People with narcissistic personality disorder have an exaggerated sense of their importance. They also crave external praise and attention. Treatment can help them manage their symptoms.

What is narcissistic personality disorder?

Narcissistic personality disorder is a personality disorder in which people have an inflated opinion of themselves. They also have an intense need for admiration and attention from others.

People with narcissistic personality disorder may feel unhappy and disappointed when they don’t receive the praise or special favors they believe they deserve. Others may see them as arrogant and conceited, and they may not enjoy being around them.

Narcissistic personality disorder can cause problems in many areas of a person’s life, including:

• Work
• School
• Relationships

Narcissistic personality disorder can affect up to 6.2% of the population and is slightly more common in men than women. People with narcissistic personality disorder can manage the disorder with talk therapy and certain lifestyle changes.

Traits of Narcissistic Personality Disorder

People with Narcissistic Personality Disorder are often described as:

• Arrogant
• Selfish
• Demanding

They often have high self-esteem and may believe that they are special or superior to others. However, they seem to need excessive praise and admiration and may react poorly to perceived criticism.

Narcissists also tend to exaggerate their talents and accomplishments while downplaying those of others. They are often preoccupied with power, success, and beauty. They may even engage in impulsive behaviors, such as gambling or certain sexual behaviors.

Some traits of Narcissistic Personality Disorder may seem similar to confidence, but healthy confidence and Narcissistic Personality Disorder are not the same thing.

People with healthy self-esteem are usually humble, while people with Narcissistic Personality Disorder are rarely. They tend to put themselves on a pedestal and see themselves as better than everyone else.

Symptoms of Narcissistic Personality Disorder

Narcissistic personality disorder usually appears in early adulthood.

People with the disorder may not realize they have a problem because having a problem interferes with their self-image. You may have narcissistic personality disorder if:

You appear grandiose and showy, causing others to avoid you

You have unsatisfying relationships

You feel sad, angry, and confused when things don’t go your way

You have ongoing problems with:

• Work
• School
• Relationships
• Finance
• Alcohol
• Drugs

If you think you have narcissistic personality disorder, make an appointment with a doctor or mental health professional. They can determine if you have narcissistic personality disorder and suggest treatments to help you manage your symptoms.

Causes and Risk Factors of Narcissistic Personality Disorder

There are no clear causes of narcissistic personality disorder.

Genetic factors are thought to be at least partially responsible for many cases of narcissistic personality disorder. Contributing environmental factors may include:

Child abuse or neglect

Overindulgence from parents

Unrealistic expectations from parents

According to a 2021 study, research is mixed on whether narcissism is more common in individualistic cultures than in collectivistic cultures.

Diagnostic Criteria for Narcissistic Personality Disorder

Clinicians and mental health professionals often use the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR), published by the American Psychiatric Association, to diagnose mental health conditions, such as narcissistic personality disorder.

The DSM-5-TR diagnostic criteria for narcissistic personality disorder include the following traits:

Exaggerated sense of self-importance and entitlement

Need for constant admiration and praise

Expecting special treatment because of perceived superiority

Exaggerating accomplishments and talents

Reacting negatively to criticism

Preoccupied with fantasies about power, success, and beauty

Exploiting others

Inability or unwillingness to recognize the needs and feelings of others

Acting in an arrogant manner

Your doctor or mental health professional may ask you to fill out a questionnaire to help determine if you meet these criteria. They may also test you for other mental health disorders and health conditions.

Treatment for Narcissistic Personality Disorder

Treatment for narcissistic personality disorder primarily consists of talk therapy, also known as psychotherapy.

If symptoms of narcissistic personality disorder occur along with depression or another mental health condition, you may be given medication to treat the other condition. There are no medications to treat narcissistic personality disorder. Talk Therapy

Talk therapy can help you learn how to better relate to others so that your relationships become more enjoyable, intimate, and rewarding. Developing positive interactions with others can greatly improve many areas of your life.

Talk therapy can also show you how to:

Improve collaboration with coworkers and peers

Maintain personal relationships

Recognize your strengths and potential so you can handle criticism or setbacks

Understand and manage your feelings

Deal with any self-esteem issues

Set realistic goals for yourself

Because personality traits can be difficult to change, it may take several years of therapy before you see improvement. During this time, you may start to see therapy as a waste of time and be tempted to stop. However, it is important to stick with it. You can connect with a mental health professional using the Healthline FindCare tool.

Attend all therapy sessions and take any medications as directed. Over time, you may see a difference in yourself and your relationships with others.

Lifestyle Changes

The following lifestyle changes may help you while you are in treatment:

Avoiding substances that may lead to problematic behaviors.

Identifying and practicing healthy habits.

Engaging in relaxation techniques such as yoga and meditation to help reduce stress and anxiety.

Outlook for Someone with Narcissistic Personality Disorder

The benefits of treatment may vary depending on the severity of your symptoms and your willingness to commit to treatment.

In general, symptoms of narcissistic personality disorder improve over time, although successful treatment takes time and can be difficult.

If you stay motivated and actively work toward change, you may be able to repair damaged relationships and become more satisfied with your daily life.

Living with Narcissistic Personality Disorder

Although treatment for narcissistic personality disorder can be difficult, it is possible to overcome it. Seeing a therapist or psychologist for counseling can be very helpful, as can changing the way you think and interact with others daily.

Remember that you are responsible for your behavior, and you can change it at any time.

There is some debate among professionals about how to deal with someone with NPD.

Don’t hesitate to compliment them when they do something right or well.

Show empathy when appropriate, and acknowledge when they feel disappointed. Conversely, you should also feel free to point out when the person is being arrogant or rude.

Be prepared for arguments based on your “criticism.” Also keep in mind that if the person with NPD doesn’t see that their behaviors are causing problems, they will be less motivated to seek help.

Even if the person with NPD doesn’t see the problem, or chooses not to seek treatment to modify their behavior, criticizing their behavior may cause them to self-regulate in your presence, knowing that you will not tolerate their behavior.