Narcissistic Personality Disorder: What You Should Know

Narcissistic personality disorder (NPD) is a mental condition that is characterized by an exaggerated sense of self-importance. NPD may be marked by arrogance, feelings of superiority, a sense of entitlement, and more.

These characteristics cause relationship issues for those with NPD. It is estimated this personality disorder affects up to 5% of people in the United States.

Read on below to learn more about the symptoms, causes, treatment, coping strategies, and more for NPD.

What Is Narcissistic Personality Disorder?

NPD falls under the umbrella of personality disorders, specifically a Cluster B personality disorder. A personality disorder is defined by the Diagnostic and Statistical Manual on Mental Disorders, Fifth Edition (DSM-5) as, “An enduring pattern of inner experience and behavior that deviates markedly from the expectations of the individual’s culture."

In addition to NPD, other Cluster B personality disorders include:

• Antisocial personality disorder
• Borderline personality disorder (BPD)
• Histrionic personality disorder
  

Symptoms

The DSM-5 lists nine symptomatic criteria for NPD. Of these nine characteristics, five or more must be met in order to be diagnosed with NPD:

• A grandiose sense of self-importance
• A preoccupation with fantasies of unlimited success
• A belief of specialness
• An excessive need for admiration
• A sense of entitlement
• Interpersonally exploitative (takes advantage of others for personal gain)
• Envious behavior (or believes others are envious of themselves)
• A lack of empathy
• Arrogant, haughty behaviors and attitudes

It's important to note that there are several different types or presentations of NPD that may not fit the more overt DSM description.

Causes

There are multiple factors that play into the development of NPD such as:

• Family history
• Personality traits
• Negative developmental experiences
• Childhood trauma
• Excessive praise during childhood

Diagnosis

NPD varies in its presentation and severity. Additionally, limited research has led to diagnostic challenges; in fact, NPD was originally planned to be omitted from the DSM-5, only to be included after feedback from the clinical and research community.

In order for someone to be diagnosed with narcissistic personality disorder, they must exhibit at least five of the nine NPD traits outlined in the DSM-5.

That said, because of the limited research on NPD, diagnosis of this mental health disorder is still quite controversial.

Treatment

Talk therapy, also known as psychotherapy, is usually the primary treatment for NPD. Examples of psychotherapy are cognitive behavioral therapy (CBT) and psychodynamic psychotherapy.

It is important to note that the person with NPD must be an active participant of their treatment in order for it to be effective. And, because the person exhibiting signs of NPD are usually unaware of their behaviors and impact, it may be difficult for them to engage in psychotherapy and change.

Coping

If you have NPD, some coping strategies include:

• Avoid alcohol and drug use
• Stay dedicated to therapy
• Continuously work on improving your relationships
• Reduce stress as much as possible

If you know or love someone with NPD, some ways to cope with their behaviors include:

• Create firm boundaries and expectations surrounding their behavior
• Separate the person from their diagnosis
• Know when to walk away
• Stay patient
• Practice compassion
  

Keep in mind that a person with NPD is often unaware of their impact and behaviors, which is why narcissistic traits can cause many relationship problems.

Summary

Narcissistic personality disorder (NPD) is a mental health condition defined by an exaggerated sense of self-importance that often reflects an underlying fragile sense of self. It can interfere with a person's work and interpersonal relationships. While personality disorders such as NPD can be difficult to treat, symptoms can improve as long as the person with NPD wants to change.

A Word From Verywell

Narcissistic personality disorder can be a difficult mental health condition to live with. It can feel both isolating and frustrating, especially since it is so hard for those with NPD to recognize their behaviors and the impact they have on others.

That said, change is more than possible. Keep in mind that NPD doesn't have to define you; it involves behaviors that can be modified. Talk therapy is a great place to start. Listen to loved ones if they express your actions have hurt them and ask how you could have done better.

Talk to a mental health professional if you or a loved one is struggling with NPD.