Treatment of paranoid personality disorder can be very effective in controlling the paranoia but is difficult because the person may be suspicious of the doctor. Without treatment this disorder will be chronic. Medications and therapy are common and effective approaches to alleviating the disorder.
The social consequences of serious mental disorders—family disruption, loss of employment and housing—can be calamitous. Comprehensive treatment, which includes services that exist outside the formal treatment system, is crucial to ameliorate symptoms, assist recovery, and, to the extent that these efforts are successful, redress stigma. Consumer self-help programs, family self-help, advocacy, and services for housing and vocational assistance complement and supplement the formal treatment system. Consumers, that is, people who use mental health services themselves, operate many of these services. The logic behind their leadership in delivery of these services is that consumers are thought to be capable of engaging others with mental disorders, serving as role models, and increasing the sensitivity of service systems to the needs of people with mental disorder.
Medications for paranoid personality disorder are generally not encouraged, as they may contribute to a heightened sense of suspicion that can ultimately lead to patient withdrawal from therapy. They are suggested, however, for the treatment of specific conditions of the disorder, such as severe anxiety or delusion, where these symptoms begin to impede normal functioning. An anti-anxiety agent, such as diazepam, is appropriate to prescribe if the client suffers from severe anxiety or agitation where it begins to interfere with normal, daily functioning. An anti-psychotic medication, such as thioridazine or haloperidol, may be appropriate if a patient decompensates into severe agitation or delusional thinking which may result in self-harm or harm to others. Medications prescribed for precise conditions should be used for the briefest interval possible to successfully control them.
Psychotherapy is the most promising method of treatment for Paranoid Personality Disorder. People afflicted with this disorder have deep foundational problems that necessitate intense therapy. A confident therapist-client relationship offers the most benefit to people with the disorder, yet is extremely difficult to establish due to the dramatic skepticism of patients with this condition. People with paranoid personality disorder rarely initiate treatment and often terminate it prematurely. Likewise, building therapist-client trust requires care and is complicated to maintain even after a confidence level has been founded.
The long-term projection for people with paranoid personality disorder is bleak. Most patients experience predominant symptoms of the disorder for the duration of their lifetime and require consistent therapy.
Self-care approaches to paranoid personality disorder are not likely to be effective forms of treatment. The high levels of suspicion and mistrust pervasive in people with this disorder make the work of support groups improbably helpful and potentially damaging.
Paranoid Personality Disorder. Last reviewed 12/31/1969
- American Psychiatric Association
- National Institutes of Health - National Library of Medicine
- Psychnet, United Kingdom