People with paranoid personality disorder (PPD) typically have a pervasive and enduring pattern of mistrust and suspicion of others, often believing that others are out to harm, deceive, or exploit them without sufficient basis for these beliefs. However, it's essential to note that the severity of symptoms can vary significantly from person to person.
Regarding whether people with PPD know their thoughts are irrational and not real, it can be challenging to generalize. Some individuals with PPD may recognize that their thoughts and beliefs are excessive or unwarranted when they are in a more objective or calm state of mind. They may acknowledge that others might not see the world in the same threatening way they do. However, despite this awareness, they may still find it difficult to control or modify their thoughts and feelings due to the deeply ingrained nature of their paranoid beliefs.
On the other hand, some individuals with PPD may be so convinced of the validity of their paranoid thoughts that they do not perceive them as irrational. In such cases, they may genuinely believe that their suspicions and mistrust are entirely justified, and others are, indeed, a threat.
As for the severity of PPD, it can indeed manifest in a range of intensities. PPD exists on a spectrum, and people can experience milder or more severe forms of the disorder. In some cases, the symptoms might not be as disruptive to daily life and relationships, leading to a milder presentation. In contrast, in severe cases, PPD can significantly impair a person's ability to maintain stable and healthy relationships, leading to social isolation and other challenges.
Regardless of the severity, individuals with PPD may have difficulty trusting others, which can create significant distress and hinder their ability to form close and meaningful connections with others.
If you or someone you know is experiencing symptoms of PPD or any other mental health concerns, it's crucial to seek professional help. A mental health professional can provide a proper evaluation, diagnosis, and recommend appropriate treatment options.