When most people think of someone that’s a narcissist, they think of a self-absorbed person that loves attention and typically treats other people poorly.
But just because someone demands approval from others and takes joy in their accomplishments (real or perceived) does not mean they have narcissistic personality disorder (NPD).
In fact, someone can certainly behave like a narcissist and exhibit many of the characteristics of NPD, but do so without being diagnosed as having NPD.
As a result, what many psychologists want the public to know is that NPD is a very real mental disorder with complex causes, and is far more than having an exaggerated sense of self-importance.
What is Narcissistic Personality Disorder?
Narcissistic personality disorder is just one of many personality disorders that have been researched and defined by psychologists and others in the field of mental health.
Broadly speaking, people with NPD have substantial difficulties with interpersonal functioning due to an extreme need for the approval of others. Likewise, a person with NPD sees themselves as being exceptional, which leads to feelings of grandiosity.
It’s that arrogance that leads some people to say, “John sure is a narcissist.” But as mentioned above, to be diagnosed with NPD requires much more than that.
How is Narcissistic Personality Disorder Diagnosed?
According to the DSM-V, the hallmark characteristics of NPD include:
- A grandiose sense of self-importance
- A belief of being special that only other special people can appreciate or understand
- A demonstrated need for admiration from others
- An extreme sense of entitlement
- A preoccupation with power, success, brilliance, or beauty
- Arrogant behavior
- A lack of empathy for others
- A practice of exploiting others
- Feeling envious of others or believing that others are envious of oneself
What is important to note is that not all of these symptoms must be present for a diagnosis of NPD to be made.
Instead, the DSM-V states that at least five of these symptoms must be present, and they must be present in different contexts, such as at work and at home.
Furthermore, these symptoms typically manifest by early adulthood.
Causes of Narcissistic Personality Disorder
Though the precise causes of NPD are not known, several risk factors make its development more likely.
According to the Mayo Clinic, the complex underpinnings of NPD likely have a lot to do with both environment and genetics, as well as neurobiology.
That is, there are likely inherited characteristics (genetics), factors related to how the brain is wired (neurobiology), and childhood experiences (environment) that all combine to make NPD more likely to manifest by early adulthood.
One of the primary risk factors of NPD is being male – it impacts far more men than women.
Likewise, some psychologists believe that parenting styles can make NPD more likely to develop. For example, parents that are overprotective and seek to minimize their child’s experience of criticism might unwittingly add “fuel to the fire” of a child that already has a genetic and neurobiological predisposition for NPD to develop.
Having said that, it has been well documented that many children who were overly protected by their parents did not develop NPD. Likewise, some children who had the opposite childhood experience and had neglectful parents ended up having NPD later in life. This just goes to show that NPD’s exact causes are highly complex.
Effects of Narcissistic Personality Disorder
As one might imagine, there are many negative effects associated with having NPD.
First and foremost, NPD causes significant difficulties in interpersonal relationships. The feelings of self-importance and the lack of empathy, in particular, can be extremely difficult for loved ones to deal with.
Secondly, people with NPD often have difficulties in their work or school lives. It can be troublesome to make friends, let alone keep those relationships going for an extended period of time when one believes they are special, has a propensity for envious feelings, and often exploits others for their own gain.
Lastly, there are a number of comorbid conditions that can exist with NPD. Depression is common, as is anxiety. Some people that have NPD abuse drugs and alcohol as well.
It is no surprise, then, that suicidal ideation and even attempts on one’s life are not uncommon for people with NPD.
How Can NPD Be Treated?
Psychologists and others in the helping professions that work with people who have NPD express that while there is no cure, treatments exist that can help people with NPD function at a higher level.
Psychotherapy, for instance, offers a number of benefits, including:
- Learning how to relate to others in a respectful, mutually supportive manner
- Discovering the root causes of one’s feelings and behavior
- Exploring ways to change thought patterns, accept criticism, and regulate feelings
- Recognizing when goals are grandiose and learn to establish attainable goals
Family therapy has also been found to be efficacious in treating NPD. Outcomes include:
- Improved ability to communicate with others
- Enhanced ability to recognize the feelings, value, and worth of others
- Development of an emotional support system
- Learn skills for coping with emotional distress, anxiety, and depression
Naturally, seeking help for comorbid conditions will also make dealing with the effects of NPD an easier task. However, it’s important to know that NPD is a pervasive condition and that even with counseling, people with NPD will continue to exhibit symptoms.
There is Hope
Perhaps more than anything, psychologists want the public to know that there is hope if you or a loved one is living with NPD.
With guidance and support from mental health professionals, friends and family members can learn effective strategies for helping their loved one improve their functioning, deepen their relationships, and develop a more positive outlook on life.
And, as noted above, therapeutic treatments can improve one’s ability to function with NPD.
But progress cannot be made if help is not sought out. And it’s that first step – recognizing that there is a problem and seeking a solution to overcome it – that is often the most difficult.
B.A. Social Studies Education | University of Wyoming
M.S. Counseling | University of Wyoming
B.S. Information Technology | University of Massachusetts
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