The Background

It’s a nice feeling to be admired. It naturally makes us feel good and feel important. And, yes, we sometimes boast and brag on ourselves as well. But, if people start describing you as cocky, manipulative, and demanding, you might be suffering from a more serious condition. Narcissistic personality disorder is a mental disorder affecting approximately 1% of the population, with a greater prevalence in men than women. It is characterized by an inflated sense of self-importance, a lack of empathy for others, and a great need for admiration. The hallmark definition of narcissistic personality disorder is grandiosity – the exaggerated sense of self-importance.  If you are living with this disorder, you may be preoccupied with power, prestige, vanity, and may think you deserve special treatment and fame.

Narcissistic personality disorder should not be confused with high self-confidence and self-esteem. Those with high self-esteem are still humble. If you are living with narcissistic personality disorder, you are likely selfish, boastful, and ignore others’ feelings and needs.  It was once thought that individuals suffering from narcissistic personality disorder have high self-esteem on the surface, but deep down are insecure. This theory was supported by the defensive state these individuals enter when provoked. Recent research discounts the earlier theory and now indicates that if you are suffering from narcissistic personality disorder, you likely also have high self-esteem – both on the surface and below the surface.

If you are living with narcissistic personality disorder, it is probably affecting your everyday life. . . in a negative way. In general, you may be unhappy with life in general and disappointed when others are not admiring you or giving you special treatment and attention. Your work, personal, and social relationships are likely suffering, though, you are unable to see your own role in these occurrences. Individuals with narcissistic personality disorder are unable to realize the damaging effects their behavior is causing themselves and others. If you have this condition, people likely will not enjoy being around you and you may feel unfulfilled at work, home, and in your social life.

What are the Symptoms?

Monopolizing conversations? Feelings of entitlement? Belittling others? These are all classic signs of narcissistic personality disorder. Do you know of someone who knows the “right” way and all other ways are wrong? Are they cocky, lack empathy, and think they are largely important? Then it’s possible they might be suffering from this condition.

Signs & Symptoms

Included below is a list of some well-recognized symptoms of narcissistic personality disorder.

• Preoccupied with fantasies of unlimited success
• Belief of great self-importance; only understood and should only associate with individuals of high-status
• Expectations of being realized as superior
• In need of and requiring constant admiration
• Exaggeration of achievements and talents
• Possessing a sense of entitlement
• Being envious of others and the exaggerated belief that others are envious of you
• Thinking about oneself the majority of the time and talking about oneself a lot; self-promotion
• Setting of unrealistic goals
• Expectation that others should do special favors for you
• Belief that nobody should question your motives and should have unwavering compliance with your requests
• Taking advantage of others to move forward in life and/or to get what you want, with no remorse toward the ones you stepped on to get there
• Arrogance, haughtiness
• Easily rejected, hurt
• Unemotional
• Power seeking
• Demonstrates superiority
• Responds to criticism with shame, anger, and humiliation
• Easily jealous

Oftentimes, individuals are initially attracted toward people with narcissistic personality disorder. You may find yourself attracted to the confidence, assertiveness, and excitement that surrounds a person with narcissistic personality disorder. However, getting to know the person in depth, you may start to despise the very same traits that initially attracted you to the person. This, of course, after realizing their unemotional response to relationships, the unattractiveness of their lack of empathy for others, and the grandiose belief they are greatly important and you should treat them as such.

What Causes Narcissistic Personality Disorder and How is it Diagnosed?

There is not a single defined cause of narcissistic personality disorder. But, researchers agree that both genetic and environmental causes are at play. Individuals with narcissistic personality disorder have been found to have less volume of gray matter in the left anterior insula, the part of the brain related to empathy, emotional regulation, compassion, and cognitive functioning.

Many of the traits of narcissistic personality disorder occur during normal stages of development. Scientists believe that full onset of narcissistic personality disorder may occur when interpersonal development during these phases is conflicted. Examples of types of negative or destructive interpersonal environments interacting with developmental phases include:

• Being born with an oversensitive temperament
• Learning manipulative behavior from parents or peers
• Being excessively praised for good behaviors and excessively criticized for bad behaviors
• Suffering from severe childhood abuse
• Inconsistent parental care giving – unreliable or unpredictable care
• Being overindulged by parents, peers, or family members
• Being excessively admired with no realistic feedback to balance you with reality
• Receiving excessive praise from parents or others over your looks or abilities

If you are suffering from narcissistic personality disorder, you might never head to the doctor for a diagnosis. Studies have shown that people suffering from this condition rarely enter treatment. If you do enter treatment, progress will be slow. However, if you or a loved one is suffering from narcissistic personality disorder, it’s important to get treatment. Prepare for your appointment by taking note of symptoms, personal experiences, medications, and your medical history. Your doctor will conduct a physical examination to rule out any underlying conditions and will then refer you to a mental health provider. A mental health provider will ask you a number of questions to gather information about your symptoms and the effects they are having on your life.

What are the Treatment Options?

Psychotherapy is the key approach in the treatment of narcissistic personality disorder.  Psychotherapy, also known as talk therapy, is used to help you learn how to relate to others better to encourage more functional interpersonal relationships and to gain a better understanding of your emotions and why you feel the way you do.

As noted above, the treatment prevalence for individuals living with narcissistic personality disorder is low and slow going. Because treatment is focused on personality traits, which are pretty steady over time, it may take many years of psychotherapy before realizing a break through. Change behaviors are focused on accepting responsibility for your actions and learning ways to engage inter personally in a more appropriate manner. These include:

• Accepting and maintaining relationships with co-workers and family
• Tolerating criticisms and failures
• Understanding and regulating your feelings
• Minimizing your desire to attain unrealistic goals and ideal conditions

There are no known medications to treat narcissistic personality disorder. But, oftentimes if you are living with this condition, you might also be living with depression and anxiety. Medications are helpful for these conditions and may be used to treat those. Individuals living with narcissistic personality disorder are also at a greater likelihood of abusing drugs and alcohol – so treatment for addiction problems is also beneficial in treating this condition.

Keep an open mind toward treatment, stick to treatment plans, educate yourself about your condition, and stay focused on your goal. You may feel negative toward treatment, but know that it can help.