In our society, the word ‘narcissist’ is sometimes thrown around as an adjective to describe individuals who may be vain or self-righteous. If someone is acting ‘narcissistic’, it might mean that the person is acting in self-serving ways or comes off as if they are totally in love with themselves. Because this word gets used so much in everyday life, many people may forget just how serious of a condition narcissism truly is. Affecting nearly 5-6% of the human population, narcissistic personality disorder is fairly common. It has the potential to cause true dysfunction and societal strain for those with the condition and the people around them. In this blog, we will explore the signs, symptoms, and treatment options that accompany narcissistic personality disorder (NPD) and how understanding these symptoms can help protect individuals who suffer from the condition and those who surround them in their daily lives. 


What is NPD?

Narcissistic personality disorder, or NPD, is a mental disorder that causes individuals to have a grandiose, highly-elevated sense of self. For individuals with the condition, they believe that they have a higher importance than others, and while it may seem like they genuinely have high levels of self-esteem, it is not necessarily genuine. Those with NPD are enamored and in love with a version of themselves that is idealized. In order to avoid deep feelings of insecurity, narcissists convince themselves that the inflated, grandiose version of themselves is the true person that exists and they become completely taken with this idea. The term ‘narcissism’ actually originates from the Greek myth about Narcissus, a young hunter in mythology who came across his own reflection in some water and became completely obsessed with himself. Essentially, Narcissus could not pull himself away from staring at his own reflection because of how beautiful he believed he was. He was convinced that no one else in the world would be able to match his level of attractiveness, and his obsession with himself eventually got him turned into a flower. Now, of course this is not how narcissism really works and this situation does not identify what many narcissistic individuals will present as. It is a display, however, of how unreasonably high narcissists’ sense of self-importance is. 

NPD is one of the 10 diagnosable personality disorders, which are a set of mental conditions in which an individual has an unhealthy, inflexible pattern of thinking and feeling about oneself or others that lead to significant and adverse effects in many aspects of their life. In a recent blog, we looked at one of the other personality disorders known as dependent personality disorder, or DPD. The 10 personality disorders are

divided up into 3 clusters, known as Cluster A, Cluster B, and Cluster C. Cluster A disorders generally include individuals that have suspicious thinking patterns, a lack of interest in others, and overall “weird” behaviors. Cluster B disorders characterize those who have dramatic, emotional, or “wild” behaviors. Finally, Cluster C disorders are characterized by anxious, fearful, “worried” thoughts and behaviors. As for NPD, it falls under the Cluster B category. In clinical settings within the United States, up to 15% of the population have varying degrees of NPD, while community samples show that up to 5% of individuals have NPD. NPD is more commonly diagnosed in women than in men, and studies show that there is a high prevalence of NPD among Black men, Black women, and Hispanic women. 

At one point or another, almost all individuals will display some attitudes or behaviors that characterize NPD. There are varying degrees to which a person may present with NPD, and there are two main subtypes of NPD: grandiose NPD and vulnerable NPD. 

Grandiose NPD is characterized by: 

  • Over self-importance 
  • Aggression 
  • Boldness 
  • Preoccupation with power and being perceived as attractive 
  • Entitlement 
  • Need to be admired 
  • Uncooperative 

Vulnerable NPD is characterized by: 

  • Hypersensitivity 
  • Defensiveness 
  • Sensitive to criticism 
  • Low-self esteem 
  • Defensive or passive aggressive personalities 
  • Jealous of other people, believes others are jealous of them 

Other types of narcissism include communal, antagonistic, and malignant narcissism. Communal narcissists may display themselves in a way to make others believe that they are altruistic and socially supportive. They want others to perceive them as caring and fair, but these individuals are truly motivated by a desire for social power and being superior to others. Antagonistic narcissists act as though they are always in competition with other individuals. They take a competitive approach to their

relationships and social interactions, and think that every situation is some type of competition of who can be the best. They present themselves as more hostile, aggressive, and almost like a bully. Lastly, malignant narcissists have more destructive personalities. This type of narcissist presents other characteristic symptoms of NPD, but they also take pleasure in watching other people struggle. These narcissists have more of a tendency to risk the safety of themselves and others. 


Symptoms of NPD

Those with NPD might find it more difficult to maintain well-functioning relationships in their personal lives or keep stable jobs. The disorder is known to be highly comorbid with other mental health conditions, and is also thought to have strong genetic and environmental developmental factors. For example, the aggression and dysfunctional behavior associated with NPD can be attributed to some genetic factors. In addition, early life events such as possible rejection as a young child or having a sensitive ego can contribute to the development of NPD as children grow into adults. By the opposite token, young children that are given unusually high praise may begin to believe that they are better than others and can also be led to developing NPD. 

Understanding NPD becomes more feasible when one understands some of the symptoms and thinking patterns that narcissists harbor. Here are some common symptoms of NPD: 

  • Feel like they are too good for ‘average’ people, only want to be surrounded by those who are of equal or ‘high status’ 
  • Exaggerate or lie about accomplishments 
  • Be critical of those that they look down on 
  • Feel like they have special rights without actually having done anything Take advantage of others 
  • Have a belief that others envy them 
  • Wanting the best of everything for themselves in a selfish way 
  • Believing their achievements are better than everyone else’s 
  • Live in a ‘fantasy’ world where they are the center of everything Fantasies of being super successful, attractive, and powerful 
  • Defensive 
  • Desire for constant praise and attention to keep their egos inflated One-sided relationships 
  • Unable to compliment, praise, or support others 
  • Using others for their benefit 
  • Expect to be treated better than other people
  • Lack empathy 
  • Demeans and bullies other individuals 
  • Feeling threatened by other people who might threaten their success or power 

These, among many other symptoms, are some of the tell-tale signs that you may be dealing with a possible narcissist. While it can be very difficult to deal with narcissists, people with NPD typically do not want to believe that they have this condition. The knowledge of having a mental health condition can weigh heavy on an individual, and this is something that narcissists have a hard time accepting. When someone with NPD does not want help with their condition, it can be wise for those around them to learn how to protect themselves from being a victim to narcissists’ selfish and sometimes emotionally destructive tendencies. 

How to Support those who Suffer from NPD and Those Who Surround Them

At this time, there are no standardized modes of treatment to treat individuals with NPD. For those with this condition, research has revealed that long-term counseling is the best course of treatment as it enables narcissists to talk through their behaviors and see what changes need to be made. Narcissists can learn to develop a healthy level of self-esteem that comes from a true sense of fulfillment, and with time they also learn how to have realistic perceptions of others around them. Providers may also find that medication can be used in conjunction to supplement other forms of psychotherapies for NPD. Antidepressants, mood stabilizers, and even antipsychotics have shown some clinical benefits for patients as they treat anxiety, mood lability, and impulse control issues. 

If an individual lives in close proximity to someone with NPD, it can be extremely difficult but very important to set boundaries with that person. Those with NPD are very good at creating a fabricated, flattering image of themselves that draws people close to them. Unfortunately, this trap can cause individuals to become ‘victim’ to narcissists’ self-serving ways and that can lead to many issues. Narcissists prey on those who they want to become their admirers, not their partners. There are many steps and boundaries that individuals close to narcissists can take to protect the person with NPD and themselves. Services such as couples/family counseling, and support groups are always an option to consider when the weight becomes overwhelming. With the right support and treatment plan, those with NPD can learn how to fix the deep-rooted insecurities they may harbor and learn how to relate to others in their surroundings in a genuine way. It can make life more enjoyable, sociable, and truly fulfilling!

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