Everyone focuses on themselves sometimes, but if you sense that you tend do so in a way that frequently interferes with your life and causes conflict with other people, you may have narcissistic personality disorder.
What is narcissistic personality disorder?
Narcissistic personality disorder is a particular pattern of extreme personality traits. Unlike many other mental health conditions, personality disorders are usually present in some form throughout a person’s life.
Personality disorders can sometimes be confused with regular personality traits, but the difference is that a personality disorder deviates from cultural norms and causes a person significant trouble on a regular basis.
People with narcissistic personality disorder focus tend to focus on themselves at the expense of everyone else. They tend to have unrealistically high opinions of themselves and generally expect that others will admire and obey them. Though they may seem very confident, these individuals actually tend to have low self-esteem. It’s common for people with narcissistic personality disorder to be frequently and severely disappointed when life doesn’t match their grandiose expectations.
Prevalence of narcissistic personality disorder
A large mental health survey in 2008 found that 6.2% of respondents had narcissistic personality disorder.
It also found this condition to be much more common for men than for women, affecting 7.7% of men as opposed to 4.8% of women.
However, people who have narcissistic personality disorder tend not to admit weakness, and so they may be less likely to seek treatment. For this reason, it’s difficult to say for sure how common narcissistic personality disorder really is.
Symptoms of narcissistic personality disorder
There is a wide range of symptoms associated with narcissistic personality disorder, and different people will experience different symptoms.
However, the most prominent symptoms of this condition include:
- Extreme self-importance: You may feel that you are superior to everyone else and deserve constant admiration.
- Lack of compassion or empathy: Other people’s feelings may seem less important than yours, and you might feel comfortable taking advantage of others to get what you want.
- Sense of entitlement to special advantages: People with this condition often believe that they deserve special treatment due to their inherent superiority.
- Setting unrealistic goals: You may think often about the success, money, or glory in your future and believe that these things will come to pass, even if you don’t have a plan for reaching them.
- Frequent and severe disappointment: When things don’t go as well as you’d imagined or when other people don’t treat you admiringly, it can be hard for you to recover.
- Difficulty forming close, stable relationships: Individuals with narcissistic personality disorder may find it hard to maintain strong relationships with friends, family, and partners.
- Inability to take criticism: You might react to negative feedback with extreme anger or defensiveness.
- Anxiety, depression, or substance use: Sometimes the challenges of living with this condition can lead to symptoms of other mental health conditions.
Types of narcissistic personality disorder
There is no clear consensus about whether or not different subtypes of narcissistic personality disorder exist. Some researchers and theorists have attempted to create these definitions, but for the most part they have not yet been clinically tested.
The important thing to note is that different people may experience narcissistic personality disorder in different ways. Some people may be more exhibitionistic, meaning that they tend to show off and brag. At the same time, others may not have as many outward symptoms, but they may still have the internal experience of believing that they are superior to others.
If you’re not sure whether your symptoms might be narcissistic personality disorder, it’s best to consult with a therapist or physician for further guidance.
Treatments for narcissistic personality disorder
There are a number of options you can explore if you think you might have narcissistic personality disorder:
- Therapy. Psychotherapy is generally considered the best treatment for narcissistic personality disorder. A therapist can help you can insight into your condition and practice the interpersonal skills that may be more difficult for you. (See below for more tips on finding a therapist.)
- Keeping a journal. Keeping a record of your thoughts, feelings, and actions can help you spot recurring patterns and gain a more realistic self-image.
- Medication. There are no medications that specifically treat narcissistic personality disorder. However, if you also have anxiety or depression related to your condition, working with a psychiatrist to find the right medication can help you manage those related symptoms.
- Hotlines: If you’re having thoughts of suicide or need immediate support, you can always call the National Suicide Prevention Hotline at at 1-800-273-8255. The Substance Abuse and Mental Health Services Administration hotline at 1-800-622-4357 can also help you locate resources and treatment options.
How to look for a therapist for narcissistic personality disorder
Psychotherapy is generally considered the best treatment for individuals with narcissistic personality disorder. A therapist can help you minimize your symptoms in a number of ways, including gaining a clearer self-image, learning valuable interpersonal skills, and practicing coping with disappointment.
Determine which therapy approach(es) appeals to you
A few specific kinds of psychotherapy that you might consider for narcissistic personality disorder include:
- Cognitive Behavioral Therapy (CBT)
- Psychodynamic Therapy
- Interpersonal Therapy
- Narrative Therapy
- Family Systems Therapy
Look for specialized training in narcissistic personality disorder
Additionally, you’ll want to make sure that your therapist is qualified to treat narcissistic personality disorder. This will usually involve:
- Advanced education in a field related to mental health, such as psychiatry, psychology, or social work
- Licensure to practice in the state where you live
- Additional training and/or experience in treating narcissistic personality disorder specifically
Prioritize personal fit
Finally, as with any therapy, it’s important to make sure that your therapist is a good fit for your unique needs. Be sure to evaluate the following in your initial calls with therapists:
- How will you pay for therapy? Does the therapist take your insurance or otherwise offer rates that will work with your budget?
- When and where will you attend sessions? Does the therapist offer treatment at a location that is convenient for you and at times that work with your schedule?
- Most importantly, do you feel comfortable talking to this therapist and sense that you have the potential to develop a therapeutic alliance?