Are You Paranoid or Just Cautious?

Do you-or does someone you know-feel distrustful of others, suspecting their motives and finding hidden meanings in their comments? This persistent and unfounded mistrust is the cornerstone of paranoia disorders.

Paranoia is common in many personality disorders, including schizophrenia, delusional disorder, paranoid personality disorder, and, to a lesser degree, depression and dementia. Personality disorders affect 10 to 15 percent of the adult U.S. population. While they can be treated, personality disorders are chronic, life-long illnesses that patients must manage.

As with other mental health disorders, psychologists and psychiatrists do not know why some people develop paranoia and related personality disorders. They believe there is a strong genetic component, especially since family history is a primary risk factor. Trauma or childhood abuse, stress, and substance abuse may also play a role.

Paranoid Schizophrenia

Paranoia is one of the primary symptoms of schizophrenia, a disabling brain disorder. Patients with schizophrenia have bizarre delusions and false beliefs that others are trying to harm them. They may also have auditory delusions, anxiety, and anger; be verbally confrontational and patronizing; and may even be violent. Mental health experts describe people with paranoid schizophrenia as having so-called positive symptoms, indicated by the presence of unusual thoughts and perceptions.

The typical treatment for paranoid schizophrenia is antipsychotic medication and, in some cases, psychotherapy.

Delusional Disorder

The symptoms Delusional Disorder are similar to those of Paranoid Schizophrenia. The primary difference is that their delusions are not quite as bizarre and unlikely.

Paranoid Personality Disorder

People with Paranoid Personality Disorder are typically self centered, self important, defensive, and always suspicious of others' motives, particularly their spouse and others close to them. In fact, one of their common beliefs is that their spouse or partner is being unfaithful.

Paranoid individuals also believe:

  • Others are exploiting or deceiving them or are untrustworthy
  • Anything they say in confidence will be used against them
  • There is hidden meaning in peoples' comments or in specific events

While antipsychotic medication can help those with Paranoid Schizophrenia, it doesn't help-and may even worsen-symptoms of Paranoid Personality Disorder. Psychotherapy can help sufferers develop coping and communications skills, and improve their social interactions and self esteem. If patients are also suffering from depression or anxiety, their physician may prescribe antidepressant or anti-anxiety medications.

Treating people with paranoid disorders is difficult, since they are inherently suspicious and distrustful. Paranoid personalities cannot see their role in situations and therefore don't see the need for treatment.


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