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Paranoid Personality Disorder

People who have a paranoid personality disorder are typically characterized by having a long-lasting feeling of distrust, suspicion, and an inability to connect with the reality of their lives. Individuals often feel threatened by others and have a constant worry that someone or something is out to get them. This disorder is most often present in young adulthood but it can co-occur with addiction and be present later in life as well.

Since drug and alcohol abuse can cause similar symptoms, these co-occurring conditions can feed off one another if left untreated. Treatment should be designed from the standpoint of dual diagnosis and addressed simultaneously to achieve recovery. 

How Does Paranoid Personality Disorder Develop?

Paranoid Personality Disorder (PPD) can develop at any age, although most commonly in adulthood. In most cases, the development stems from a combination of genetic and environmental factors. If there is a family history of any personality disorders, including schizophrenia and Borderline Personality Disorder (BPD),  you may be at higher risk of developing one yourself. 

There is no direct known cause of PPD, however researchers have made a connection between childhood characteristics and the development of this disorder. Early signs of paranoid personality disorder include:

  • Individuals who prefer solitude and have obvious anxiety around others
  • Difficulty focusing in school
  • Hypersensitivity
  • odd or uncommon phobias
  • being generally perceived as “odd” or “different”
  • Talking to yourself often 

There is a strong link between having a family history of mental health disorders and paranoid personality disorder. It remains undetermined whether the exposure to personality disorders can pass down these types of behaviors and thought patterns, or if it is a genetic inheritance. It is likely a combination of both for many people who suffer from PPD, but regardless of the cause, this disorder can present itself in many different ways. 

What Does Paranoid Personality Disorder Look Like?

As with any condition, the specific symptoms will differ from person to person. Some will exhibit more of some characteristics and none of the others. Usually, people who have a paranoid personality disorder will not be aware that their behavior is abnormal. Their paranoid tendencies may cause them to not discuss or admit their symptoms to others. 

If someone with a paranoid personality disorder has a co-occurring condition like substance and alcohol abuse, it may be hard to identify which condition is causing certain symptoms to surface. For this reason, a clinical professional should perform a full analysis of the symptoms associated with a dual diagnosis to better determine the root causes.

Some of the most common symptoms include:

  • Thinking others have hidden motives
  • Difficulty trusting others
  • Feeling the need to isolate oneself and one’s thoughts
  • Not responding well to criticism
  • Not working well with others
  • Having an underlying fear or worry of others intentions
  • Trouble relaxing
  • Being unaware of abnormal behaviors

These symptoms can stand on their own. But, if the individual has a dual diagnosis of PPD and substance abuse, the line of which condition is causing these symptoms is blurred.  

Dual Diagnosis: PPD and Substance Abuse

There are many different possible combinations of co-occurring disorders. A paranoid personality disorder commonly co-occurs with substance abuse.

Drug and alcohol abuse can leave individuals in an unnatural state of mind. Often the chemical imbalance that occurs as a result of repeated substance use alters the mind and body’s ability to be in touch with reality. The thoughts that occur while high on drugs or drunk can transfer to a sober mind if the individual uses these substances frequently. 

The first step in recovery is understanding what conditions you are experiencing, how and why they co-occur and receiving an official diagnosis from a medical professional. It’s important to see an experienced physician to conduct a full evaluation of your symptoms. This will enable the medical professional to properly identify the conditions and come to the conclusion of a dual diagnosis. When both of these conditions co-occur, treating only one will not make for successful rehabilitation. 

Doctors and therapists can identify these coexisting conditions in several ways. They can also create a treatment plan from the perspective of not one condition, but both simultaneously. 

The processes of diagnosing will likely include the following:

  • Physical Examination
  • Lab Tests
  • Psychological Examination

The human mind and body are smart. But they adapt to the circumstances we put them in. If we use substances and are exposed to unnatural behaviors and thought patterns, the body can start to be tricked into thinking its normal.

Individuals who experience this will lose the ability to control their state of mind. These symptoms mimic a lot of those associated with a paranoid personality disorder. So, when they are combined and active simultaneously, each fuels the other’s fire. 

People often use substances to cope with the unnerving thoughts that occur with a paranoid personality disorder. Drugs and alcohol can lower the levels of anger, tension, and stress, and temporarily make someone feel more “normal”.

The National Epidemiological Survey on Alcohol and Related Disorders found paranoid personality disorder to be the third most prevalent personality disorder for people with an active alcohol use disorder, with 10 percent of people receiving treatment for alcohol addiction also meeting criteria for a PPD diagnosis.

Unfortunately, this state of “normal”  a person might feel after using substances to cope will be followed by a more intense and dramatic spiral of symptoms. The individual will lose further ability to control their emotions and state of mind. He or she will also experience lowered inhibitions as a result of substance abuse. 

This intensity can be so bad that people describe their state of being as “insane” or “uncontrollable”. The feelings can be intense and these co-occurring conditions can cause serious mental health concerns. But the right treatment and rehabilitation approach can bring those suffering from this dual diagnosis back to a healthy and calm state of being. 

Treatment For Paranoid Personality Disorder

If someone is suffering from co-occurring substance abuse and paranoid personality disorder, their treatment plan needs to address both conditions at the same time. In some cases, individuals don’t know they have PPD until they are diagnosed in a clinic while being treated for addiction. 

Initially, the individual will need to complete a full detox. Through this process, medical professionals can evaluate what symptoms persist once the substances are no longer in the body. From there, it will be easier to identify which symptoms are triggered by which condition. 

Treatment for a dual diagnosis of paranoid personality disorder and substance abuse will include a combination of treatments. Each approach will address both the mental and physical side effects of these co-occurring conditions. Treatment will look different for each individual case, but common options for treatment typically include: 

  • Detox
  • Depression/Anxiety medications
  • Talk Therapy (CBT, ACT therapy)
  • Nutritional Therapy
  • Meditation & Yoga
  • Behavioral Modification Therapy
  • Relapse Prevention 

Cognitive behavioral therapy will be important to verbally talk through the specific thought patterns that trigger PPD behaviors. It will also help individuals to learn new healthy ways to cope and act on certain triggers. Group therapy will help individuals overcome their paranoia and learn to re-integrate themselves into society. 

Holistic treatments can help the individual with physical and emotional tension that occurs as a result of these co-occurring conditions. These treatments include acupuncture, yoga, and art therapy. Each treatment plan will be tailored to the individual’s specific needs. But it’s crucial to address both conditions of dual diagnosis at the same time. This allows treatment to be effective and long term. 

Treatment At Northbound Recovery 

Northbound Recovery provides comprehensive services designed to address all aspects of the disease of addiction and mental health. We offer an initial assessment and detox to begin the treatment process.

Our clients can then engage in therapies and support groups. Finally, thorough aftercare, we are here to support our clients complete their journey through treatment. Our team is with you, from start to finish!

Our facility offers multiple evidence-based approaches. Each one has been shown clinically to fight addiction and co-occurring personality disorders from a variety of angles.

After treatment, our clients will have the tools and confidence they need to maintain sobriety and regain control of their lives! To learn more about our services, contact us by calling (863) 311-0003! 





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