How Paranoid Personality Disorder Took Over My Brother’s Life

Paranoid personality disorder (PPD) is a serious mental illness that causes suspicion, distrust, isolation, and hypersensitivity to criticism and slights. The paranoia associated with PPD can easily take over someone’s life, leading to damaged relationships, social isolation, and an inability to function normally or keep a job. While PPD is damaging and disruptive, treatment can be effective. An intensive, residential mental health facility  that focuses on the individual and all their needs helps people with PPD live more normal, satisfying lives.

My brother, Jim, and I were always close as kids. We were only 18 months apart in age and had no other siblings. We were each other’s best friends for a long time.

Things started to change toward the end of high school when he became isolated, overly sensitive about everything, and distant with me. I couldn’t joke or laugh with him anymore.

It would take several more years before I found out the underlying cause: paranoid personality disorder. Thankfully a careful diagnosis led to a plan to get help, and Jim was able to rebuild his life again.

But first it would all fall apart.

It Began With a Poor Sense of Humor

My favorite thing about my brother was always his ability to laugh at everything. We joked and teased each other constantly growing up. It was how we related to each other. What really got weird for me was when he couldn’t joke anymore.

Jim became hypersensitive, which if it had only happened with other people, I might not have thought much of it. But we always teased and made fun of each other, and then we didn’t. First, I just didn’t get a laugh out of him. Instead, he would glare at me and walk away.

Eventually he actually started to get hostile toward me. He accused me of thinking he was stupid, or ugly, or whatever I was joking about. He lashed out and yelled at me. He was so angry. This turned into a distance we had never had before. I could barely talk to him about anything at all, and our parents couldn’t get much more out of him.

And It Got So Much Worse

For his last year of high school, my brother became more isolated. He stopped doing anything other than going to school. He nearly failed his last semester and barely passed and graduated. He would have some better days here and there when he would actually talk to me.

But even then, he talked about teachers being out to get him. He said his grades were fine but that they all wanted him to fail. It seemed so strange to me. A girl Jim dated the year before tried to reconnect with him, and he told me that he thought that she was trying to track him through his phone.

After graduating, Jim insisted on moving out and getting a job. We tried to convince him to work but stay home. He said he needed to be alone. For a couple of years, it actually worked out well. He earned enough to rent an apartment, but my parents were worried he had no real future working at a warehouse.

I lost touch with Jim when I went to college, but at home one summer I found out from my parents that things had gotten worse. After not hearing from him for a month, I went to his apartment to find it in complete disarray. He had put up light-blocking curtains and sat in the dark not even watching TV.

He Agreed to Get Help When His Life Fell Apart

This was when Jim agreed to get some kind of mental health help. He didn’t know that he had a mental illness. He only knew he couldn’t cope. He had stopped going to work and was living on meager savings for a few months. His landlord was on the verge of evicting him. He told me about his former co-workers who he believed spied on him regularly. He thought his boss had fired him illegally when really Jim just stopped showing up at the job.

I brought him home, and together as a family we convinced Jim to see the pediatrician he’d always liked. He was an adult now, but it was the best we could do. He had some lingering trust from childhood experiences with a good doctor. She was able to get him to see a psychiatrist, although it took a lot of convincing. The diagnosis was paranoid personality disorder, or PPD.

We Found a Mental Health Facility With a Trauma-Based Approach

One thing we learned about PPD as my brother received his diagnosis is that it can be related to childhood experiences. This made sense. He unfortunately experienced some abuse by a babysitter that my parents didn’t find out about until it had gone on for a few months.

While it’s not really possible to say that the experience definitely caused his paranoia, it seems likely it played a role. That babysitter violated his trust and made him question adults and authority figures. The physical and emotional trauma stuck with him, and I’m sorry to say my parents preferred to sweep it under the rug rather than deal with it at the time.

An important factor in choosing a facility for my brother was a facility that understood the impact of trauma. He needed to learn to process his past experiences. This would begin to help him realize that his thoughts of paranoia were often irrational. He benefited from a plan that addressed both his trauma and his PPD symptoms.

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There Is Not a Cure

My parents and I have learned from this experience that, unfortunately, Jim will always live with PPD. He can’t truly escape it, and there will never be a cure. That was a tough pill to swallow, because I just wanted my brother back.

Honestly, Jim has handled it better than I have. He settled into the mental health facility grudgingly, but pretty well in the long run. Because trust is such a big issue with him, he got one dedicated therapist to work with all of the time. It has taken a while, but they established a good bond and Jim trusts him now.

This distrust and paranoia have also meant that Jim needed to spend several months at the facility. Once he got established there, it worked out well. In fact, it took a lot of convincing to get him to leave. We had to transition him to living back at home and working with his therapist daily.

Rebuilding Our Family, Together

Another really important part of Jim’s recovery plan has been the involvement of the rest of us. My parents and I participated as soon as he stabilized in care. We attended therapy sessions, met with support groups, and just spent time with him as he stayed at the mental health facility.

Bringing Jim home was tough. He spent the first week almost entirely in his room with the curtains closed, refusing to spend any time with us. He only left to eat, use the bathroom, and go to therapy. After the first week, he talked to us through the door, and after another week he came out in the evenings to watch TV.

It took even longer to get him to eat with us; he claimed we might poison his food. The rebuilding of trust has been so hard, but continuing with therapy and patience have been what it takes to get back to some type of normal. Mostly we were just relieved he agreed to live at home.

We have had to adapt significantly to help Jim rebuild his life. A year later, he still isn’t ready to live by himself. He is, however, able to challenge his paranoid thoughts and calm himself down when fears and suspicions threaten to overwhelm him.

The journey from the beginning of my brother’s PPD to where we are now has been long and difficult. This condition took over his life, so I encourage anyone who is concerned about a loved one to act as soon as you feel something is off. The sooner you can get help for someone with a complicated mental illness like this, the better. The mental health facility and time have allowed us to help Jim put his life back together.