Narcissistic personality disorder (NPD) is a complicated condition often found alongside other emotional and personality issues. Individuals with NPD are often seen as self-absorbed, lacking understanding of others’ feelings, and craving constant attention and approval. However, there’s more to it than just these surface traits.

People with NPD may encounter difficulties in their relationships due to how others perceive them and their behaviors.

Therapy and expert guidance can sometimes assist them in developing new ways to relate to others and handle the mood swings that often accompany this personality disorder.

What is Narcissistic Personality Disorder?

Narcissistic personality disorder (NPD) is when someone consistently shows off, craves attention, and doesn’t really care about others’ feelings, according to the Diagnostic and Statistical Manual of Mental Disorders (DSM–5). It’s put in the “Personality Disorders” category. People with NPD often have other mental health issues as well.

People with NPD might get upset if they don’t get the praise or special treatment they think they deserve. Others might see them as stuck-up and full of themselves and might not want to be around them.

NPD can mess up different parts of a person’s life, like their job, school, and relationships.

Since NPD is part of the cluster B personality disorders, it means those who have it tend to:

• Be overly dramatic and blow things out of proportion
• Show a lot of emotions and be intense about them
• Act in unpredictable and erratic ways

Not everyone with NPD acts exactly the same, though.

What Narcissistic Personality is?

Most of us might exhibit some narcissistic traits at times in our lives, but these behaviors or attitudes typically differ from a full-blown personality disorder in terms of severity, frequency, and duration.

However, for some individuals, these narcissistic traits can become so intense and persistent that they significantly affect their relationships and self-perception in harmful ways.

Occasional displays of narcissistic behavior might arise in certain situations. For example, you might find yourself engaging in rivalry with a specific co-worker, leading you to make snide remarks or exaggerate your achievements when they’re around. However, this behavior is limited to that specific circumstance and doesn’t reflect a general attitude toward others.

In contrast, individuals with NPD exhibit a consistent pattern of narcissistic traits across various situations. For instance, they might constantly view themselves as superior to others, harbor ongoing rivalries with multiple people, and believe they deserve higher positions in every aspect of life. 

Symptoms and Diagnosis of Narcissistic Personality Disorder

The symptoms vary in intensity from person to person, but to receive a diagnosis, an individual must consistently exhibit at least five of them over time and in different situations.

Grandiosity and Sense of Self-importance

They may exaggerate their abilities, achievements, and charm to reaffirm their superiority.

Fantasies of Perfection and Superiority

They may constantly fantasize about having limitless power, intelligence, or beauty, believing they deserve it more than others.

Believe They Are Special

Those with NPD feel a need to emphasize their uniqueness.

Need for Excessive  Praise and Attention

They may react poorly to criticism and resent those who don’t view them as exceptional.

Sense of Entitlement

They may expect others to fulfill their demands and become resentful if their expectations are not met.

Exploitative

They may use others to achieve their goals without regard for the well-being of others.

Lack Empathy

This can lead to selfish behavior and a lack of empathy and compassion.

Jealousy, Envy, and Distrust

Individuals with NPD often believe others are envious of them and may harbor jealousy toward others’ accomplishments. They may also distrust others, feeling they are in constant competition.

Arrogance

Some individuals with NPD display arrogance and contempt toward others, considering them inferior or unworthy.

A diagnosis of Narcissistic Personality Disorder is usually made by a psychiatrist, psychologist, or another mental health professional who has direct access to the individual and their medical history. Diagnosis involves assessment of long-standing patterns of behavior and functioning.

What Causes Narcissistic Personality Disorder?

The causes of NPDr are complex. Some studies indicate that there might be a genetic tendency toward the disorder. People with NPD often show traits like being aggressive, having a low tolerance for stress, and struggling to regulate their emotions effectively.

Negative experiences during childhood, such as feeling rejected, and having a fragile ego early on, could play a role in developing NPD later in life. On the other hand, getting excessive praise as a child, even to the point of being told they’re exceptionally talented, might also contribute to NPD.

Treatment of Narcissistic Personality Disorder

Treatment for NPD mainly involves talk therapy, also called psychotherapy.

If NPD symptoms occur alongside depression or another mental health issue, medications may be prescribed to address those conditions. However, there are no specific medications to treat NPD itself.

Talk therapy 

It aims to help individuals with NPD improve their relationships and overall well-being. It can assist in:

• Learning better ways to interact with others for more fulfilling relationships.
• Enhancing collaboration with co-workers and peers.
• Developing and maintaining personal relationships.
• Recognizing strengths and managing criticisms or setbacks.
• Understanding and managing emotions.
• Dealing with self-esteem issues.
• Setting realistic goals.

Lifestyle changes

In addition to therapy, lifestyle changes can support the therapeutic process:

• Avoiding substances that may worsen problematic behaviors.
• Adopting healthy habits.
• Practicing relaxation techniques like yoga or meditation to reduce stress and anxiety.

Summary

Narcissistic personality disorder (NPD) is a recognized mental health condition, not simply a choice of behavior. It necessitates a formal diagnosis from a qualified mental health professional. 

The typical symptoms include a profound sense of entitlement and superiority, a constant need for attention, and a lack of empathy. These symptoms significantly influence how individuals interact with others and perceive themselves.

With dedication to long-term therapy, individuals can learn to manage NPD symptoms effectively. Therapy helps regulate emotions and encourages the transformation of harmful behaviors into healthier ones.

References

1. Caligor, E., Levy, K. N., & Yeomans, F. E. (2015). Narcissistic personality disorder: Diagnostic and clinical challenges. American Journal of Psychiatry, 172(5), 415–422. https://doi.org/10.1176/appi.ajp.2014.14060723 
2. Diagnostic and statistical manual of mental disorders, 5th edition, text revision (DSM-5-TR). (2022). Washington, D.C.: American Psychiatric Association Publishing.
3. Mitra, P. (2023, March 13). Narcissistic personality disorder. StatPearls [Internet]. 
4. Pincus, A. L., & Lukowitsky, M. R. (2010). Pathological narcissism and narcissistic personality disorder. Annual Review of Clinical Psychology, 6(1), 421–446. https://doi.org/10.1146/annurev.clinpsy.121208.131215 
5. Weinberg, I., & Ronningstam, E. (2022). Narcissistic personality disorder: Progress in understanding and treatment. FOCUS, 20(4), 368–377. https://doi.org/10.1176/appi.focus.20220052