Owen McCarthy

Period 4

With this disorder, it’s difficult for me to consider anything as okay in my world. I’ve always got

the conscious feeling that someone is observing me. That someone I once encountered will lose

my trust, if they haven’t already. It’s quite difficult for me to believe one’s promise that they’re

“always here for support”. When really, these people are like hackers and will look to use my

personal information that I said was private and use it against me. This may explain why I have

little to no friends. I’ve had to end relationships because the people I once knew just had to

criticize me any chance they got. It feels impossible to maintain a relationship because people are

just mean nowadays. Now everyone wants to make a person they may have known for a good

while feel that they need a lot of help. I think that people are too unaware of their surroundings

and other people’s feelings. It’s almost never necessary to point out the minor flaws of an

individual. But maybe they were right? Maybe I’m too sensitive to small, meaningless side

comments. Whenever I’m available to the public eye, I get the sensation that people are

observing my every move and my every action. It feels like I’ve been given the spotlight and that

I’m the center of attention when I don’t want to be. I feel like I’m having to deal with the

negative side effects of what the stereotypical “popular kids” have to deal with. There’s been

numerous times where someone will use a word to describe someone else, or maybe they will

criticize someone else, and I immediately think they’re aiming those words towards me. As an

immediate reaction to this, I will go into a panic-like state and start asking everyone around me

what criticism was said and who said it, so that I know to be ready to defend myself whenever I

see this person. I was never really looked after when I was a child. My parents didn’t take the

minor things I had done as a child too kindly. My family and I were very limited on the basic
needs of survival. Whether it was clothes, health care, a stable shelter, and others. My parents

had been so stressed out by those circumstances to the point where they surrounded themselves

and me with alcohol. Now I feel a sense of higher arousal when I’m casually walking outside.

It’s because of some anxiety or maybe depression I’ve gradually developed throughout my

childhood. None of the hardship that took place in my childhood was because of me, so unless

it’s because of the previously mentioned anxiety or depression that makes me act more

impulsively than others, then I couldn’t tell you why. My parents had told me to check myself

into a doctor, but I continuously refused because I don’t find myself to be the root of the issues in

my life. Reluctantly, I decided to start seeing a psychotherapist. They started our conversations

by getting to know me and why I made appointments with them. But not too long afterwards,

they went on to ask me about how I would describe my childhood. And from there, I just

rambled about the lack of resources I had in my unstable home. I was asked about the thoughts I

would have when I would be out in public, and I responded by saying that I was always on guard

because you never know the type of people that surround you when you’re outside. AFter some

reality testing was performed after I expressed my thoughts about the public eye as a whole, I

was told that the thoughts I had were not realistic. Because I thought the test was inaccurate, the

therapist asked me if I had vivid memory of someone assaulting me in public. I said there was no

experience of someone assaulting me, but I did mention one comment that was made about my

clothing and how old it had looked. The therapist understood my frustration with that one

comment, but they brought up the point that I probably had never seen this person again. That

what I thought was a planned attack that would continue to develop wasn’t actually the case.

And after psychodynamic therapy, now I can see that portions of my anxiety and depression

come from myself and my thought process rather than outside factors that triggered a response.
Paranoid personality disorder (PPD) describes individuals who have a lack of trust for others and

feel they are being used by people they surround themselves with for their own benefit. A

specific cause of the disorder has not been found, but it is believed that a mixture of

environmental and biological factors are the likely causes. A couple environmental factors that

are seen as possibilities as to why this disorder occurs are childhood emotional neglect, physical

neglect, and supervision neglect. Childhood emotional neglect occurs when one’s parent(s) or

guardians(s) don’t respond in a helpful manner to the child’s emotional needs. Physical neglect is

when a parent or guardian doesn’t provide the basic needs so their child can survive. This may

include the lack of personal hygiene products, clothing, healthy nutrients, medical care, and

shelter. Supervision neglect takes place when a parent or guardian’s decisions that affect their

ability to supervise could place the child at a high risk of physical, emotional, or psychological

harm. It was initially believed that this disorder had genetic links to schizophrenia and

schizotypal personality disorder. But after further studies were conducted, the conclusion was

made that there wasn’t a strong genetic link between the three disorders. However, there is a

strong association between PPD and other personality disorders, as 75% of people with this

disorder have some kind of personality disorder. The most frequent ones that are found are

avoidant personality disorder, borderline personality disorder, and antisocial personality disorder.

It’s also more likely for someone with PPD to have panic disorder and substance use disorder

than the general U.S. population. This disorder evolves throughout child and adolescent

development, which is why one isn’t diagnosed until after they turn 18 years old. Paranoid

personality disorder is considered to be very difficult to diagnose because the patients themselves

don’t believe there’s a problem with how they behave or their way of thinking. The most

common way of an individual being diagnosed with PPD is by them seeking help because of a
mental condition such as anxiety or depression. But what these specific patients don’t know is

that the problems in their life that led to their mental condition were caused by paranoid

personality disorder. There are many characteristics and symptoms that come with having

paranoid personality disorder, some regarding trust, and others regarding sensitivity issues aimed

towards yourself. Some symptoms of PPD that affect one’s ability to trust others are that an

individual doubts the commitment and loyalty of others, resists to reveal personal information

because of a fear that information will be used against them, holds grudges and is unforgiving,

reads the meanings of innocent looks of others, have recurrent suspicions of their spouses loyalty

for no reason, and may become controlling or jealous. Some symptoms regarding one’s

sensitivity issues are that they are hypersensitive and don’t respond well to criticism, perceive

attacks as if they are towards themselves and react with anger and retaliation, cannot see their

role in situations and never think they’re in the wrong, are hostile, stubborn, and argumentative,

and struggle to relax. When some of these symptoms are present, the doctor looks over the

patient’s medical and psychiatric history, and possibly a physical exam if they need further

confirmation on whether or not the patient has paranoid personality disorder. Other diagnostic

tests may be performed as physical exams don’t determine if an individual has a personality

disorder. When no physical reasons are found, the doctor sends the patient to a psychiatrist or

psychologist, since they are able to initiate interviews and use other assessment tools with the

patient to find the roots of the patient’s paranoid personality disorder. Within hospitals, there is a

higher rate of paranoid personality disorder in individuals who were assigned male at birth

compared to individuals who were assigned female at birth. However, in and outside the

hospital, there are higher rates of personality disorder in individuals assigned female at birth

compared to being assigned male at birth. Since PPD correlates to childhood trauma, people who
have PPD are more likely to live in households with low-income, be black, Hispanic, or Native

American, and be divorced or never married. Paranoid personality disorder is considered to be

more difficult to treat because the patients themselves don’t sense a problem with their behaviors

and thinking, as that is one of the symptoms of the disorder. Because patients typically don’t get

themselves to a doctor or mental health professional, a family member, coworker, or employer

has to send the individual to those professionals, which isn’t always easy because the people that

the individual surrounds themselves with don’t always sense that there is something wrong. The

normally chosen forms of treatment are these kinds of therapy; psychotherapy, cognitive

behavioral therapy, dialectical behavior therapy, psychodynamic therapy, or reality testing.

Psychotherapy is when a mental health problem is treated by the patient talking with a

psychotherapist, psychologist, psychiatrist, or other mental health provider. Cognitive behavioral

therapy teaches patients how to notice and change their disturbing thought patterns that

negatively impact their behavior and emotions. Dialectical behavior therapy treats a patient's

thoughts and behaviors, similarly to cognitive behavioral therapy. However, dialectical behavior

therapy focuses specifically on suicidal thoughts, self-destructive behaviors, and destructive

behaviors as a whole. Psychodynamic therapy can shift a patient’s locus of control, meaning that

a patient will soon be able to see that their anxiety comes from themselves rather than outside

factors triggering their anxiety. Reality testing looks into a patient’s thoughts and whether or not

they are realistic to have. With this testing, the patient and their therapist can discuss the patient’s

paranoid thoughts and the evidence or lack of evidence they have to support them. A challenge

that may come into play for mental health professionals is the absence or presence of trust.

People with paranoid personality disorder normally have trouble trusting others, making

psychotherapy more challenging for mental health professionals because the presence of trust is
vital for psychotherapy to flow smoothly. And because people with paranoid personality disorder

have a lack of trust for others, they may disregard what the therapist is advising them to think

about and possibly question why the therapist is even talking to them in the first place.

Medications are not prescribed to treat paranoid personality disorder, but medications are

provided for an individual's psychological condition, with depression and anxiety being common

examples, or for one’s extreme symptoms. These medications may include anti-anxiety,

antidepressant, and antipsychotic drugs. Like many personality disorders, paranoid personality

disorders can’t be prevented. The symptoms can only slow down when the individual learns new

ways to handle the thoughts and situations that trigger a response out of them. The prognosis or

outcome of one’s paranoid personality disorder is determined by one’s acceptance and

commitment of treatment. When an individual decides against treatment, their ability to make

and keep hold of relationships for themselves is inhibited by paranoid personality disorder. The

individual also will have less of an ability to work and even function in social circumstances than

the normal person. People with paranoid personality disorder may end up in worse financial

situations than others as well.

References

Bhandari, S. (2020, June 30). Mental Health: Paranoid Personality Disorder. WebMD.

Retrieved May 16, 2022, from https://www.webmd.com/mental-health/paranoid-

personality-disorder

Lee, R. (2017, May 18). Mistrustful and Misunderstood: A Review of Paranoid

Personality Disorder. NCBI. Retrieved May 16, 2022, from

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5793931/
Paranoid Personality Disorder (PPD): Symptoms & Treatment. (2022, April 28).

Cleveland Clinic. Retrieved May 16, 2022, from

https://my.clevelandclinic.org/health/diseases/9784-paranoid-personality-disorder

Paranoid Personality – Getting Help for Paranoid Personality. (2018, September 27).

GoodTherapy. Retrieved May 16, 2022, from https://www.goodtherapy.org/learn-about-

therapy/issues/paranoid-personality/get-help