CLUSTER A PERSONALITY DISORDERS

10 Signs You Might Have Paranoid Personality Disorder

For those who ever wondered whether they have PPD

1. You are preoccupied with the thoughts of finding the perfect relationship/love

Similar to individuals with Borderline Personality Disorder, people with Paranoid Personality Disorder have an intense need for relationships — they have a deep desire to love and be loved. They crave intimacy. From an early age, they tend to be obsessed with the idea of finding “the one”. As a result, romantic fantasization is a common feature of the disorder.

2. You have a fearful-avoidant attachment style

People with this attachment style fear abandonment and have a deep-seated fear of rejection, which means they worry that they will be hurt if they allow themselves to become too close to others. As a result, they can go to extreme measures to avoid real or imagined separation or rejection, such as by people-pleasing even at a cost to themselves or making suicide threats to guilt people into staying in relationships.

They are uncomfortable getting close to others, even though they want emotionally intimate relationships. They find it difficult to trust and depend on people. They push people away despite their fear of abandonment because they feel ill at ease with emotional closeness. When someone tries to become intimate with them, they can become aggressive and rejecting, because they have unconscious negative views about themselves and others. They view themselves as unworthy of responsiveness.

3. You have health anxiety and/or somatoform disorders

People with this disorder tend to be very paranoid regarding their health. This is also known as hypochondriasis, which means worrying excessively that you either are or may become seriously ill. They may misinterpret minor symptoms as signs of severe illness.

Their assumptions that body sensations such as muscle twitching are potentially signs of serious conditions often result in extreme anxiety. This anxiety — as opposed to the physical symptoms — is what causes distress and disruptions in their lives.

In addition to health anxiety, having a co-morbid somatic symptom disorder is also not uncommon. This is a mental health condition that causes an individual to experience physical bodily symptoms in response to psychological distress.

4. You exhibit high levels of psychopathic traits including conduct disorder in childhood

It is not unusual for people with this disorder to be diagnosed with co-morbid Antisocial Personality Disorder (It is also not unusual for psychopaths to be diagnosed with co-morbid Paranoid Personality Disorder). They are probably what many mistakenly refer to as “secondary psychopaths” because they often have the appearance of being cold and unemotional, take pride in always being objective and rational and can engage in antisocial and criminal activities.

Their other psychopathic traits may include impulsivity and recklessness (substance abuse, reckless spending, gambling, making foolish investments without thinking, binge eating, promiscuity, reckless driving, etc), antagonism, manipulativeness, self-centredness and the tendency to hold grudges for a long time. They are however different from psychopaths because they desire intimate relationships.

…the person with paranoid personality characteristically lacks the chronicity of antisocial behaviour — and the child to adult continuum — found in the psychopath. His acts are more consistent with projection and paranoia, without the stimulating quality usually seen in antisocial personality.¹

5. You have experienced mood lability from a young age

While it’s normal to have experiences with anxiety and depression throughout life, it is not normal if these are chronic and experienced most of the time.

People with Paranoid Personality Disorder are emotionally dysregulated. Their emotions can be all over the place, and often unexpected, eruptive, explosive, dysregulated, chaotic and disorganised. It can also be difficult for them to label these emotions.

They tend to suffer from social anxiety, pervasive shame (a sense that you are flawed and defective as a human being), depression and low self-esteem. They often have a “thin skin” and take things personally and tend to externalise blame when there’s a conflict.

Kernberg associated paranoid personality with a borderline personality organization or a “lower-level” character pathology. At this level of character organization, superego integration is minimal, and the synthetic function of the ego is impaired. Splitting, denial, and projective identification are the central defensive operations of the ego instead of repression and its related mechanisms.²

6. You have difficulty controlling your anger

Like patients with all personality disorders, people with Paranoid Personality Disorder have black-and-white thinking (splitting). This manifests in idealization and devaluation of people — shifting between (“I’m so in love!”) and devaluation (“I hate you”) — which results in unstable personal relationships. It also causes inappropriate and intense anger episodes, such as frequently losing your temper, being sarcastic or bitter, or having physical fights.

7. You experience dissociative symptoms

Individuals with Paranoid Personality Disorder often report dissociative episodes. These present as periods of loss of contact with reality, feeling detached from the world (the world around feels unreal), feeling detached from their body, feeling disconnected from themselves and feeling like they are in a dream (derealization). Dissociative episodes can last for a short time (from a few minutes to a few hours) but can also be longer (weeks or months).

8. You are introverted and excessively autonomous

Since they have trouble trusting others, people with Paranoid Personality Disorder have an excessive sense of self-sufficiency and autonomy. They are often loners.

Polatin also noted that such individuals tend to be arrogant, secretive, critical, humorless, and inconsiderate. Often these characteristics are covered by a facade of affability. However, if there is any difference of opinion, the facade shatters readily and the underlying mistrust, authoritarianism, hate, and rage burst through.²

9. You experience high levels of paranoia and hypervigilance

Individuals with this disorder have hostile attribution bias and experience high levels of suspicion and mistrust. They often suspect that others are planning to harm or deceive them without any evidence. They can also be preoccupied with doubts regarding the trustworthiness of associates and have recurrent suspicions about the fidelity of intimate partners.

They tend to be reluctant to confide in others because they fear that the information will be maliciously used against them. They are also prone to reading hidden demeaning or threatening meanings into benign events and perceive attacks on their character that are not obvious to others, to which they are quick to react angrily.

Individuals with Paranoid Personality Disorder typically do not have psychotic features such as hallucinations. They are clearly in contact with reality (they have impaired reality testing, not no reality testing). However, they may experience brief psychotic episodes in response to stress.

10. You are rigid and prefer predictability

People with this disorder often have a rigid and unhealthy pattern of thinking, functioning and behaving. They are stubborn, insist that everything is done in specific ways and therefore unable to collaborate with others and have difficulty accepting criticism and instead tend to blame others for their shortcomings.

References:

[1]: Reid, W. H. (1985). The antisocial personality: A review. Hospital & Community Psychiatry, 36(8), 831–837.

[2]: Akhtar S. (1990). Paranoid personality disorder: a synthesis of developmental, dynamic, and descriptive features. American journal of psychotherapy, 44(1), 5–25. https://doi.org/10.1176/appi.psychotherapy.1990.44.1.5

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