extreme or unfounded parental rage, or, again, being the victim of or witness to a traumatic event. To adequately determine triggers or causes for paranoid personality disorder, further research is necessary into the illness. However, this remains challenging as it is challenging to find participants with paranoid personality disorder willing to participate in a clinical study.  

Managing Paranoid Personality Disorder

Regardless of one’s age, managing and coping with paranoid personality disorder can be challenging. However, there are a few things that your teen can do to reduce the severity and disruptive nature of their symptoms. 


Paranoid personality disorder symptoms are often accompanied by and induced by stress or stressful events. Although it is impossible to remove all stress, there are self-care actions your teen can take and practice to reduce their stress levels. Encourage them to consider breathing and breathing exercises. This can be accomplished through mindfulness practices such as yoga and meditation. 


Similar to deep, relaxing breathing, exercise can also help reduce stress. Exercise increases the flow of certain hormones in the body, helping increase blood flow and the release of the body’s “feel-good” hormone, Dopamine. It is important to remember that exercise does not have to be rigorous or exhausting. Even a brisk walk can be highly beneficial to one’s mental and physical health. 

Get a Healthy Amount of Sleep

Some studies indicate symptoms of paranoid personality disorder are more prevalent when sleep is scarce. Getting enough sleep each night and ensuring it is restful sleep can help reduce the intensity of symptoms. 

Immerse Yourself in the Things You Love

An excellent way to reduce stress and the symptoms of paranoid personality disorder is to have a distraction. Ensuring your teen takes the time to focus on the things that are important to them can work wonders for clearing their mind and reducing anxiety. Encourage them to participate in activities or hobbies they currently enjoy or to take the opportunity to get involved in something new. If they are focused on pleasure and happiness, they are less likely to experience stress and, consequently, the symptoms of PPD. 

Be Aware of Triggers

Certain people, events, and places can bring about worsening symptoms. These are known as triggers. Helping your teen acknowledge and understand their triggers can provide valuable guidance on avoiding them. Being aware of triggers can allow your teen to be prepared for what “may happen” so they can address the situation in a safe and healthy way. 

Encourage your Love One to Seek Help

There is limited information surrounding paranoid personality disorder, and therefore, medical and mental health professionals are only beginning to understand the best treatment methods. If your teen is struggling with paranoid personality disorder, they are unlikely to acknowledge their symptoms or seek out help on their own. Many people who struggle with PPD do not see themselves as having a problem, and therefore there is nothing they need to seek help with. When treating paranoid personality disorder at a teen-focused treatment center like Hillcrest, treatment plans generally consist of a combination of therapy and, depending on one’s unique treatment needs, medications. Still, even these pose a challenge because trust, a challenging emotion for those with a paranoid personality disorder, is an essential psychotherapy element. Consequently, many people with a paranoid personality disorder do not follow their treatment plan and may even question the therapist’s motives. For this reason, outpatient treatment programs may not be suitable if your teen has a paranoid personality disorder.

Many therapists believe that CBT or cognitive-behavioral therapy may help alleviate symptoms. Cognitive-behavioral therapy sessions help encourage your teen to become more trusting of others and stop them from reacting to perceived insults with anger and hostility. In addition, therapy helps prevent your teen from questioning family and close friends’ loyalty and viewing benign or even positive comments as threats. Depending on your teen’s individual treatment needs, medications may be considered as part of their treatment program. 

Currently, the Food and Drug Administration (FDA) has not approved any treatments specifically for paranoid personality disorder. However, some evidence indicates utilizing the same drugs used to treat borderline personality disorder may be beneficial in addressing the symptoms of paranoid personality disorder. It is believed the two conditions share several diagnostic criteria, including hostility and aggression towards others. Mental health professionals may also prescribe antipsychotics, mood stabilizers, and anti-depressants to help reduce aggressive symptoms. If your teen is diagnosed with a co-occurring mental health disorder such as anxiety or depression, the medications prescribed to alleviate the associated symptoms may also reduce the symptoms of a paranoid personality disorder.

Paranoid personality disorder can lead to significant complications for teens as they struggle to maintain and forge new relationships with family and friends. The symptoms of PPD, such as aggression and even violence, can lead to teens feeling socially isolated and depressed. Paranoid personality disorder often occurs alongside other conditions associated with an increased risk of suicide. However, it remains unclear whether suicide rates are higher among people, specifically those with a paranoid personality disorder. Although paranoid personality disorder has been included in the Diagnostic and Statistical Manual of Mental Disorders for over 40 years, there remain many questions around the most beneficial course of treatment. 

Like many mental health conditions, a paranoid personality disorder cannot be prevented; however, with treatment, your teen can learn more productive ways of managing their emotions and reactions to stressful situations. If you are concerned your teen is struggling with paranoid personality disorder, reach up to your primary care provider to discuss their symptoms and consider asking for a referral to a teen-focused treatment center like Hillcrest. 

At Hillcrest, our caring and compassionate team of treatment providers will work with you and your family to design a comprehensive, evidence-based treatment plan focused on your teen’s unique needs. We understand the decision to encourage your teen to seek treatment away from home is likely one of the most challenging decisions you as a parent will ever need to make. However, it is vital to keep in mind that paranoid personality disorder symptoms often limit the success of an outpatient treatment program. Therefore, a residential treatment program like Hillcrest provides your teen the most significant opportunity for recovery. If you have questions about how our treatment programs may be able to help your teen and your family, reach out to our admissions team today to learn more.

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