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An Interesting Look at Paranoid Personality Disorder

PPD is treatable—but it’s challenging. Learn more about this mental health condition.

Up to 4.4% of the population may be afflicted with paranoid personality disorder (PPD).1 The good news is that PPD can be treated. Unfortunately, mistrust is one of the hallmarks of this disorder, which can make treatment difficult.

What is paranoid personality disorder?

Your personality is composed of the complex behavioral and emotional characteristics that make you a unique individual. A personality disorder is a set of traits that negatively impacts your life and interpersonal relationships. Paranoid personality disorder is a mental health condition distinguished by a sustained pattern of mistrust and suspicion without basis for those feelings.2


These are typical behaviors a person with PPD exhibits:3

  • They believe others are dangerous and out to harm them or take advantage of them.
  • They misinterpret innocuous words and actions as insults.
  • They have difficulty building close relationships because they mistrust people.
  • They quickly lash out when they believe they have been threatened.
  • They hold grudges.
  • They have difficulty working with others or are unable to work with others.

Other symptoms of paranoid personality disorder are overreaction to criticism, secretive behavior, hostility, and social isolation.

An important distinction is that although the thoughts and behavior of people with PPD may be irrational, they are not caused by delusions or hallucinations. Hallucinations and delusions are more common hallmarks of schizophrenia and severe bipolar disorder manic episodes.4

What causes PPD?

Mental healthcare professionals believe there is a genetic component to PPD. Researchers say that childhood trauma, abuse, and neglect may increase the risk of developing it.5

How can PPD be treated?

Therapy can be of great help to people with PPD. They can learn coping skills in treatment, and counselors can help them improve their ability to socialize and communicate effectively. Patients can learn to develop more trust and empathy with the help of a skilled mental health professional.

What’s difficult about treating PPD?

There is no FDA-approved drug to treat paranoid personality disorder. And because people with PPD are generally distrustful of others, they may not even recognize that their behavior is problematic. Therefore, people with PPD rarely seek help. Family members, co-workers, and employers are often the ones who refer people with PPD to mental health professionals. But the patient’s tendency toward mistrust can make it challenging for them to develop a rapport with their therapist, which can lead them to abandon their treatment plan or quit therapy altogether.6

Keep this in mind …

Remember, PPD is a mental health condition. The sooner a person with PPD seeks help, the less disruptive PPD can be to their life. Therapists can effectively treat paranoid personality disorder by helping patients manage their thoughts and behaviors. If someone you care about exhibits signs of PPD, they may need your help to get treatment.

And don’t put your own mental health on the back burner. You might be feeling stressed, isolated, or depressed. Take care of yourself and seek the help of a qualified mental health professional.

Starting a career as a mental health counselor

If you want to help people improve their mental health, you could thrive in a career as a licensed clinical mental health counselor. If you already have your bachelor’s degree, take the next step with a master’s program in clinical mental health counseling. An accredited MS in Clinical Mental Health Counseling program provides the academic foundation needed to pursue licensure or certification as a professional mental health counselor in many states.

Walden University offers an MS in Clinical Mental Health Counseling program accredited by the Council for Accreditation of Counseling and Related Educational Programs (CACREP). In this online master’s degree program, you’ll gain the skills to help your clients deal with life’s challenges. With your skills and knowledge, you could work in a variety of settings, such as at a hospital, in a court system or correctional facility, at a mental health center, in shelters, at universities, in a government agency, at a substance abuse center, or in private practice.

You can choose the General Program for a broad base of counseling knowledge or select one of several specializations. If you’d like to academically prepare to seek work as a substance abuse therapist, addiction counselor, chemical dependency counselor, or drug and alcohol counselor, you can specialize in Addiction Counseling. Forensic Counseling can help you develop your knowledge of mental health law, including juvenile justice. Marriage, Couple, and Family Counseling is the specialization to choose if you want a career counseling families or couples. To start a career as a military counselor, choose the Military Families and Culture specialization. If you want to help communities respond to crises and individuals heal from trauma, there’s the Trauma and Crisis Counseling specialization.

No matter which specialization you choose, you can make a positive difference in the lives of others in a career as a licensed clinical mental health counselor.

Walden University is an accredited institution offering an MS in Clinical Mental Health Counseling degree program online with a variety of specializations. Expand your career options and earn your degree in a convenient, flexible format that fits your busy life.


Note on Licensure
Walden University’s MS in Clinical Mental Health Counseling program is accredited by the Council for Accreditation of Counseling and Related Educational Programs (CACREP), a specialized accrediting body recognized by the Council for Higher Education Accreditation (CHEA), which is a requirement for licensure in many states. The MS in Clinical Mental Health Counseling program is designed to prepare graduates to qualify to sit for licensing exams and to meet the academic licensure requirements of many state counseling boards. Because no graduate program can guarantee licensure upon graduation, we encourage students to consult the appropriate agency to determine specific requirements. For more information about licensure, students should visit the National Board for Certified Counselors at, the American Association of State Counseling Boards at, and contact the appropriate licensing body. International students are encouraged to identify and contact their appropriate licensing body. Learn more about professional licensure.

Walden University is accredited by The Higher Learning Commission,