Narcissistic personality disorder (NPD) is a mental disorder in which people have an inflated sense of their own importance and a deep need for admiration. Those with narcissistic personality disorder believe that they're superior to others and have little regard for other people's feelings. But behind this mask of ultra-confidence lies a fragile self-esteem, vulnerable to the slightest criticism. Narcissistic personality disorder is one of several types of personality disorders, and its treatment is centred around psychotherapy.
Symptoms
The disorder is characterised by dramatic, emotional behaviour, in the same category as antisocial and borderline personality disorders, and may include:
• Believing that you're better than others
• Fantasising about power, success and attractiveness
• Exaggerating your achievements or talents
• Expecting constant praise and admiration
• Believing that you're special and acting accordingly
• Failing to recognise other people's emotions and feelings
• Expecting others to go along with your ideas and plans
• Taking advantage of others
• Expressing disdain for those you feel are inferior
• Being jealous of others
• Believing that others are jealous of you
• Trouble keeping healthy relationships
• Setting unrealistic goals
• Being easily hurt and rejected
• Having a fragile self-esteem
• Appearing as tough-minded or unemotional
When to see a doctor
When you have narcissistic personality disorder, you may not want to think that anything could be wrong-doing so wouldn't fit with your self-image of power and perfection. But by definition, narcissistic personality disorder causes problems in many areas of your life, such as relationships, work, school or your financial affairs. You may be generally unhappy and confused by a mix of seemingly contradictory emotions. Others may not enjoy being around you, and you may find your relationships unfulfilling. If you notice any of these problems in your life, consider reaching out to a trusted healthcare provider or mental health provider.
Causes
It's not known what causes narcissistic personality disorder. As with other mental disorders, the cause is likely complex. Some evidence links the cause to a dysfunctional childhood, such as excessive pampering, extremely high expectations, abuse or neglect. Other evidence points to genetics or psychobiology-the connection between the brain and behaviour and thinking.
Risk factors
Narcissistic personality disorder is rare, and affects more men than women. It often begins in early adulthood, and although some adolescents may seem to have traits of narcissism, this may simply be typical of the age and doesn't mean they'll go on to develop narcissistic personality disorder. Risk factors for narcissistic personality disorder may include:
• Parental disdain for fears and needs expressed during childhood
• Lack of affection and praise during childhood
• Neglect and emotional abuse in childhood
• Unpredictable or unreliable caregiving from parents
• Learning manipulative behaviours from parents
Complication and treatment
If left untreated, NPD can lead to substance abuse, alcohol abuse, depression, suicidal thoughts or behaviour, eating disorders, particularly anorexia nervosa, relationship difficulties, and problems at work or school. Narcissistic personality disorder treatment is centred around psychotherapy. There are no medications specifically used to treat the disorder. However, if you have symptoms of depression, anxiety or other conditions, medications such as antidepressants or anti-anxiety medications may be helpful. Because personality traits can be difficult to change, therapy may take several years. The short-term goal of psychotherapy is to address such issues as substance abuse, depression, low self-esteem or shame. The long-term goal is to reshape your personality, at least to some degree, so that you can change patterns of thinking that distort your self-image and create a realistic self-image.