Table of ContentsView AllTable of ContentsParanoia as a BPD SymptomParanoid Ideation in BPDTreatmentHow to Cope

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Table of Contents

Paranoia as a BPD Symptom

Paranoid Ideation in BPD

Treatment

How to Cope

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Many people withborderline personality disorder (BPD)experienceparanoiaor paranoid thinking under conditions of stress.Paranoia is a term generally used to refer to intense beliefs of mistrust or the malicious intentions of others. For example, someone with paranoia may have the belief that the government is listening to their phone calls or that their spouse is having an affair.

At a Glance

Paranoia as a Symptom of BPD

Paranoia is one of the nine symptoms identified in the diagnostic criteria for the condition in the “Diagnostic and Statistical Manual of Mental Disorders” (DSM-5-TR). The other eight symptoms of BPD that are listed in the DSM-5-TR are:

In order to be diagnosed with BPD, a person must experience five or more of the nine symptoms.

The paranoia that occurs in BPD is considered non-delusional. This distinguishes the paranoia that occurs in borderline personality disorder from the type of paranoid delusions that occur in psychotic conditions like schizophrenia or schizoaffective disorder.

Prevalence of Paranoia in BPDResearch indicates that around 87% of people with BPD experience paranoia.

Prevalence of Paranoia in BPD

Research indicates that around 87% of people with BPD experience paranoia.

Episodes of paranoid thinking, or ideation, can range from mild and short-lived to very severe and chronic. Some individuals with psychotic disorders, such asschizophreniaor delusional disorder, tend to have severe, chronic paranoid ideation that has no relationship to reality.

While many people with borderline personality disorder do experience paranoia since it is part of thediagnostic criteria for BPD, it tends to occur only under conditions of stress or interpersonal conflict.

Examples of Paranoia in BPD

For example, an adolescent with BPD might see two of his friends talking in the hallway and develop the paranoid belief that his friends all secretly hate him and are planning to humiliate him. Or an adult with BPD might misread their partner’s cues that they want some alone time as a sign that the relationship is being terminated and dwell on this belief even when a great deal of evidence to the contrary is presented.

Treatment for Paranoic in BPD

Borderline personality disorder is a treatable condition, and getting treatment can improve functioning and reduce the impact of symptoms on a person’s life.

Treatment typically involves psychotherapy, but medication may also be prescribed. It is also not uncommon for people with BPD to receive inpatient hospitalization in times of crisis.

Therapy

Types of therapythat can be helpful for borderline personality disorder includedialectical behavior therapy(DBT) andmentalization-based treatment(MBT). DBT is a form of cognitive-behavior therapy that helps people with emotional regulation, relationships, and distress tolerance. MBT can help people learn to recognize how emotions affect behaviors.

Medication

Medicationsthat can be used to treat certain symptoms of BPD include antidepressants, mood stabilizers, anxiolytics, and antipsychotics.

How to Cope With Paranoia in BPD

Because paranoia in BPD is worse when you are under stress, you may find it helpful to find ways to relax andwork through your stress. Some popular stress busters are:

Biofeedback

Deep Breathing

Deep breathingis a highly effective way to reduce stress and anxiety. The advantage of deep breathing is that it can be done anywhere, anytime. Sit or lie down, fill your lungs slowly, and then exhale your breath back out slowly. Repeat.

Meditation

Meditation is a mindfulness practice that has existed for centuries. While there are different techniques, most focus on quiet, calm, relaxation, and focusing one’s attention. Differentmeditation methodscan be found online.

Evidence indicates meditation and other mindfulness practices can be useful for relieving symptoms of stress and improving overall well-being.Research has found that mindfulness training may be a useful tool for relieving some aspects of BPD symptoms.

Tai chi

Yoga

Like meditation, the focus withyogais on calm, relaxation, quiet, as well as posture and flexibility. There are many free yoga apps and instructional videos online to instruct you how to do yoga on your own, or you can sign up for a class at your local gym.

RecapFinding ways to cope with stress may help reduce feelings of paranoia in borderline personality disorder. A few stress-relieving strategies that can help include biofeedback, deep breathing, meditation, Tai chi, and yoga.

Recap

Finding ways to cope with stress may help reduce feelings of paranoia in borderline personality disorder. A few stress-relieving strategies that can help include biofeedback, deep breathing, meditation, Tai chi, and yoga.

Keep in Mind

While there are many stress relievers that can be helpful if you have borderline personality disorder, it is important to seek professional treatment. Paranoia and other BPD symptoms can affect many different areas of your life, including your health, your relationships, and your work. While the symptoms of the condition can create problems in your life, getting treatment and finding ways to cope can help you manage your stress and lead a fulfilling life.

If you or a loved one are struggling with borderline personality disorder, contact theSubstance Abuse and Mental Health Services Administration (SAMHSA) National Helplineat1-800-662-4357for information on support and treatment facilities in your area.For more mental health resources, see ourNational Helpline Database.

If you or a loved one are struggling with borderline personality disorder, contact theSubstance Abuse and Mental Health Services Administration (SAMHSA) National Helplineat1-800-662-4357for information on support and treatment facilities in your area.

For more mental health resources, see ourNational Helpline Database.

Paranoid Ideation

8 Sources

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Masland SR.Managing mistrust, paranoia, and relationship rupture. In: Palmer B, Unruh B, eds.Borderline Personality Disorder. Springer; 2018:49-60.

American Psychiatric Association (APA).Diagnostic and Statistical Manual of Mental Disorders. 5th ed, text revision. Washington, D.C.; 2022.

Oliva F, Dalmotto M, Pirfo E, Furlan PM, Picci RL.A comparison of thought and perception disorders in borderline personality disorder and schizophrenia: psychotic experiences as a reaction to impaired social functioning.BMC Psychiatry. 2014;14:239. doi:10.1186/s12888-014-0239-2

Choi-Kain LW, Finch EF, Masland SR, Jenkins JA, Unruh BT.What works in the treatment of borderline personality disorder.Curr Behav Neurosci Rep. 2017;4(1):21–30. doi:10.1007/s40473-017-0103-z

U.S. National Library of Medicine, MedlinePlus.Relaxation techniques for stress.

Behan C.The benefits of meditation and mindfulness practices during times of crisis such as COVID-19.Ir J Psychol Med. 2020;37(4):256-258. doi:10.1017/ipm.2020.38

Kounidas G, Kastora S.Mindfulness training for borderline personality disorder: A systematic review of contemporary literature.Personal Ment Health. 2022;16(3):180-189. doi:10.1002/pmh.1529

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