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Paranoid Personality Disorder

Symptoms and treatment of PPD

Paranoid personality disorder (PPD) is marked by extreme paranoia – a suspiciousness and mistrust of others. While the people with such a disorder view themselves as blameless, they are constantly on guard for the next perceived attack, and are hypersensitive to finding the latent meanings behind remarks or actions. They tend to be self-centered, emotionally distant, and demanding, significantly impeding work and home life.

They look for the malicious intents behind others' words or actions, all the while ignoring any evidence to the contrary, and are quick to react with anger. Men are more likely to be of the 0.5 to 2.5 percent of the population suffering from this debilitating disorder.

Although similar, PPD should not be mistaken for paranoid schizophrenia, because someone with a personality disorder is clearly in contact with reality but lacks the telltale sign of extreme cognitive and behavioral disorganization, even though they may slip into psychotic behaviors.

Paranoid Personality Disorder Treatment

This blurred thinking can be coupled with other psychological disorders, most notably depression, and can be treated with cognitive behavioral therapy aimed at restructuring beliefs and substituting adaptive thoughts for automatic thoughts. Since those with PPD tend to be hostile and difficult, pharmaceutical drugs such as Thorazine, Risperdal, or Haldol have proven effective in managing these severe reactions and maladaptive thought patterns.

Most patients entering treatment for PPD do so at others' insistence and generally put the responsibility for success onto others. They will avoid the focus of the therapy and will most likely have fragile relationships with their therapists. Changing the underlying thought and behavior patterns can prove to be most difficult because they are held up by ingrained elements of the core psyche (learned action and thought). Nevertheless, when paired with medications and tasks intended to challenge the entrenched dysfunctional assumptions and beliefs, the patient has marked potential to experience promising results.

PPD usually strikes in young adulthood, although it can be a manifestation of dementia in elderly or older adult patients. Neurological testing can rule out the onset of dementia or other organic brain diseases. When an elderly person experiences the first symptoms of dementia (a sense of distrust or paranoia), it can easily be seen as an element of their personality rather than the symptom of an underlying condition. Older adults, with mostly set thought patterns and views of the world, are unlikely to suddenly have a personality disorder; more often, they are experiencing later-life disorders such as a form of dementia or Alzheimer's.

Coping with PPD

Family members of a person with PPD should expect a continual cycle of paranoia, distrust and self-centered thinking. The strain placed upon family members is enormous; as is the blame and guilt laid on thick by the PPD suffer. Even with medication and therapy, the psychological elements of paranoid personality disorder are extremely difficult to eradicate. Effectiveness of treatment may be at its highest when treated as an inpatient, restricting the acting-out behavior in a safe environment, and providing 24-hour care. Those who have a family member exhibiting signs and symptoms of paranoid personality disorder should seek counseling themselves to learn coping mechanisms helpful in dealing with anger, depression or anxieties caused by the stormy relationship.

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