Teen Paranoid Personality Disorder Treatment

Paranoid Personality Disorder is a condition that causes teens to experience deep, intractable feelings of fear, distrust, and paranoia. Depending on the severity of the disorder, this may include obsessive beliefs that everyone is conspiring against them to harm them, or that everyone they know has a “hidden agenda” with dishonest motivations. This causes them to withdraw and self-isolate from the world in a misguided attempt to self-protect, but the loneliness they experience often worsens symptoms instead of helping them.

What Does Teen Paranoid Personality Disorder Look Like?

  • “Paranoia” and suspicion about the motives of others, including friends, families, and healthcare providers. Paranoia may center on one person or everyone.
  • When paranoia is focused on an individual, it is often someone the person cares about such as a friend, family member, or teacher. They may become hostile, angry, or even attack the person verbally, accusing them of trying to harm them.

Signs of Teen Paranoid Personality Disorder

Emotional sensitivity to criticism

Emotional sensitivity to criticism

Self-isolation and withdrawal

Self-isolation and withdrawal

Intense anger and aggression

Intense anger and aggression

Hostile, angry behavior

Hostile, angry behavior

Feeling suspicious of kindness

Feeling suspicious of kindness

Inability to trust loved ones or friends

Inability to trust loved ones or friends

Different Types of Teen Paranoid Personality Disorder

Obdurate Paranoids – Teens with Obdurate Paranoia seem extremely self-confident, stubborn, and demanding. They often behave “obstinately,” even if it harms others.

Fanatic Paranoids – Fanatic Paranoia is focused on the self; it often includes narcissism and self-aggrandizing behaviors, like boasting and lying about accomplishments.

Querulous Paranoids – Querulous Paranoia causes teens to be markedly negative in behavior and presentation. This includes demanding, whining, arguing, and resentment.

Insular Paranoids – Teens who have Insular Paranoia are intensely suspicious of the motivations of others, believing they are “out to get them.” They will go to extreme measures to avoid social interaction out of a belief that harm will befall them.

Malignant Paranoids – Malignant Paranoia is also one of the most severe forms. It often causes incredibly hostile behavior and/or aggression, sometimes including violence.

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Teen Paranoid Personality Disorder Treatment | Paradigm San Francisco

What Are The Causes of Teen Paranoid Personality Disorder?

As with several other mental health issues, the causes for paranoid personality disorder are complex and multi-layered. There is no single concrete cause that one can point at in any given case, and each teen with paranoid personality disorder developed their symptoms for individual reasons. Common risk factors associated with the disorder include:

Family history of psychosis – it’s shown that teens with a family history of schizophrenia or disorders on the schizophrenic spectrum are more likely to develop paranoid symptoms and a paranoid personality disorder.

Early childhood trauma – trauma is shown to play a role in the development of paranoid personalities, as a person begins to withdraw inwards, become increasingly isolated, and lose all trust for others as a coping mechanism to deal with extreme stress after a severe personal betrayal. Teens with paranoid personality disorder may have had their sense of trust irrevocably shattered at some point in a developmental stage in their life.


of all Americans are diagnosed with a personality disorder


Americans have Paranoid Personality Disorder


Men are 2.5 times more like to be diagnosed with Paranoid Personality Disorder

How Can I Help with Teen Paranoid Personality Disorder?

Tread carefully and be honest – Teens with Paranoid Personality Disorder can and will scrutinize everything you say – even when you are attempting to be kind. This isn’t malicious; it’s simply a product of the mental health condition they’re struggling with. It is extremely important that you encourage them to get help, but forcing them or tricking them into “interventions” often only serves to make them more paranoid. Instead, try to recognize that your teen’s fears may be irrational, but they are very real to them. Keep the focus on the fact that you want them to feel better and be happy, not that you’re frustrated with their behavior. Keep the lines of communication open, and be patient, non-judgemental, and willing to let go the little things so you can focus on the things that matter most. For bigger behavioral issues, approach it from a non-judgemental space – you just want to help them be the best they can be. It won’t always be easy, but your dedication and patience will go a long way.

Don’t lash out at your teen – From the outside in, paranoia seems really irrational. It’s easy to think things like, “you’re being ridiculous,” or “why can’t you just snap out of it?” The reality for your teen is that just isn’t an option, especially during intense episodes, because teens can’t lose focus on what’s reality what is the manifestation of paranoia. If you are struggling with frustration, focus it on outside sources (such as therapy for yourself) instead of at your teen. Your relationship might count on it!

Work with professionals to help them – Teen Paranoid Personality Disorder causes sufferers to struggle greatly with socialization. Ironically, lack of socialization can worsen loneliness, which leads to greater feelings of paranoia. The good news is that working with a therapist to address paranoid feelings and social skills can help teens overcome their struggles and go on to live a relatively healthy life. However, no two teens are alike; it’s important to find the right mental health professional and the right approach. Don’t be afraid to turn to the professionals if you need help – for you or your teen – and stick with it for best results. With consistency and loving kindness, most parents do convince teens to seek help.

What Types of Teen Paranoid Personality Disorder Treatment Are Available?

Teens with Paranoid Personality Disorder often struggle significantly with thoughts of people harming them. Loving interventions may be perceived as attempts to harm them, and this often extends to therapists, counselors, and treatment centers. However, resistance is not a reason to stop trying; treatment is a must for wellness.

It is completely normal for teens with Paranoid Personality Disorder to feel untrusting of medical providers; thus, the fix becomes finding ways to convince them to start the process and at least try therapy once or twice. Just getting teens to attend therapy on a consistent basis, even if all they talk about is the weather or everyday activities.

Some teens may benefit from temporary or long-term medication, especially if symptoms seem uncontrollable or include hallucinations and delusions. This, too, may be perceived as an attempted attack, making it a challenging sell. Earmarking medication as a solution for other associated conditions, such as Depression, may help.

Gaining Trust

Don’t be surprised if your teen demonstrates resistance or shares feelings of suspicion about doctors and therapists. Remember that teens rarely see themselves as paranoid; they often believe their fears are rational and real instead. Therapists build trust with every session, slowly showing teens that they don’t have to fear being harmed or emotionally injured. This process takes time.

Consistency is important. The more sessions your teen attends, the easier it becomes to work on tougher topics over time without triggering paranoia. Eventually, trust becomes high enough that the therapist can work with them to expose false negative views, suspicions, and negative beliefs directly without triggering an immediate and negative response.

Talk Therapy

Talk therapy (“Psychotherapy”) is by far the best way to treat teen Paranoid Personality Disorder. Research shows that only therapy has the ability to affect real, long-term, consistent change; however, results often take time and commitment from parents and teens. The goal of talk therapy is to help teens better understand themselves and how to identify irrationality.

Therapists work with teens to help them understand the ways in which their view of themselves, the world around them, and the actions of others are distorted. They also show them how to judge their own behaviors (such as being disruptive or aggressive) without feeling shameful about it. This non-judgemental approach gives paranoid teens the power to actively choose other behaviors that are more healthy, while also reducing isolation and antisocial tendencies. But recognizing the problem is just the first step; once teens acknowledge the problem, they can begin to work with the therapist to identify healthier coping skills, ways to regulate emotion more effectively, and how to really judge character without experiencing intense fear or episodes of paranoia.


Medication may help teens with Paranoid Personality Disorder. However, teens are almost universally suspicious of medication and may display extreme resistance to taking it.

Even if teens do agree to take medication, they may take it inconsistently. Or they may claim to be taking it, yet hide it or throw it away. Still, medication is useful when symptoms become so severe that they become dangerous or put your teen’s life at risk. This includes when teens experience delusions, hallucinations, or suicidal thoughts. Common options include Selective Serotonin Reuptake Inhibitors (SSRIs), antipsychotics, and mood stabilizers.

Teen Paranoid Personality Disorder Treatment at Paradigm San Francisco

Paradigm San Francisco is structured as a place of healing and peace, but it can still feel like a dangerous place to be for a teen with Paranoid Personality Disorder. It may take time to convince your teen to attend inpatient or outpatient therapy with us, but we encourage you to continue to try. Some parents find it helpful to connect with us in advance or to schedule a visit to our facility before admission; the local environment is beautiful, surrounded by nature, and soothing, which may help to convince them they will be safe.

A Place for Trust

When teens come to Paradigm, they have their own room and their own spaces to relax, heal, and spend time reflecting. They are encouraged to explore our beautiful surroundings, sitting or chatting among the trees, the nearby beach, or our cozy, perfect-for-conversation beach. They may choose to spend time alone or spend time with their peers at their own will, ensuring they’re never forced to socialize. Group therapy sessions create structured opportunities for socialization with the guidance of an established therapist.

At Paradigm San Francisco, we understand the need to establish trust before all other therapeutic steps, especially when it comes to teens with Paranoia. We are happy and willing to take the process slowly and let teens move at their own place. After all, if they’re moving forward, they’re still improving – and that’s something worth celebrating.

“ It's been three months since my 17-year-old son returned to us from his 30-day stay at Paradigm Malibu and, I can honestly say, I have never seen him happier, more optimistic, or more excited about his future. This program not only saved my son's life, it provided him a means by which to heal, as well as an array of tools for dealing with his anxiety and depression. Too, and just as importantly, it taught my husband and me how to be better parents to our teenager; how to more effectively communicate with him; and how to let him be responsible for his own happiness. Like so many other deeply grateful parents, I can't say enough about the team of therapists whose expertise, kindness, compassion and dedication drew my son out of his dark depression, challenged him to challenge himself, re-instilled in him the will to live, and brought the beautiful smile back to his face. Thank you! Thank you! Thank you! “

– Chantal C.

Frequently Asked Questions About Teen Paranoid Personality Disorder

How successful is teen Paranoid Personality Disorder?

The answer to this question differs for every teen. Some teens bounce back quickly and engage with the process immediately, while others may need more time. Parents should be prepared to stay involved with therapy and treatment for the “long run.” Teens who stay in therapy and develop strong support networks very often go on to live healthy lives enriched with mental wellness, continuing to experience success and happiness well into the future.

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