Most Misunderstood Facts About Paranoid Personality Disorder

If your teen struggles with a paranoid personality disorder, they struggle with feelings of paranoia and an unrelenting mistrust and suspicion of those around them. These feelings are not reserved for strangers or community members. They also extend to family, friends, and loved ones the teen may know well. These feelings occur even when there is no reason to feel suspicious and when nothing has been done or said to provoke a lack of trust in others. Someone with a paranoid personality disorder will often have significant difficulties fostering and maintaining relationships with family, friends, co-workers, or other essential people in their lives due to their distorted perceptions of things those people “have done or said.”

Paranoid personality is part of a group of conditions often called eccentric personality disorders or “cluster A” personality disorders. This group of personality disorders involves odd or eccentric ways of thinking. It is one of the most commonly diagnosed personality disorders, and mental health treatment experts believe it may affect up to five percent (teens and adults) of the population. However, these estimates may be drastically underreported. Someone who struggles with a paranoid personality disorder will often feel threatened by others, and therefore they are typically reluctant to seek medical or mental health treatment.

Unfortunately, this leads to inaccurate estimates of how many people struggle with this disorder and a limited body of diagnosing and treatment knowledge throughout the medical and mental health communities. Also, different from many other mental health diagnoses, there are virtually no clinical studies or treatment guidelines available to provide diagnostic or treatment guidance, and very few individuals have come forward to share their life experiences with a paranoid personality disorder.

Understanding Paranoid Personality Disorder

The teen years are often emotionally challenging, even under the best of circumstances. A teen with a paranoid personality disorder will usually be more sensitive to criticism. They will also seem more emotionally rigid and always “on alert” as compared to their peers. If your teen struggles with symptoms of paranoid personality disorder, they will often believe that others are trying to exploit, betray, or harm them. These threatening individuals do not need to be strangers. As previously noted, the individuals they believe want to harm them can be people they live with or interact with daily. Teens with paranoid personality disorder are not commonly grounded in reality, nor will they admit that they have negative feelings about other people. Their distrust for others is frequently so strong that they will not discuss how they feel with anyone (including parents or teachers) and will harbor suspicions or grudges based on a perceived “wrong” for lengthy periods.

The symptoms of a paranoid personality disorder often present in childhood or early adolescence, and some studies indicate it is more common in males than in females. Diagnostic criteria for the often-misunderstood illness have been part of the Diagnostic and Statistical Manual of Mental Disorders since its third edition was published in 1980. Although a teen can struggle with a paranoid personality disorder as a unique diagnosis, several conditions commonly co-occur. Some of the most common examples include schizophrenia, brain injuries, schizoaffective, and psychotic states of bipolar disorder.

Common Myths and Misconceptions About Paranoid Personality Disorder

A paranoid personality disorder is an illness cloaked in misunderstanding because, due to the nature of its most common symptom, many who struggle with a diagnosis do not willingly work with or open up to others. Paranoia, the hallmark symptom of paranoid personality disorder, is the intense fear or anxiety that others are harmful, dangerous, or “out to get you.” Everyone has the occasional paranoid thought at some point; however, someone who struggles with constant and debilitating paranoia may meet the diagnostic criteria for paranoid personality disorder. There are several myths about paranoid personality disorder, but understanding the difference between myth and fact can help parents provide support and guidance for their teens while assisting them in seeking treatment at a teen-focused treatment center like Hillcrest. Below are a few of the most common misunderstandings surrounding paranoid personality disorder.

Someone with Paranoid Personality Disorder Experiences Hallucinations or “altered reality.”

A hallucination is a perception or belief in something that is not present in the moment. Hallucinations are not merely seeing things or hearing voices. They can involve any of the five senses, including touch, taste, and smell. The presence or lack of hallucinations is one of the differences between a paranoid personality disorder and schizophrenia. Someone with schizophrenia experiences warped thoughts, behaviors, perception, sense of self, and emotional state. Someone with a paranoid personality disorder does not have disordered or warped perceptions.

Paranoid Personality Disorder is Based on False Beliefs

This common misconception is, in itself, a false belief. A paranoid personality disorder is not rooted in false beliefs. This is another symptom of schizophrenia. A teen with a paranoid personality disorder will live in constant and overwhelming fear that people are out to harm or threaten them. Their symptoms are rooted in fear, not falsity. While this may seem like a minor distinction, it is essential nonetheless.

The Cause of Paranoid Personality Disorder is Understood

Although paranoid personality disorder has diagnostic criteria clearly outline in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, the exact cause of the disorder remains unknown. Unlike various other mental health diagnoses, little is known today about the root cause of paranoid personality disorder. The personality develops in early childhood and is shaped by a combination of genetics and environment (household and family dynamic). Some scientific evidence suggests that a teen’s genetic makeup can influence the development of paranoid personality disorder. Additionally, their experiences as a child (trauma, abuse, etc.) will then affect whether they actually go on to develop the disorder. It remains unknown which situations, circumstances, or events trigger the development of paranoid personality disorder. Some scientists believe experiences related to physical or emotional trauma during early childhood and adolescence play a significant role.

Paranoid Personality Disorder is Nothing More Than Social Awkwardness

A teen who is socially awkward struggles to make friends and maintain relationships because they are uncomfortable around others or are unsure “how to act” around peers and other people in social environments. They may get nervous around a classmate they are attracted to or get extremely flustered when trying to communicate with others. A teen with paranoid personality disorder experiences struggles with emotions above and beyond those of inept social skills. The inability to form and maintain relationships is not difficult because of the discomfort surrounding social interactions; they are difficult due to paranoia. A teen with a paranoid personality is extremely suspicious of others and the perceived intentions of others. They believe the worst about others and have overwhelming trust issues. These emotions lead to isolation and difficulty with relationships of all kinds.

Paranoid Personality Disorder is Easy to Treat

Overwhelming paranoia and distrust of others are two of the hallmark symptoms of paranoid personality disorder. These two symptoms make it very difficult for a teen with a paranoid personality disorder to trust anybody, including mental health treatment professionals. The inability to trust those who are inevitably trying to help them is a significant roadblock for medical providers (such as primary care physicians) in mental health professionals alike. Because an individual with a paranoid personality disorder often refuses to cooperate with doctors, it can be difficult to provide timely and appropriate medical or mental health care. Also, these individuals are often suspicious that the medications being prescribed are being used to hurt them in some way. Consequently, it is difficult to get them to take their

medications consistently enough to provide any medical or mental health treatment benefit.

Attempting to Treat Paranoid Personality Disorder

Due to the limitations listed previously and the limited amount of information regarding paranoid personality disorder, doctors and mental health professionals are only beginning to understand the best treatment methods for this challenging condition. Because a teen with paranoid personality disorder likely does not believe they have a problem, it can be very challenging to convince them to seek treatment for something they think they don’t have. In the treatment setting, mental health professionals will sometimes consider treatment options that include medications and traditional psychotherapy techniques. Still, even these pose a challenge because trust in others is something an individual with paranoid personality disorder struggles to foster or maintain. Unfortunately, trust is an essential element of the psychotherapy process. Therefore many people with a paranoid personality disorder do not follow treatment plans and may even question their therapist’s motives. Because of these unique circumstances, outpatient programs may not be suitable as a mental health treatment option for a teen with a paranoid personality disorder.

At an inpatient residential treatment center like Hillcrest, a comprehensive treatment program will be designed to meet your teen’s unique needs and goals. In most cases, this will consist of medications and psychotherapy. To date, the Food and Drug Administration has not provided approval for any drug treatments specifically related to paranoid personality disorder. There have been some suggestions that treating this disorder with the same drugs used to treat borderline personality disorder and other personality disorders with similar symptoms could be beneficial. The idea behind this is that the disorders share many of the same symptoms and similar diagnostic criteria. Depending on your teen’s specific symptoms, their treatment providers may also prescribe mood stabilizers, anti-depressants, or anti-psychotic medications to help reduce aggressive symptoms. If your teen struggles with a co-occurring disorder, these medications may help alleviate co-occurring symptoms related to both conditions.

Medical providers also do not know much about psychotherapy’s effectiveness for paranoid personality disorder treatment. However, many providers believe that cognitive-behavioral therapy may help alleviate symptoms due to its effectiveness in treating a wide variety of mental health and addiction conditions that share similar symptoms. Unfortunately, there’s a limited number of key studies to support its use. The overall goal of therapy is to encourage your teen to become more trusting of others and to stop reacting with hostility and anger to the actions and suggestions of others that are perceived as insults or threats

While it is not possible to prevent paranoid personality disorder, and the exact cause of the disorder is not well understood, it may be possible to provide treatment options to mitigate the most debilitating symptoms. A comprehensive treatment program at a teen-focused facility like Hillcrest may help your teen learn more effective and productive ways to deal with their emotions. If you suspect your teen struggles with paranoid personality disorder symptoms, consider reaching out to their primary care provider to discuss their symptoms and your concerns. They may provide a referral or suggest enrolling your teen in a treatment program such as Hillcrest. At Hillcrest, our treatment programs are uniquely designed to meet your teen and your family’s specific treatment needs and goals. We understand the decision to send your teen to a treatment program is difficult, but a residential treatment program like Hillcrest will provide your teen the most significant opportunity for recovery success. If you would like to learn more about our treatment programs, reach out to the admissions team at Hillcrest today.