Narcissistic rage is an outburst of intense anger or silence that can happen to someone with narcissistic personality disorder.

Narcissistic personality disorder (NPD) happens when someone has an exaggerated or overly inflated sense of their own importance. It’s different from narcissism because NPD is linked to genetics and your environment.

Someone experiencing narcissistic rage may feel that someone else or an event in their life is threatening or may injure their self-esteem or self-worth.

They may act and feel grandiose and superior to others. For example, they may demand special treatment and honor even if it appears that they’ve done nothing to earn it.

People with NPD may have an underlying feeling of insecurity and feel unable to handle anything they perceive as criticism.

When their “true self” is revealed, a person with NPD may also feel threatened, and their self-esteem is crushed.

As a result, they may react with a variety of emotions and actions. Rage is only one of them, but it’s often one of the most visible.

Repeated unreasonable reactions happen to people with other conditions, too. If you or a loved one is frequently having these rage episodes, it’s important to get a proper diagnosis and find the best treatment.

We all desire attention and admiration from the people around us.

But people with NPD may react with narcissistic rage when they aren’t given the attention that they feel they deserve.

This rage may take the form of screaming and yelling. Selective silence and passive-aggressive avoidance can also happen with narcissistic rage.

Most episodes of narcissistic rage exist on a behavior continuum. On one end, a person may be aloof and withdrawn. Their goal may be to hurt another person by being absent.

On the other end are outbursts and explosive actions. Here again, the goal may be to turn the “hurt” they feel into an attack on another person as a form of defense.

It’s important to remember that not all angry outbursts are episodes of narcissistic rage. Anyone is capable of having an angry outburst, even if they don’t have a personality disorder.

Narcissistic rage is just one component of NPD. Other conditions might also cause episodes similar to narcissistic rage, including:

There are three primary reasons that narcissistic rage happens.

Injury to self-esteem or self-worth

Despite an oversized opinion of themselves, people with NPD are often hiding self-esteem that’s easily injured.

When they’re “hurt,” narcissists tend to lash out as their first line of defense. They may feel that cutting someone out or intentionally hurting them with words or violence can help them protect their persona.

A challenge to their confidence

People with NPD tend to try building up confidence in themselves by continually getting away with lies or false personas.

When someone pushes them and exposes a weakness, people with NPD may feel inadequate. That unwelcomed emotion can cause them to lash out as protection.

Sense of self is questioned

If people reveal that someone with NPD isn’t as capable or talented as they may pretend to be, this challenge to their sense of self may result in a cutting and aggressive outburst.

NPD can cause issues in a person’s life, relationships, work, and financial situation.

People with NPD often live with illusions of superiority, grandiosity, and entitlement. They may also face additional issues like addictive behavior and narcissistic rage.

But narcissistic rage and other NPD-related issues aren’t as simple as anger or stress.

A healthcare provider or a mental health specialist like a therapist or psychiatrist can diagnose symptoms of NPD. This can help someone with NPD and symptoms of rage find the proper help they need.

There are no definitive diagnostic tests. Instead, your healthcare provider will request and review your health history as well as behaviors and feedback from the people in your life.

how NPD is diagnosed

A mental health professional can determine if you have NPD based on:

  • reported and observed symptoms
  • physical exam to help rule out an underlying physical issue that could be causing symptoms
  • psychological evaluation
  • matching criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) by the American Psychiatric Association
  • matching criteria in the International Statistical Classification of Diseases and Related Health Problems (ICD-10), a medical classification list by the World Health Organization (WHO)

People in your life who have NPD and episodes of narcissistic rage have many resources to get help.

But it can sometimes be challenging to find the right help, as many treatment options haven’t been validated by research.

According to a 2009 report published in the Psychiatric Annals, there haven’t been many studies done on treatments for NPD and people who experience narcissistic rage as a symptom of NPD.

So while psychotherapy may work for some people, it’s not necessarily effective for all people with NPD. And not all mental health professionals even agree as to exactly how to diagnose, treat, and manage this disorder.

A 2015 study published in The American Journal of Psychiatrysuggests that the variety of symptoms that can happen in each individual with NPD can make it challenging to make a firm diagnosis of what “type” of NPD someone has:

  • Overt. Symptoms are obvious and easier to diagnose with the DSM-5 criteria.
  • Covert. Symptoms aren’t always visible or obvious, and behaviors or mental health conditions associated with NPD, like resentment or depression, may be hard to diagnose.
  • “High-functioning”. NPD symptoms may be difficult or impossible to consider separately from the person’s regular behavior or psychological state. They may just be identified as generally dysfunctional behaviors like pathological lying or serial infidelity.

Since conditions like NPD can often only be diagnosed by looking at observable symptoms, there may be many underlying personality traits or mental activities that are impossible to tease apart into a diagnosis.

But that doesn’t mean you shouldn’t seek help. Try speaking with several mental health professionals and try different techniques to see what kind of treatment plan works best for you.

And while you or the person with NPD in your life are working through their behaviors and history, others might also find it beneficial to seek professional help for themselves.

You can learn techniques to manage narcissistic rage when it occurs or to prepare for future episodes to minimize or process the mental and emotional turmoil you might feel during an episode.

At work

Limit engagement with the individual. Trust what they say but verify that what they’ve told you is either true or false.

People with NPD may talk up their accomplishments and abilities. But if you realize they can’t or don’t perform important tasks, prepare yourself to manage their future professional deficiencies.

Also, be cautious in giving direct feedback and criticism. This can spur an intense reaction in the moment, which may put you at personal or professional risk.

It’s not your responsibility to get the person to seek help. Your feedback or criticism may be one way you’re able to encourage the individual to seek help.

Talk to your manager or the other person’s manager or seek help from your company’s human resources (HR) department.

Here are some other strategies you can use to manage interactions with coworkers who may have narcissistic tendencies or episodes of rage:

  • write down every interaction you have with them in as much detail as possible
  • don’t escalate conflicts with the person, as this may end up causing harm to you or others in the workplace
  • don’t take it personally or attempt to get revenge on the person
  • don’t reveal too much personal information or express your opinions to the person that they may be able to use against you
  • try not to be in the same room alone with them so that others can be witnesses to their behaviors
  • report any illegal harassment, activities, or discrimination that you observe firsthand to your company HR department

In relationship partners

It’s possible to have a healthy, productive life with a person who has NPD and episodes of rage.

But both of you may need to seek out therapy and build behavior and communication strategies that work for your relationship.

People with narcissistic rage can be hurtful. Learning how to communicate with them may help you protect yourself from physical and emotional harm. Try some of the following strategies for coping with NPD:

  • present the truest version of yourself to your partner, avoiding any lying or deception
  • recognize NPD symptoms in your partner or yourself, and do your best to communicate what’s going through your head when you exhibit certain behaviors
  • don’t hold yourself or your partner to difficult or impossible standards, as these may exacerbate feelings of insecurity or inadequacy that lead to narcissistic rage
  • set forth specific rules or boundaries within your relationship so that you and your partner know what’s expected of them as a romantic partner, rather than react on a situational basis with no structure to your expectations
  • seek therapy both individually and as a couple so that you can work on yourself and on the relationship in tandem
  • don’t think of yourself or your partner as having anything “wrong” but identify areas that may be disruptive to the relationship that need work
  • be confident in ending the relationship if you no longer believe a relationship is healthy for you or your partner

In friends

Limit your exposure to any friend who subjects you to physical, mental, or emotional harm from narcissistic rage.

You may want to consider removing yourself from your friendship entirely if you believe the friendship is no longer healthy or mutually beneficial.

If this is a close friend whose friendship you value, you might also seek help from a mental health professional.

They can help you learn behaviors that make coping easier. You may also learn behaviors that can help you better manage interactions and communicate with your friend during episodes of rage.

This can make your time together less frustrating and more fulfilling or productive.

From a stranger

The best option is to walk away. Neither you nor that person will likely be able to reach any constructive conclusion from your interaction.

But realize that your actions didn’t cause the reaction. It’s driven by underlying factors that you don’t in any way influence.

A mental health professional can help treat both NPD and rage.

They can use talk therapy, or psychotherapy, to help people with NPD understand their behaviors, choices, and consequences. Therapists may then work with the individual to address underlying factors.

Talk therapy can also help people with NPD create new plans for behavior to develop healthier coping and relationship skills.

Help if you feel threatened
  • People with NPD and narcissistic rage can hurt people in their lives, even when they don’t realize it. You don’t need to live with the constant worry about future rage. You can take steps to protect yourself.
  • If you’re afraid a person with NPD in your life may cross over from verbal abuse to physical abuse or you think you’re in immediate danger, call 911 or local emergency services.
  • If the threat isn’t immediate, seek help from the National Domestic Abuse Hotline at 800-799-7233. They can connect you with service providers, mental health professionals, and shelters in your area if you need assistance.

Help is available for people with NPD and narcissistic rage. With proper diagnosis and ongoing treatment, it’s possible to live a healthy, rewarding life.

In the moment, the rage may seem all-consuming and threatening. But encouraging a loved one (or yourself) to seek help may spur healthier choices for you, them, and everyone else in your lives.