We all have those people who think incredibly highly of themselves and have no regard for the feelings of others. Sometimes it can be very difficult to deal with these people. They think they are on top of the world and everyone else is inferior to them. Can this really be a mental condition? Yes, it is called Narcissistic Personality Disorder, or `(Narcissistic Personality Disorder - NPD)`. Let's talk about this in a little more detail today.
What is narcissistic personality disorder (NPD)?
Simply put, narcissistic personality disorder is a mental health condition. It affects the way you see yourself and your relationships with others. A person with NPD has an insatiable desire to impress others and to feel important. This desire can be so intense that it can lead to behaviors that are harmful to you and those around you.
The name "narcissistic" comes from the Greek mythological hunter Narcissus. According to the story, Narcissus was so fascinated by his own beauty that he couldn't stop staring at his own reflection in a pool of water. In the end, it is said that he died while staring at his own reflection.
However, while many people associate the word "Nazism" with appearance, NPD is not just about your appearance. It can also be about other things you have, such as your intelligence, speaking skills, artistic abilities, athletic abilities, wealth, power, and success .
How common is this condition?
Experts are unsure exactly how common NPD is. Research suggests that between 0.5% and 5% of the American population may have the condition. It is also said that between 50% and 75% of those with the condition are male .
However, many people hide their narcissistic beliefs and behaviors. This is sometimes called "covert narcissism." Therefore, it is very difficult to accurately estimate how many people actually have NPD.
What are the symptoms of narcissistic personality disorder?
The symptoms of NPD are all related to your thoughts, feelings, and actions . The American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, fifth edition text revision (DSM-5-TR™) lists nine criteria for this disorder. Symptoms that fall under these criteria may appear to others as follows:
1. Having an overestimation and arrogance of oneself:
- They overestimate their abilities, or set goals that are too high for them to ever reach.
- They exaggerate even the smallest things they have done, and they exaggerate their achievements.
2. Constantly dreaming of getting or wanting these things:
- Success
- Power
- Intelligence
- Beautiful
- Love
- Being satisfied with oneself.
3. The belief that one is superior to others:
- I think I am a very special and unique person.
- They believe they should only associate with people who are as "worthwhile" as they are.
4. Constantly needing appreciation and praise from others:
- Self-esteem is very fragile.
- They constantly doubt themselves, blame themselves, and feel empty.
- I'm always worried about what other people think of me.
- You do different things to get compliments from others. For example, instead of saying something like, "I'm not good at this," you can say, "Oh, no, you're really good at it."
5. The attitude that everything should be their way and that they deserve special treatment:
- They think too highly of their own worth.
- They expect unusual special treatment.
- They get angry when others don't listen to them or make them happy. Think of it like trying to get to the front of a line and expecting everyone to put them first.
6. The temptation to use others for one's own benefit:
- Knowingly or unknowingly, they use others.
- They only keep as friends and connections those they think are good for their self-esteem and status.
- They deliberately use others to achieve their own selfish goals.
7. Lack of empathy:
- They say things that hurt others.
- They see the feelings, needs, and wants of others as a weakness.
- The kindness and interest shown to you by others is not reciprocated in the same way. Imagine, when your friend is in a big problem, you brag about one of your victories instead of listening to his or her suffering. That's what it's like.
8. Frequent jealousy:
- I feel jealous when others succeed, especially when they are higher than me.
- I think others are jealous of me.
- They belittle and belittle the talents and successes of others.
9. Arrogant, arrogant behavior:
- They act as if they don't care about others and are showing favoritism.
- Behaving rudely and disrespectfully.
- They speak to others in a condescending and sarcastic manner.
In addition to these nine main criteria, people with NPD may exhibit a variety of other behavioral patterns. For example:
- The fear of showing weakness, trying to avoid it.
- They stay away from others because they feel weak.
- Trying to do everything perfectly (`(Perfectionism)`) (which can be okay or not, with the fear of failure).
- Criticism, rejection, and failure are unbearable. Even the smallest things are taken to heart.
- Rejection or failure can lead to severe depression .
- If they feel criticized or rejected, they react with intense anger (`(rage)`) .
- They fake humility to hide their feelings and protect their own greatness.
- They avoid situations where they might fail, and there is a high chance of that happening. This can limit their achievements.
The important thing is that just because someone has one or two of these symptoms does not mean they have NPD. Only a qualified doctor can make an accurate diagnosis.
What are the causes of NPD?
Because NPD is a mental health condition, experts can't say exactly why it happens. Although some subtle changes have been observed in the brain structure of people with NPD, it is still unclear whether those changes cause NPD or whether NPD causes those changes.
There are several main factors that are currently identified that contribute to the development of NPD:
- Genetics: People with NPD are more likely to have parents or close relatives who have the condition. This means that there may be a genetic influence that runs in families.
- Observation and Imitation: From an early age, children observe and imitate the things they see, especially the behaviors of their parents and caregivers, and those traits can develop into NPD.
- Adverse childhood experiences: Childhood trauma, rejection, neglect, and lack of support can contribute to the development of narcissistic traits.
- Parenting style: Overindulging, overprotecting, and interfering in everything (helicopter parenting) can lead children to expect and demand the same attention from others as they grow up. This can also prevent children from learning to control and regulate their emotions. Then, when they don't get what they want, they find it difficult to control their emotions.
- Culture: Research shows that the culture you grow up in can also affect your risk of developing NPD. Cultures that value individuality and personal autonomy seem to have a higher risk. People who grow up in cultures that value collectivism and unity are less likely to develop NPD.
What are the possible complications of NPD?
It is very common for NPD to coexist with other mental health problems and conditions. Here are some of the most common complications:
- Mood disorders or bipolar disorder: People with NPD are more likely to experience anxiety and depression. Bipolar disorder is also common among people with NPD.
- Other personality disorders: Examples include borderline personality disorder (BPD) and antisocial personality disorder (ASPD).
- Body dysmorphic disorder (`(Body dysmorphic disorder)`): People with NPD may also experience this condition (also called ``body dysmorphia``). This can be caused by negative feelings about their body and appearance.
- Substance use disorders (SUDs): When reality doesn't go as they expected, people with NPD may turn to alcohol or drugs. Stimulants like cocaine are especially common, as they are the type of high people with NPD seek out.
- Suicide: People with NPD can experience severe depression and hopelessness when faced with challenges, failures, and rejection. These are more likely to be planned suicides than sudden "calls for help." Therefore, people with NPD are at a higher risk of suicide. This is a very serious matter.
How is narcissistic personality disorder diagnosed?
A healthcare provider, usually a psychiatrist or psychologist, diagnoses NPD. They will talk to you and ask you questions about your life and your relationships with others (especially family, friends, and loved ones). They may also ask questions to rule out other conditions that may cause similar symptoms.
You must meet at least five of the nine criteria in the American Psychiatric Association's (DSM-5-TR™) manual to be diagnosed with NPD. There are currently no specific lab tests or imaging tests that can diagnose NPD.
What are the treatments for NPD?
The main treatment for NPD is some form of psychotherapy.
Some of the most commonly used treatments for NPD are:
- Dialectical behavioral therapy (DBT)
- Cognitive behavioral therapy (`(Cognitive behavioral therapy - CBT)`)
- Metacognitive therapy (`(Metacognitive therapy)`)
- Group therapy (`(Group therapy)`)
- Couples or family therapy
Because there are so many treatment options, your mental health professional is the best person to tell you more about these different methods. You can ask them any questions you have about how these methods work and which method is right for you.
Medication for NPD
There are currently no medications that directly treat NPD. However, medications can be used to treat symptoms of other conditions that may be associated with it, such as anxiety and depression. Some of the medications that may help include:
- Antidepressants
- Antianxiety medications (`(Antianxiety medications / anxiolytics)`)
- Antipsychotic medications
- Anticonvulsant medications - Although these primarily treat epilepsy, some medications, such as lamotrigine, can help stabilize mood.
If I have NPD, what should I expect?
People with NPD may sometimes be unaware of it. Some may not know it for years or even decades. Often, a stressful event or situation triggers the full onset of symptoms. Here are some examples of such events or situations:
- Significant negative changes: Things like a demotion, job loss, bankruptcy.
- Personal crises: relationship breakdown, divorce.
- Other life crises: Illnesses or changes that come with aging, especially those that affect the ability to live independently, or the death of a loved one.
- Ultimatums: People with NPD may only seek help if loved ones ask for it or insist on it.
What is the outlook for NPD status?
The outlook for NPD, that is, the ability to recover, depends on several factors. These include:
- Your symptoms: Some symptoms of NPD may make you less willing to seek help or seek treatment. People who don't want to appear weak, especially those who don't want to be seen as weak, may not pay attention to how they receive a diagnosis.
- How severe your NPD is: If it becomes severe, it can be a major disruption to your life. People with severe NPD are often aggressive, confrontational, and have little empathy for the feelings and needs of others. They are also less likely to ask for help or seek treatment.
- Other conditions you have: People with NPD may have additional challenges if they have other conditions. For example, anxiety, depression, other personality disorders (especially antisocial personality disorder), and substance use disorders can make NPD worse.
Because so many factors affect this, the best person to ask about the outlook for your condition is your mental health professional. They can give you more information about what to expect and what you can do to help.
Can NPD be prevented or the risk of developing it reduced?
NPD occurs for reasons that experts don't fully understand. It can also run in families. For both of these reasons, you or your child can't prevent it from developing.
However, by the way you raise your children, that is, by adapting your parenting style to suit different situations , you can reduce your child's risk of developing this to some extent. Your child's pediatrician can educate you about this, or recommend a child psychologist.
How do I take care of myself (if I have NPD)?
If you have NPD, it can be difficult for you to accept the diagnosis. Because of the symptoms of this disorder, you may feel like you have a disorder and want to avoid it. However, it is important to understand that treatment can improve your life and your relationships with others . It can make it easier for you to build and maintain relationships, and achieve personal or professional success.
Some of the most important things you can do are:
- See your mental health professional as recommended. People with NPD are more likely to drop out of treatment. This can cause more problems for you in the long run.
- Take your medications as prescribed. This will help you manage and regulate your emotions and NPD symptoms.
- Avoid using drugs or alcohol. While they may make you feel better temporarily, they can make things worse in the long run. If you take medication, alcohol or other drugs can cause dangerous drug interactions.
When should I see my doctor, or when should I seek medical advice?
You should see your doctor as prescribed. They will set up a schedule for treatment and follow-up visits. You should see your doctor if you notice any changes in your symptoms or if you notice a change in the effectiveness of your medications.
When should I go to a hospital or emergency room?
If you have thoughts of harming yourself, committing suicide, or harming others , you should go to an emergency room immediately, call 1990 (Sri Lanka's ambulance service), or tell someone you trust and seek medical advice immediately. These thoughts are very serious, so do not try to deal with them alone.
Are there different types of narcissism?
The DSM-5-TR™ (the latest revision of the DSM-5) does not describe the different types of narcissism or NPD. However, experts sometimes classify narcissism based on characteristics or behaviors.
Some of the features used for it are:
- Grandiose (expecting appreciation and recognition) versus vulnerable (needing approval to maintain self-esteem and fearing disapproval).
- Overt (`(Overt)`) versus covert (`(Covert)`).
- Harmless (`(Benign)`) versus malicious (`(malignant)`) (those who want to hurt or use others).
These are not formal classifications, but a mental health counselor can help you understand your situation. If you think these characteristics apply to you, you can also ask a professional about them.
Can I take a test to see if I have narcissistic traits?
Doctors can use various diagnostic screening questionnaires to help diagnose NPD. While you may be tempted to take an online test to see if you have it, you should remember that it is not a formal diagnosis . You should definitely see a trained, qualified professional to be sure of your diagnosis.
What do I do if I think someone I love has NPD?
People with NPD may not be able to recognize their own symptoms. Often, family, friends, and loved ones are the first to suspect that someone has NPD. If you suspect that someone you love has NPD, you should keep these things in mind:
- You can't change someone with NPD. Only they can change their behavior. Even if you feel frustrated that your loved one doesn't want to change, remember that it's not your fault. You can encourage them to seek treatment, but they have to be willing to do so for this to be successful.
- Stay calm and don't take things personally. People with NPD, especially when angry, can try to provoke you and get a reaction. Don't take it personally, and don't react the same way they do.
- Set healthy boundaries. People with NPD often try to get what they want through others, whether consciously or unconsciously. If your loved one has NPD, setting healthy boundaries can be essential. Be clear about what you are willing to do and what you are not, and stick to those boundaries. It may be difficult, but giving in to their demands won't help (and may even make things worse).
- Protect yourself. People with NPD may try to undermine your boundaries and control you by ``gaslighting'' (meaning, changing something you or they said or did to make you look crazy). If you feel like you need to be reassured in the future about what you said or did, write it down. They may also become verbally or physically abusive in their anger. Take care to protect your own health and well-being.
- Consider your own mental health as well. Those of you who have a loved one with NPD should consider seeing a mental health counselor . This can help you work through your own feelings and difficulties surrounding NPD, as well as be better prepared to deal with the effects of this condition on a loved one.
- Don't ignore the warning signs. People with NPD are at increased risk of suicide. If you suspect that a loved one with NPD is withdrawing from society or thinking about harming themselves, talk to them directly. If you think they are in immediate danger, call 911 immediately, or seek medical help immediately.
Finally, things to remember
Narcissistic personality disorder is not a character flaw or a flaw. It is a mental health disorder. If you have this condition, there are things you can do to help yourself and strengthen your relationships with others in a healthy way. It may be difficult to accept and deal with this condition, but it can seriously damage your relationships and disrupt your life. So, don't ignore it or run away from reality.
If someone you know has NPD, learning about it can help you take care of yourself and try to help them. Sometimes, the best thing you can do is set boundaries and not interfere with their behavior unnecessarily. Remember, you can't force someone with NPD to change. They have to be willing to do it.
` Narcissistic personality disorder, NPD, mental health, personality disorders, grandiosity, arrogance, lack of empathy, psychotherapy
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