Narcissistic Personality Disorder

What is narcissistic personality disorder?

Narcissistic personality disorder (NPD) is a pattern of feeling more important than others, needing to be admired, and being unable to identify with the feelings of others. It is normal and healthy to be concerned about your own well-being. However, people who have NPD carry this to an extreme.

How does it occur?

No one really knows why people develop NPD. One theory is that children who are made to feel bad by not getting regular attention, love, and support start to believe that they have to be someone extra special just to be accepted. They may actually have very fragile self-esteem. A person with NPD may not show it, but is easily hurt and rejected. This often happens because their expectations are so high. Their relationships with other people tend to be very poor.

Other possible causes may include genetics, environment, and trauma or abuse in childhood. No biological cause has been found for narcissism. Most people diagnosed with this disorder are men, but it can occur in women as well. Narcissism usually becomes a problem in the teen or early adult years.

What are the symptoms?

People who have NPD have at least 5 of the following characteristics.

believing and acting like they are better than others
constantly fantasizing about success, power, or beauty
believing that they are special and can only be understood by other special people
expecting everyone to admire them and go along with what they want
taking advantage of other people
not recognizing or identifying with other people's feelings
being jealous of what other people have or thinking others are jealous of what they have
acting stuck-up
being unable to maintain healthy relationships.

Many people show some signs of narcissism. However, when these signs interfere with your life and ability to function, it is considered a disorder.

How is it diagnosed?

A health care provider or therapist will ask about the person's symptoms. They may also be asked to complete a personality test. The therapist will also rule out depression or other mental health problems.

How is it treated?

People may resist treatment because they find it hard to admit that something is wrong. Psychotherapy can help them see themselves more clearly. It helps them recognize the effects of their behavior on others. This can help them change behaviors that get in the way of living a satisfying life. Psychotherapy usually takes several years. Treatment goals include helping the person to:

admit that they have some weaknesses and shortcomings
gain greater self-control
better understand and accept themselves and other people.

Medicines, such as antidepressants or anti-anxiety medicines, may be prescribed if the person is also depressed or anxious.

When should I seek help?

If you are having personal, social, family, work, or legal problems as a result of your attitudes and behaviors, get treatment.

For more information, contact the National Mental Health Association (NMHA). NMHA's toll-free Information Center number is 1-800-969-NMHA. The Web site address is http://www.NMHA.org.

Disclaimer: This content is reviewed periodically and is subject to change as new health information becomes available. The information provided is intended to be informative and educational and is not a replacement for professional medical evaluation, advice, diagnosis or treatment by a healthcare professional.

HIA File BHV3342F.HTM Release 9.0/2006