Q. I’ve been dating someone over a year who I concluded has paranoid disorder personality. It has been an emotional roller coaster for me in this relationship from the beginning and I knew something was wrong. But the more and more I spent time with him I started watching him closely. I’ve confirmed almost all the symptons he had displayed that I have read on the internet. I brought it to his attention. And to make this story short this was later used against me that I was using this excuse to cover up on my infidelity (not true at all). I am 100% he has a paranoid personality problem. If I were to talk to you in person I can tell you probably over 50 examples what had happened to me. Since I confronted him I no longer bring the subject up anymore. My question to you is does people with paranoia aware they have this problem? I know I am not the one to help him because he does not trust me no matter how much I try. I have tried to give him hints or open his eyes. But he either don’t say anything or pretends he doesn’t hear me.

A. The only way to know for sure if he has paranoid personality disorder is to have him examined by a psychiatrist or other trained mental health personnel with experience in diagnosing mental health disorders. He could have paranoid personality disorder or his paranoia could be indicative of another type of disorder, one in which paranoia is just one symptom among other symptoms. You mentioned that he was paranoid, to the point that you think it is a disorder but you did not detail how often his accusatory behavior occurs. You also did not mention whether or not you have cheated on him in the past. If it is that he thinks you are cheating on him, because you have in the past, this may not necessarily mean he has a disorder. His paranoia, in this case, may be justified. He may just be worried about being hurt again. If he thinks you are cheating on him and you never have and he mentions the possibility of you cheating a few times a week, then he may be a little paranoid but not enough to warrant a paranoid personality disorder diagnosis. In this situation, he may be displaying jealously or insecurity. If on the other hand he thinks that you are covering up your infidelity and that you have instructed all of your friends to uphold a set of orchestrated and elaborate lies about your infidelity or that all of you have created a code of hand gestures to use around him then this type of paranoid thinking might be indicative of paranoid personality disorder. There are too many unknowns for me to diagnosis exactly what is occurring.

If he is paranoid, I do not think you will be able to convince him that he is paranoid. It is likely that he is not even aware of it. This makes treatment of any kind extremely difficult. If he does not think there is a problem then he is not going to seek help no matter how much evidence you provide him with to prove you are correct. Antipsychotic medication could be helpful to reduce paranoia if he were willing to seek help. You will have to decide how problematic his paranoia is to you. If it is too much and he is not willing to seek help, then you may need to end the relationship. Take care.