Narcissistic Personality Disorder

Written by Michael Kerr | Published on June 14, 2012
Medically Reviewed by George Krucik, MD

What Is Narcissistic Personality Disorder (NPD)?

Narcissistic personality disorder (NPD) is a mental condition in which sufferers have an inflated opinion of themselves and an intense need for the admiration and attention of others.

Identifying Narcissistic Personality Disorder Behaviors

Narcissists are usually described as arrogant and self-centered. People with NPD can be defensive and may react poorly to criticism. They often exaggerate their own talents and accomplishments while downplaying those of others. They are usually preoccupied by power, success, and beauty. Sufferers often engage in impulsive behaviors, such as risky sex and gambling.

Causes of Narcissistic Personality Disorder

The causes of NPD aren’t well understood. Inherited genetic defects are thought to be responsible for up to 50 percent of cases. Contributing environmental factors may include childhood abuse or neglect, excessive pampering, or unrealistic expectations from parents. Other causes may include sexual promiscuity, peer influence, and cultural role models (i.e. from TV). The condition usually appears in early adulthood.

Symptoms of Narcissistic Personality Disorder

People with NPD are often good looking and charming. They may even have early successes in relationships or careers. However, their early luck can run out.

Because it goes against their self-image, NPD sufferers usually don’t recognize that they have a problem. Signs you may have NPD include:

  • others avoid you
  • your relationships are unfulfilling
  • you have ongoing problems financially, at work, in relationships, or in school
  • you are unhappy and confused when things aren’t going your way
  • you have problems with alcohol or drugs (in addition to other symptoms)

NPD and Self-Esteem

It was once thought that people with NPD had low self-esteem because of their poor reaction to criticism. However, new research shows that they actually havehigh self-esteem. In fact, a person with NPD can be secure to the point of aggressiveness. It is important to note that high self-esteem and NPD are not the same thing. People with high self-esteem are usually humble, while narcissists almost never are.

Treatment for Narcissistic Personality Disorder

Treatment for NPD is primarily psychotherapy. A counselor will encourage sufferers to become more empathetic toward others. Developing positive interactions with others can greatly improve the narcissist’s life.

If symptoms of NPD occur alongside depression or other conditions, an antidepressant or an antianxiety medication may be used.

Long-Term Outlook

The benefits of treatment may vary depending on how severe the person’s NPD is. However, symptoms of NPD usually diminish greatly by age 30 without any intervention.

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