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Narcissistic personality
disorder
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Overview
Narcissistic personality disorder is a mental health
condition in which people have an unreasonably high
sense of their own importance. They need and seek
too much attention and want people to admire them.
People with this disorder may lack the ability to
understand or care about the feelings of others. But
behind this mask of extreme confidence, they are not
sure of their self-worth and are easily upset by the
slightest criticism.
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A narcissistic personality disorder causes problems in
many areas of life, such as relationships, work, school
or financial matters. People with narcissistic
personality disorder may be generally unhappy and
disappointed when they're not given the special favors
or admiration that they believe they deserve. They may
find their relationships troubled and unfulfilling, and
other people may not enjoy being around them.
Treatment for narcissistic personality disorder centers
around talk therapy, also called psychotherapy.
Narcissistic personality disorder affects more males
than females, and it often begins in the teens or early
adulthood. Some children may show traits of
narcissism, but this is often typical for their age and
doesn't mean they'll go on to develop narcissistic
personality disorder.
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Symptoms
Symptoms of narcissistic personality disorder and how
severe they are can vary. People with the disorder can:
Have an unreasonably high sense of self-
importance and require constant, excessive
admiration.
Feel that they deserve privileges and special
treatment.
Expect to be recognized as superior even without
achievements.
Make achievements and talents seem bigger than
they are.
Be preoccupied with fantasies about success,
power, brilliance, beauty or the perfect mate.
Believe they are superior to others and can only
spend time with or be understood by equally
special people.
Be critical of and look down on people they feel
are not important.
Expect special favors and expect other people to
do what they want without questioning them.
Take advantage of others to get what they want.
Have an inability or unwillingness to recognize the
needs and feelings of others.
Be envious of others and believe others envy
them.
Behave in an arrogant way, brag a lot and come
across as conceited.
Insist on having the best of everything — for
instance, the best car or office.
At the same time, people with narcissistic personality
disorder have trouble handling anything they view as
criticism. They can:
Become impatient or angry when they don't
receive special recognition or treatment.
Have major problems interacting with others and
easily feel slighted.
React with rage or contempt and try to belittle
other people to make themselves appear
superior.
Have difficulty managing their emotions and
behavior.
Experience major problems dealing with stress
and adapting to change.
Withdraw from or avoid situations in which they
might fail.
Feel depressed and moody because they fall
short of perfection.
Have secret feelings of insecurity, shame,
humiliation and fear of being exposed as a failure.
When to see a doctor
People with narcissistic personality disorder may not
want to think that anything could be wrong, so they
usually don't seek treatment. If they do seek treatment,
it's more likely to be for symptoms of depression, drug
or alcohol misuse, or another mental health problem.
What they view as insults to self-esteem may make it
difficult to accept and follow through with treatment.
If you recognize aspects of your personality that are
common to narcissistic personality disorder or you're
feeling overwhelmed by sadness, consider reaching
out to a trusted health care provider or mental health
provider. Getting the right treatment can help make
your life more rewarding and enjoyable.
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Causes
It's not known what causes narcissistic personality
disorder. The cause is likely complex. Narcissistic
personality disorder may be linked to:
Environment — parent-child relationships with
either too much adoration or too much criticism
that don't match the child's actual experiences
and achievements.
Genetics — inherited characteristics, such as
certain personality traits.
Neurobiology — the connection between the
brain and behavior and thinking.
Risk factors
Although the cause of narcissistic personality disorder
isn't known, some researchers think that overprotective
or neglectful parenting may have an impact on children
who are born with a tendency to develop the disorder.
Genetics and other factors also may play a role in the
development of narcissistic personality disorder.
Complications
Complications of narcissistic personality disorder, and
other conditions that can occur along with it include:
Relationship difficulties
Problems at work or school
Depression and anxiety
Other personality disorders
An eating disorder called anorexia
Physical health problems
Drug or alcohol misuse
Suicidal thoughts or behavior
Prevention
Because the cause of narcissistic personality disorder
is unknown, there's no known way to prevent the
condition. But it may help to:
Get treatment as soon as possible for childhood
mental health problems.
Participate in family therapy to learn healthy ways
to communicate or to cope with conflicts or
emotional distress.
Attend parenting classes and seek guidance from
a therapist or social worker if needed.
By Mayo Clinic Staff
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Diagnosis & treatment
Nov. 15, 2022
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