Some people truly believe that everyone is out to get them. They have baseless suspicions of family, friends, co-workers, the trash man, the police, or even the cashier at the grocery store intentionally harming them. They imagine hostile conversations and project their irrational fears as real motives of others. When confronting the accusations, they insist the problem is everyone else. They are paranoid.
So what is Paranoid Personality Disorder? Here is the technical definition according to the DSM-V:
- Global mistrust and suspicion of others motives after 18 years old.
- suspects, without sufficient basis, that others are exploiting, harming, or deceiving him or her
- is preoccupied with unjustified doubts about the loyalty or trustworthiness of friends or associates
- is reluctant to confide in others because of unwarranted fear that the information will be used maliciously against him or her
- reads hidden demeaning or threatening meanings into benign remarks or events
- persistently bears grudges, i.e., is unforgiving of insults, injuries, or slights
- perceives attacks on his or her character or reputation that are not apparent to others and is quick to react angrily or to counterattack
- has recurrent suspicions, without justification, regarding fidelity of spouse or sexual partner
- Does not occur exclusively during the course of Schizophrenia, a Mood Disorderwith Psychotic Features, or another Psychotic Disorder and is not due to the direct physiological effects of a general medical condition.
The practical definition looks more like this:
- Believes others are using or taking advantage of them
- Reluctant to confide in others out of fear
- Unforgiving and holds grudges for unusually long periods of time
- Reacts negatively to criticism and refuses to let go
- Reacts with anger, retaliates against anyone they perceive is causing harm
- Cold, distant, controlling, and jealous
- Believes they are always right
- May utilize recording devices in order to prove the infidelity of others
- Suspicious without any justification
- Frequently believes they are in danger and scans environment for proof
- Sensitive to slights of others
Mel Gibson in his portrayal of Jerry in “Conspiracy Theory” did a wonderful job showing what paranoids look like in real life. The constant looking over his shoulder, reading more meaning into seemingly meaningless things, the hypervigilant behavior, and intense anger are all characteristics of PPD.
So how do you deal with a person who might be PPD? Here are a few suggestions:
- Although they are highly logical, don’t attempt to logically reason the paranoid thoughts away. It won’t work because their thoughts are rooted in deep emotional fear.
- Paranoid beliefs begin in childhood and have little to do with present circumstances. There are no magic ingredients of affirmation that will stop the paranoia. They must decide to abandon the belief on their own.
- They record as many things as possible by video or audio including people or family in their own home, so expect it. This may seem a bit strange and weird, but to them this is normal.
- Choose words carefully when speaking as they frequently read far more meaning into them than intended.
- All it takes is one comment they don’t like and they will shut a person out of their life forever. Use past slights of others as indication of their potential triggers.
- Their ability to assess risk in an environment is very high. Sometimes, they are right about potential dangers, listen and don’t immediately discount.
- Sometimes they are right about the ill motives of others. Validate these times.
- They are highly perceptive which can be quite useful in a variety of vocations. Appreciate their ability.
Living with PPD can be exhausting, exciting, and challenging. They have the ability to fake social interaction in front of others despite their strong dislike of others. Often, they will leave saying shocking things about the very people they seemed to be enjoying. Their paranoia is pervasive in nearly every close conversation. They say things like, “I was just trying to keep you safe” or “I can see things that you don’t” as a way of softening the paranoia. Frequently their intentions are good as they are very protective of those they love.