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Behavioral Health Advisor 2007.2: Narcissistic Personality Disorder Health Library

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Narcissistic Personality Disorder

What is narcissistic personality disorder?

Narcissistic personality disorder (NPD) is a pattern of feeling more important than others. People with this disorder need to be admired. They do not seem to notice or pay attention to the feelings of others. It is normal and healthy to care about your own well-being, but people with NPD take this to an extreme.

How does it occur?

No one really knows why people develop NPD. One theory is that children who do not get regular attention, love, and support start thinking that they have to be extra special just to be accepted. They may actually have very fragile self-esteem. A person with NPD may not show it, but is easily hurt and rejected. This often happens because their expectations are so high. Their relationships with other people tend to be very poor.

Other possible causes may include genetics, environment, and trauma or abuse in childhood. Most people diagnosed with this disorder are men, but it can occur in women as well. NPD usually becomes a problem in the teen or early adult years.

What are the symptoms?

People who have NPD have at least 5 of the following signs.

  • believing and acting like they are better than others
  • constantly fantasizing about success, power, or beauty
  • believing that they are special and can only be understood by other special people
  • expecting everyone to admire them and go along with what they want
  • taking advantage of other people
  • not recognizing or identifying with other people's feelings
  • being jealous of what other people have or thinking others are jealous of what they have
  • acting stuck-up
  • being unable to maintain healthy relationships.

Many people show some signs of narcissism. However, when these signs interfere with your life and ability to function, it is considered a disorder.

How is it diagnosed?

A healthcare provider or therapist will ask about the person's symptoms. They may also be asked to complete a personality test. The therapist will also rule out depression or other mental health problems.

How is it treated?

People may resist treatment because they find it hard to admit that something is wrong. Psychotherapy can help them see themselves more clearly. It helps them recognize how their behavior affects others. This can help them change behaviors that get in the way of living a satisfying life. Psychotherapy usually takes several years. Treatment goals include helping the person to:

  • admit that they have some weaknesses and shortcomings
  • understand the reasons for the behavior
  • gain greater self-control
  • better understand and accept themselves and other people.

Medicines, such as antidepressants or anti-anxiety medicines, may be prescribed if the person is also depressed or anxious.

When should I seek help?

If you are having personal, social, family, work, or legal problems as a result of your attitudes and behaviors, get treatment.

For more information, contact:

The National Alliance for the Mentally Ill (NAMI)
800-950-NAMI
Web site: http://www.nami.org

The National Mental Health Association (NMHA)
800-969-NMHA
Web site: http://www.NMHA.org

Developed by McKesson Corporation
Published by McKesson Corporation.
Last modified: 2006-09-21
Last reviewed: 2007-02-06
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
Copyright © 2007 McKesson Corporation and/or one of its subsidiaries. All Rights Reserved.
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