Paranoid personality disorder (paranoid psychopathy)

General information

Paranoid personality disorder , which is also commonly called paranoia , is a form of psychosis in which a person periodically has delusional ideas or they become stronger in his mind.
But at the same time, normal mental abilities and relatively correct thinking are preserved. There are also no sudden changes in the patient's mood. Paranoia is a condition in which the patient shows suspicion and mistrust of people.
At the same time, he believes too much in his own abilities and ideas. Consequently, such people have high self-esteem, mental rigidity and a tendency to suspicion.

Paranoid personality disorder - treatment

Researchers have only recently begun to study BPD, so doctors know little about treating the condition. However, they may prescribe the following treatment options for people with BPD.

Use of drugs

Doctors suggest treating BPD with the same drugs used to treat borderline personality disorder. The premise behind this is that the two conditions share similar diagnostic features, such as hostility and aggression towards other people. Doctors may prescribe the following medications to reduce aggression:

• antipsychotic drugs
• mood stabilizers
• antidepressants

However, the researchers noted that the effects of these drugs are too small to benefit the patient.

Like drug therapy, doctors know little about the effectiveness of psychotherapy for BPD. However, many psychiatrists believe that cognitive behavioral therapy can relieve symptoms of BPD, and some research supports its use. The general goal of therapy is to:

• encourage a person to become more trusting of other people,
• remove doubts from a person about the loyalty of family and close friends,
• do not allow a person to perceive criticism as a threat,
• stop the person from reacting to perceived insults with anger and hostility, and encourage the person to become more forgiving towards other people.

Causes

Some experts believe that the reasons why a person develops paranoia are disturbances in the early period of child development. Excessive demanding parents can have a negative impact. As a rule, this is a father who is detached from the child’s life, but at the same time demanding, and a mother who is overprotective of the baby, who at the same time rejects the child. It is precisely as a result of high demands that the child develops a negative and distrustful attitude towards everyone around him and accumulates a number of negative feelings. There is also a theory that paranoia manifests itself in humans under the influence of a genetic factor. However, until today, scientists have only put forward theories about the factors that provoke paranoid disorders. The exact causes of the disease have not yet been determined.

Symptoms of paranoid psychopathy

P.B. Gannushkin noted that until a psychopath began to openly quarrel with others, he could be an extremely useful employee. In a certain professional field, a paranoid person will work with all tenacity, accuracy and pedantry, without being distracted by extraneous interests and hobbies. In fact, such cases should be classified as character accentuations, and according to Gannushkin - “latent psychopathy.”

K. Leonhard identified the so-called “stuck” personality type as one of the norm options. A typical quality of this type is “stuckness”. First of all, it concerns emotional affect, which can be maintained for a long period of time. The affect is not eliminated and the individual cannot react to it. However, even with success, “getting stuck” makes itself felt. In this case, it turns into arrogance and narcissism. This type equally carries the possibility of both positive and negative personality development. The main driving force of paranoids is ambition. They can achieve great success in their careers, but when they encounter an obstacle, they easily become embittered, suspicious and vindictive.

Gannushkin believed that the main feature of this type is a penchant for so-called super-valuable ideas, the dominant position among which is occupied by the idea of ​​​​the special meaning of one’s own “I”. Close to this judgment were the ideas of I. Lange that the main feature of this type is “hypersensitivity of the self.”

This is where paranoid patients become convinced that everything they do is always right; everything they say is always true; and what they claim is their unconditional right. It is for this reason that they are rarely inclined to ask for advice. Patients are impervious to the most benevolent forms of criticism and never listen to objections. A paranoid person is touchy and easily vulnerable. When faced with an objection, he very quickly begins to show aggression.

Symptoms

From early childhood, people prone to paranoia have one-sided interests. They are stubborn and prefer to express their own opinions straightforwardly. Their activity leads to the fact that such people strive to be leaders, while often ignoring the resistance of other people. If someone disagrees with the opinion of a person prone to paranoid disorder, he expresses extreme indignation. Paranoid psychopaths are very difficult to forgive even the most minor offenses, and they treat others with disdain and arrogance. By about the age of 20, such people develop signs of paranoid reactions and overvalued ideas.

The condition of a person who develops paranoid syndrome worsens with age.

It is very difficult for a patient with such a neurotic disorder to build daily communication in society and in the family. First of all, the obstacle to normal coexistence is the lack of the ability to compromise and accepting only one’s own opinion.

A paranoid person is especially interested only in what is directly related to his person and concerns his personal interests. A person considers all areas that do not affect his personality to be unworthy of attention.

Doctors determine another feature of this condition is the fact that a paranoid person can be completely indifferent to the problems of his own physical condition. If a patient receives news that he is seriously ill with a somatic disease, he does not react to this fact like other people. He has no anxiety about this, no fear of dying, the person’s mood remains stable. Consequently, the patient can completely ignore the doctor’s advice - not take medications, practice physical activities that are dangerous to his health.

The hallmarks of paranoids are hypervigilance and distrust of others. These traits are formed due to the opposition of oneself to other people, the feeling of hostility of this world. A person is constantly in a state of searching for external threats, he is ready to react to the slightest alarm signal.

Often the patient fears an attack on his spouse, on property, on his own rights. Distrust of other people gradually transforms into pronounced suspicion: at some point a person begins to realize that everyone is treating him unfairly and wants to infringe on his authority and humiliate him. A paranoid person is unable to interpret the words and actions of others in a multifaceted way. As a result, he constantly has unfounded suspicions.

Another distinctive feature of a person who exhibits paranoid disorders is the appearance of overvalued ideas . Over time, extremely valuable ideas completely subjugate a person. Thus, a person does not control his own thoughts, but thoughts control him.

Human Traits and Characteristics

A patient with psychopathy is characterized by a number of symptoms: together they provide a clear clinical picture of his condition. The main behavioral traits of such a person:

• Suspicion, without sufficient reason, that others are exploiting, harming, or deceiving him.
• Unjustified doubts about the loyalty or reliability of friends and partners.
• Mistrust caused by an unreasonable fear that information will be used maliciously.
• Appraising benevolent remarks or events as threatening or humiliating.
• Conscious remembering of grievances, inability to forgive psychological trauma, criticism expressed towards him.
• Perception of advice as an attack on his character or reputation, immediate reaction to statements with anger or counterattack.
• Repeated suspicions without justification regarding the fidelity of a spouse or sexual partner.

These manifestations occur regardless of the state of general mood, accompanied by psychotic symptoms. The symptoms have nothing to do with the physiological response of the medical condition.

Types of paranoid psychopathy

Experts distinguish two opposing types of paranoia: expansive (strong) and sensitive (weak).

Expansive paranoids are, as a rule, conflicting individuals prone to pathological jealousy and truth-seeking. Already from childhood they are marked by deceit and vindictiveness. Very often they point out the shortcomings of other people, but they do not notice them in themselves. Such people generally always have a favorable attitude towards their own personality, and even failures do not unsettle them.

It is very difficult for paranoids of this type to obey anyone, but they are always in a state of struggle with personal opponents. They are not at all worried about the common cause. Such people have an increased rate of mental activity, energy, fussiness, and mobility. Often this person does not even need rest, he is always cheerful.

Separately, experts identify fanatics , who also belong to expansive paranoid individuals. These patients show exceptional passion, completely devoting themselves to one activity. Almost their entire life is subordinated to one specific idea. Often their obsession is so strong that they can attract other people to their object of worship. Fanatics blindly believe in what they have subordinated their lives to and do not require proof. However, unlike patients with other types of paranoid disorders, fanatics do not put their own personality forward. At the same time, they still do not show love and compassion for their neighbors and are often cruel.

With the sensitive version of paranoia, a person combines opposite traits. On the one hand, psychopathy consists of a combination of contrasting personality traits. On the one hand, the patient shows shyness and looks vulnerable. On the other hand, he is ambitious and has an inflated sense of self-worth. Such patients are fearful and shy, but at the same time especially suspicious and irritable. They subject themselves to self-torture, constant self-analysis, which negatively affects the quality of their life. As a rule, a person has established standards that he has not reached, and this provokes a heightened sense of failure.

Treatment of paranoid psychosis

The presence of paranoid psychosis does not allow all the symptoms (character oddities) to reach a high psychotic level, that is, to manifest themselves on a full scale. The patient does not have flattened emotions and personal manifestations, and there is no disturbance in thinking inherent in schizophrenia. Psychosis in the paranoid form is observed mainly in young people. Statistics point to men as being most susceptible to the disease.

A number of social restrictions arise that the patient exposes himself to because of his suspicion, intolerance of criticism, and reputation as a brawler. With this psychosis, the patient will sooner or later find himself in a situation of certain self-isolation. This condition can become chronic. If you ignore a visit to the doctor, inappropriate behavior can persist throughout your life. Treatment for paranoid psychosis is prescribed after diagnosis.

A long-term psychotherapeutic technique is used, which is aimed at improving life skills in a general aspect, improving the quality of social interaction, and strengthening the patient’s sense of personal dignity. Drug therapy is used to a limited extent. It is possible to use tranquilizers, antidepressants, and antipsychotics, but only in cases of extreme symptoms. If there are other diseases that are associated with this psychosis, medications are prescribed by a therapist.

Author of the article:

Mochalov Pavel Alexandrovich |
Doctor of Medical Sciences therapist Education: Moscow Medical Institute named after. I. M. Sechenov, specialty - “General Medicine” in 1991, in 1993 “Occupational diseases”, in 1996 “Therapy”. Our authors

Treatment

Treatment of paranoid syndrome with medications is usually ineffective. But if there is still a need to undergo a course of treatment with medications, then they should be selected exclusively by a doctor after individual work with the patient.

Therefore, psychotherapy . During the process of such treatment, the doctor gradually explains to the patient the nature of his anger and suspicion, and also works on the patient’s hidden desires to have normal relationships with others. People are taught to control anxiety, cope with mistrust, and realistically evaluate the actions and attitudes of other people.

Paranoid schizophrenia

People suffering from paranoid disorders tend to develop paranoid schizophrenia . This form of the disease manifests itself in a person after 20 years of age. The disease is characterized by delusional and hallucinatory disorders. Depending on which disorders dominate the clinical picture of the disease, delusional and hallucinatory variants of the course of the disease are distinguished. When hallucinations and delusions are combined, hallucinatory-paranoid syndrome .

Paranoid schizophrenia with the dominance of delusional disorders is manifested by delusions of influence (the patient is sure that someone is influencing him and directing his behavior or thoughts); delusions of persecution (the patient is sure that some mysterious organizations or groups want to deal with him); delusions of attitude (the person thinks that they are looking at him, talking about him, laughing at him). There are also other types of delusions with absolutely ridiculous ideas.

When hallucinatory disorders dominate, auditory verbal hallucinations most often occur. Sometimes bodily sensations, olfactory, gustatory, and visual hallucinations .

In paranoid schizophrenia, changes in the patient's personality are expressed relatively easily, so he is able to live independently. Excessive religiosity is often noted in paranoid schizophrenia. The course of the disease can be either continuous or episodic.

Summarize

What is paranoid personality disorder Photo: Depositphotos
Paranoid personality disorder is a mental illness that makes a person suspicious, distrustful, hostile and vindictive. The exact causes of the pathology are unknown: scientists put forward several theories.

Paranoid people themselves do not consider their thoughts and behavior strange, so they do not seek help from specialists. Although over time the condition may worsen.

If you notice similar symptoms in a loved one, do everything possible to start psychotherapy - this is what will help relieve the symptoms and establish contact with the person.

Material prepared by: Alexander Sergeev Cover photo: Depositphotos

Sources

Paranoid Personality Disorder (PPD) Paranoid Personality Disorder Paranoid Personality Disorder

Features of communication with a patient with paranoia

If a loved one has a paranoid disorder, then an important point in the treatment process is the correct approach to communicating with him. Under no circumstances should the patient be allowed to drink alcohol. Monitoring by loved ones over compliance with all doctor’s recommendations and timely attendance at psychotherapy sessions is important.

It is important for those who live next to a paranoid person to expect that they will need a lot of patience. You cannot show aggression towards the patient or excessively express your emotions. You need to have a conversation with him, as with a healthy person, but do not laugh at him. The tone of the conversation should always be confident and calm. You cannot humiliate a patient. On the contrary, you should convince him that there is truth in his words, since attempts to convince a person are doomed to failure. But the most important thing is to contact a specialist in time who will help develop treatment tactics.

How to stay in a resourceful state if a loved one has paranoid disorder

Supporting someone with paranoid disorder is not easy. This requires a lot of patience, compassion and takes a lot of mental strength. The constant stream of pessimism that comes from such people threatens to be emotionally draining. Therefore, it is important to maintain yourself in a resourceful state - not to slip into negativity and not let your self-esteem drop.

1. Don't isolate yourself from society. Your loved one's paranoid personality disorder and total control on their part can lead to you eventually isolating yourself from family and friends. To prevent this from happening, set boundaries regarding your personal space. After all, from time to time you need support and positive emotions.
2. Get good sleep and eat right. When you have a mentally ill person next to you, it is easy to forget about rest and diet. But still try to take care of yourself. Getting adequate sleep will help you cope with stress and control your emotions. And proper nutrition will provide you with energy throughout the day.
3. Don't give up on training. And if you haven’t trained before, be sure to start. This will relieve anxiety and stress, as the body begins to produce endorphins - happiness hormones. It’s great if you work out together – you motivate and inspire each other.