People with narcissistic personality disorder (NPD) have an exaggerated sense of their importance. They also desire external praise and attention. Therapy can help them manage their symptoms.
Narcissistic personality disorder (NPD) is a personality disorder in which people have an inflated opinion of themselves. They also have an intense need for the admiration and attention of others.
People with NPD may be unhappy and disappointed when they don’t receive the praise or special favors they believe they deserve. Others may see them as snobbish and conceited and may not enjoy being around them.
NPD can cause problems in many areas of a person’s life, including:
NPD may affect
People with NPD are usually described as:
They often have high self-esteem and may believe they’re special or superior to others. However, they seem to need excessive praise and admiration and may react poorly to perceived criticism.
Narcissists also tend to exaggerate their talents and accomplishments while downplaying those of others. They’re usually preoccupied with power, success, and beauty. They might even engage in impulsive behaviors, such as gambling or certain sexual behaviors.
Some traits of NPD may appear similar to confidence, but healthy confidence and NPD aren’t the same.
People with healthy self-esteem are usually humble, while people with NPD seldom are. They tend to put themselves on a pedestal and perceive themselves as better than everyone else.
Overt narcissism vs. covert narcissism
There are two subtypes of narcissistic personality disorder (NPD): overt and covert.
Overt and covert narcissism share many of the same traits and symptoms, but people with these subtypes may interact with others in different ways. People with covert narcissism are more likely to have traits not typically associated with NPD, such as shyness and low self-esteem.
NPD usually appears in early adulthood.
People with the disorder may not recognize that they have a problem since having a problem goes against their self-image. You may have NPD if:
- you come across as pretentious and boastful, causing others to avoid you
- your relationships are unfulfilling
- you become unhappy, angry, and confused when things don’t go your way
- you have ongoing issues with:
If you believe you have NPD, schedule an appointment with a doctor or mental health professional. They can determine whether you have this personality disorder and suggest treatments to help you manage your symptoms.
The causes of NPD aren’t well-understood.
Genetics are thought to be at least partly responsible for many cases of NPD. Contributing environmental factors may include:
- childhood abuse or neglect
- excessive parental pampering
- unrealistic expectations from parents
According to a 2021 study, research is mixed on whether narcissism is more common in individualistic cultures than in collectivistic cultures.
Doctors and mental health professionals often use the “Diagnostic and Statistical Manual of Mental Disorders, 5th edition, text revision (DSM-5-TR),” published by the American Psychiatric Association, to diagnose mental health conditions, such as NPD.
The DSM-5-TR diagnostic criteria for NPD include the following traits:
- having an inflated sense of self-importance and entitlement
- needing constant admiration and praise
- expecting special treatment due to perceived superiority
- exaggerating achievements and talents
- reacting negatively to criticism
- being preoccupied with fantasies about power, success, and beauty
- taking advantage of others
- having an inability or unwillingness to recognize the needs and feelings of other people
- behaving in an arrogant manner
A doctor or mental health professional may ask you to fill out a questionnaire to help determine whether you meet these criteria. They may also test you for other mental disorders and health conditions.
Treatment for NPD primarily consists of talk therapy, also known as psychotherapy.
If symptoms of NPD occur alongside depression or another mental health condition, you may take medications to treat the other condition. There are no medications to treat NPD.
Talk therapy can help you learn how to relate better to others so your relationships can become more enjoyable, intimate, and rewarding. Developing positive interactions with other people can greatly improve various areas of your life.
Talk therapy can also show you how to:
- improve collaboration with your co-workers and peers
- maintain personal relationships
- recognize your strengths and potential so you can tolerate criticisms or failures
- understand and manage your feelings
- cope with any self-esteem issues
- set realistic goals for yourself
Since personality traits can be difficult to change, it may take several years of therapy before you see an improvement. During this time, you may begin to see therapy as a waste of time and be tempted to quit. However, it’s important to stick with it. You can connect to a mental health professional using the Healthline FindCare tool.
Attend all your therapy sessions and take any medications as directed. With time, you may see a difference in yourself and your relationships with others.
The following lifestyle changes may help you as you go through therapy:
- Avoid substances that may trigger problematic behaviors.
- Identify and pursue healthy habits.
- Engage in relaxation techniques such as yoga and meditation to help reduce stress and anxiety.
The benefits of treatment may vary depending on your symptoms’ severity and your willingness to commit to treatment.
In general, symptoms of NPD usually improve over time, though successful treatment takes time and can be challenging.
If you stay motivated and actively work toward change, you’ll likely be able to repair damaged relationships and become more content with your everyday life.
While it can be challenging to treat NPD, you can work through it. Seeing a therapist or psychologist for counseling can be very helpful, as can changing how you think and interact with others daily.
Remember that you’re in charge of your behavior, and you can change it anytime.
How can I maintain healthy boundaries with someone who has narcissistic personality disorder?A Healthline reader
If you suspect you may be in a relationship with someone with NPD, the following are ways in which you may maintain healthy boundaries:
- Be cognizant of patterns of gaslighting and other forms of abuse.
- Vocalize your boundaries and expectations.
- Maintain your self-care.
- Don’t engage in emotional warfare or their tendency to put others down while putting themselves on a pedestal.
- Reach out to other people you trust and get informed on how to identify abusive tendencies and treatment.
There’s some debate among professionals about how to handle a person with NPD.
Feel free to praise them when they do something right or well.
Convey empathy when appropriate, and acknowledge when they’re disappointed. Conversely, you should also feel free to point out to the person when they’re acting haughty or rude.
Be prepared for arguments based on your “calling them out.” Also keep in mind that if the individual with NPD doesn’t realize that their behaviors are causing problems, they’re less motivated to seek help.
Even if the person with NPD doesn’t see the problem, or chooses not to seek therapy to modify their behavior, calling them out on their behavior may cause them to self-regulate in your presence, knowing that you won’t tolerate their behavior.