Narcissistic Personality Disorder

The mental illness of narcissistic personality disorder (NPD) is one of many varieties. Those with NPD may come across as superior with an inflated opinion of themselves, but a person with narcissistic personality disorder likely has a deep need for excessive attention and admiration, which leads to troubled relationships and a true lack of empathy for others. The fragile sense of self-worth that lies beneath the tough and difficult exterior is susceptible to even the smallest criticism. Fortunately, there are tested methods to diagnose and treat the symptoms of this disorder.

NPD stands for Narcissistic Personality Disorder and is characterised by a host of symptoms.

To fully comprehend this condition, one must first establish what constitutes a narcissist. “Narcissist” is a common phrase used to describe those who are self-absorbed or vain, but narcissistic personality disorder means something different and is considered a serious mental health condition. Someone diagnosed with narcissistic personality disorder likely finds it difficult to relate to others or experience any true self-worth, and at the same time, feel generally unhappy when they are not given the praise they believe is inherently deserved.

To others, an individual who has narcissistic personality disorder (NPD) appears conceited and snobbish. As a result, this can cause a person problems across their work life, studies and personal relationships. Fortunately, treatment options include talk therapy, psychotherapy, and dietary and lifestyle changes. For the 6 percent percent of people who are estimated to have this type of personality disorder, symptoms can start to appear in the late teen years and in early adulthood.

What Are Personality Disorders?

According to the American Psychiatric Association, people with personality disorders like narcissistic personality disorder have thoughts and behaviours that deviate from the “norm.” For instance, they will likely have poor coping skills and difficulty forming and maintaining healthy relationships with others. Relationships, career prospects, and general well-being can all be jeopardised by these unwelcome personality traits. Individuals who suffer from a personality disorder are frequently unaware that they have a problem and do not believe that their atypical personality traits are responsible for the problems in their lives or have an impact on their behaviour.

Narcissistic Personality Disorder Symptoms

Arrogance, self-centeredness, and demandingness are frequently used to describe someone with narcissistic personality disorder. Those who suffer from narcissistic personality disorder are more likely to engage in risky behaviours like gambling and sex with strangers that could end badly. Slight, moderate, severe, or all of the following symptoms may be present.

  • Feeling an overinflated sense of one’s own importance
  • Feeling a sense of entitlement and requiring constant, excessive admiration
  • Expecting to be recognised as superior even without achievements that warrant it
  • Exaggerating achievements and talents
  • Being preoccupied with fantasies about success, power, brilliance, beauty, or the perfect partner
  • Confident in their superiority and limited in their social circle to those who share their sense of superiority
  • monopolising conversations and demeaning those they believe to be below them in social standing
  • Expecting special favours and unquestioning compliance with their expectations
  • Taking advantage of other people in order to obtain one’s own ends
  • Having an inability or unwillingness to recognise the needs and feelings of others
  • Being envious of others and believing others envy them
  • being conceited, boastful, and pretentious in one’s behaviour or demeanour
  • Obsessiveness, such as a need for a top-of-the-line vehicle or workplace

In addition to these common symptoms, people who have narcissistic personality disorder have difficulty coping with anything that could be considered criticism. In the event of criticism, the following reactions may occur:

  • When they don’t get special treatment, they get angry, impatient, or even angry.
  • Struggling to regulate their emotions and behaviour in reaction to criticism or perceived criticism
  • As a result of their symptoms, they begin to experience interpersonal difficulties with those around them.
  • Feeling depressed or moody with underlying feelings of shame, insecurity, and humiliation
  • Having a hard time adapting to change or dealing with stressors

DSM-5 Criteria for Narcissistic Personality Disorder

The American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders details nine specific traits that a medical professional uses to diagnose a person with narcissistic personality disorder. In early adulthood, these tend to begin to show up, and they can do so in a variety of settings. A person must indicate five (or more) of the following characteristics to receive a concrete diagnosis:

  • Has an inflated view of one’s own importance (e.g., exaggerates achievements and talents, expects to be recognised as superior without commensurate achievements)
  • Fancies success, power, brilliance, and/or physical attractiveness as an end in itself; or
  • Believes that they are “special” and unique and can only be understood by or should be associated with, other special or high-status people (or institutions) (or institutions)
  • Excessive adoration is required.
  • is filled with self-righteousness (i.e. unreasonable expectation of especially favourable treatment or automatic compliance with their expectations)
  • Is interpersonally exploitative (i.e., takes advantage of others to achieve their own ends) (i.e., takes advantage of others to achieve their own ends)
  • One who doesn’t understand the feelings and needs of others lacks empathy.
  • Is often envious of others or believes that others are envious of them
  • Displays conceited and conceited behaviour and attitude

Narcissistic personality disorder has many different types and subtypes, despite the fact that the above criteria appear to be fairly straightforward. For example, a “overt” subtype that is more grandiose and boisterous will show little evidence of anxiety. In contrast, an individual who is more of a “covert” subtype will be more fragile, thin-skinned and hypersensitive to others’ slights. It doesn’t matter how these characteristics appear; both are characterised by a focus on oneself, and a person can easily swing between the two.

When to Seek Assistance

Because of the nature of narcissistic personality disorder, an individual may be unwilling or unable to seek treatment on their own because they do not perceive anything wrong with themselves. Depression, substance abuse, and other symptoms of this disorder make it more likely that someone will look into treatment options, and treatment may be difficult to accept because it is seen as a slight or insult. Feeling help from a doctor or mental health professional can be a lifesaver if you’re struggling with narcissistic personality disorder or simply need someone to talk to about your feelings of sadness.

Causes and Consequences of Narcissistic Personality Disorder

Professionals in mental health know how personality disorders develop, but they don’t know what causes them. It is generally accepted that a number of factors, including but not limited to:

  • Trauma in any form during childhood
  • Anxiety about how you’ll get along with your parents, siblings, or other relatives.
  • Genetics
  • In childhood, being overly sensitive to things like texture, sound, and light
  • Personality or temperament

Generally speaking, narcissistic personality disorder impacts more men than women, and starts showing signs during the teenage years or early adulthood. It is important to note that some children may show signs of narcissism, but this is mostly typical of their age and does not mean a disorder will be developed. Overprotective or neglectful parenting may contribute to the emergence of narcissistic personality disorder in biologically vulnerable children, but no one knows for sure.

If left untreated, some complications of narcissistic personality disorder can include:

  • Relationship difficulties
  • Problems at work or school
  • Anxiety and depressive disorders
  • Physical health problems
  • Misuse of drugs or alcohol
  • Suicidal ideation or conduct

Looking for a Narcissistic Personality Disorder (NPD) Diagnose

Getting help for narcissistic personality disorder can be as simple as going to a doctor and having a diagnosis made. Any qualified mental health professional (psychologist, for example) has the training and expertise to properly diagnose someone like this in the first place. In an initial session, the mental health professional will go over what is causing a person distress and review any long-term patterns of thinking, feeling, behaving, and engaging with others.

An assessment of personality traits, such as those associated with narcissism, may also be performed by a therapist as part of the diagnosis process. The key is to answer questions honestly to provide true insight into how you think. The following are examples of diagnostic tests that may be used:

  • Self-report instrument for diagnosing personality disorders, the PDQ-4 (personality diagnostic questionnaire-four)
  • Millon clinical multiaxial inventory III (MCMI-III) — This tool reports patient personality characteristics and an assessment of clinical syndromes
  • International personality disorder examination (IPDE) — This is a structured clinical interview that is used to assess the major categories of personality disorders

Treating Narcissistic Personality Disorder

There are a variety of long-term treatment options for narcissistic personality disorder, and they are all intended to help a person gain greater insight into their problems and help manage them. A combination of psychotherapy (also known as talk therapy) and pharmaceuticals is used to treat these conditions. In addition to helping people with this disorder better relate to others, improve their self-esteem, and lower their unrealistic expectations of others, finding the right treatment combination can help them. Often, treatment will also help address symptoms occurring alongside narcissistic personality disorder, such as depression or other mental health conditions.

Inpatient therapy (or Talk Therapy)

Narcissistic personality disorder treatment is generally centred around talk therapy. Talk therapy is effective in helping the individual relate better to others to make their relationships more enjoyable and rewarding. As a result, it’s easier to figure out why someone feels a certain way or why they compete or have low self-esteem. Talk therapy can also help someone accept responsibility and learn to:

  • Accept and maintain real personal relationships and collaboration with co-workers
  • Recognize and accept actual competence and potential to better tolerate criticisms
  • Increase the ability to understand and regulate feelings
  • Understand and tolerate the impact of issues related to self-esteem
  • Let go of your desire for unattainable ideals and conditions and learn to accept what is actually feasible.

Personality traits can be difficult to shift so it may take a few years of consistent therapy before any tangible improvements are made. Stay positive and committed to your treatment by attending all therapy sessions and taking your medications as directed. Over time, the positive differences and improvements will make the process worth it.


While there are no specific medications used to treat narcissistic personality disorder, a medical professional may recommend certain medications to treat underlying symptoms of anxiety and depression. These medications may include:

Treatment with antidepressant medications aims to alleviate depression symptoms by regulating the primary chemical processes that are responsible for the condition of depression.

Anti-manic and anti-depressive medications — Mood stabilisers are drugs used to treat bipolar disorder and can help reduce mood swings.

Antipsychotic drugs — These medications can reduce or relieve symptoms of psychosis, such as delusions (false beliefs), as well as help with symptoms of depression and anxiety. Aripiprazole and risperidone are two kinds of antipsychotic drugs that may be prescribed.

Lifestyle Changes

A person with narcissistic personality disorder may feel that psychotherapy and any medications prescribed are unnecessary, but it is important to stick to the treatment plan put forward by your doctor to actually see results. As you follow a treatment plan, be sure to avoid alcohol, drugs and other substances that can trigger negative behaviour, while getting in regular exercise and finding relaxation techniques to de-stress. Throughout treatment, keep in my mind the following to stay motivated:

  • Keep an open mind — Focus on the rewards of treatment.
  • Stick to your treatment plan — Attend scheduled therapy sessions and take any medications as advised. Even if you experience setbacks, it doesn’t mean that your treatment isn’t doing its job.
  • Stay focused on your goal — Stay motivated by keeping your goals in mind and reminding yourself that you can work to repair damaged relationships and become more at peace with your life.
  • Get treatment for alcohol or drug misuse or other mental health problems —
  • A vicious circle of dependency and self-destructive behaviour can be created when the emotions of depression, anxiety, and stress are all exacerbated by one another. Seek treatment to stop these unhealthy patterns whenever possible.

Getting Ready to Seek Help

The first time you speak to your doctor about narcissistic personality disorder might feel intimidating. Keep in mind that they will likely refer you to a mental health provider for talk therapy and ask specific questions about your mental health, personal information, medical background and inquire about any medications you are taking. You might want to come up with a list of questions ahead of time to help you feel more confident during your initial discussion. These may include:

  • What type of disorder do I have?
  • Is it possible that I’m suffering from something else?
  • What is the treatment’s end goal?
  • What treatments are most likely to be effective for me?
  • How much do you expect my quality of life may improve with treatment?
  • Approximately how many times a week and for how long should I expect to attend therapy?
  • Would family or group therapy be helpful in my case?
  • Are there any medications that can help me with the symptoms I’m having?
  • These are the other health issues I’m dealing with. How can I best manage them together?
  • Can you provide me with any printed materials, such as brochures? What websites do you recommend?

With help, the symptoms of narcissistic personality disorder will improve over time. However, the advantages of medication and therapy treatments are dependent on the severity of your symptoms and the degree to which you are willing to fully commit to treatment. Staying motivated and actively working toward change is the only clear way to mend relationships and find greater happiness.

You should keep in mind that narcissistic personality disorder is a mental health condition and that there are many different types of personality disorders. Those with this diagnosis may come across as arrogant and conceited, but beneath their tough and difficult exterior lies a fragile sense of self-worth that is easily shattered by the slightest criticism. All of the long-term treatment options available for this mental illness are geared toward helping the patient better understand and manage their problems. Psychotherapy and medication are the mainstays of these approaches, which aim to alleviate unpleasant symptoms while also promoting long-term progress.

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