Narcissistic Personality Disorder (NPD): Traits, Causes, Treatment (2024)

Narcissistic personality disorder (NPD) is a type of mental condition. People who have NPD inflate their feelings of self-worth and want others to admire them. They often feel superior to other people but are very sensitive to any criticism or judgment.

Narcissism is one of many types of personality disorders. A personality disorder affects how a person behaves, feels, and thinks. People with the disorder usually do not recognize that they have a problem.

This article explains more about narcissistic personality disorder and how it affects a person's relationships.

Characteristics, Traits, and Symptoms

A person with narcissistic personality disorder may have the following traits:

• Feeling of superiority and entitlement
• Selfishness
• Arrogance
• Need for admiration
• Fragile self-worth
• Trouble getting along with others
  

In general, people with NPD think they are better than others. Narcissism may also lead to aggression and violence in both men and women. Aggression and violence may appear because the person with NPD feels threatened or wants to protect the ego.

Diagnosis

To diagnose narcissistic personality disorder, a person will need a psychological evaluation. A psychologist or psychiatrist can evaluate the person's symptoms and determine the severity of NPD. They often use the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) during the diagnosis process.

According to the DSM-5, you may have NPD if you have at least five of the following characteristics:

• Have an inflated sense of self-importance
• Fantasize about being more successful, powerful, beautiful, and rich than other people
• Think you are special and only want to be around other special people
• Need more than the normal amount of admiration
• Feel entitled
• Are willing to exploit others to your advantage
• Do not feel empathy for others
• Feel jealous of others or think they are jealous of you
• Behave arrogantly

Causes

The exact cause of narcissistic personality disorder is not known. However, some factors may contribute to the risk of a person developing NPD, including:

• Trauma during childhood
• Relationship problems with family or friends
• Genetics
• Family history
  

Types

There are several types of NPD; a person may not fit easily into one single category. Two extreme types are grandiose and vulnerable narcissism.

A person with grandiose narcissism may have:

• Arrogance
• Boldness
• Exploitative traits
• No empathy
• Extreme jealousy
• Aggression
  

A person with vulnerable narcissism may have:

• Defensiveness
• Hypersensitivity to criticism
• Feelings of shame
• Introversion
  

Treatment

It is often difficult to treat NPD because the patient may have negative transference, which is redirecting their feelings of anger or hatred from one person to the therapist. People with NPD may also not trust healthcare professionals or believe they can help them. Often, people with NPD do not think there is anything wrong with them and blame their problems on other people.

Psychotherapy

Patients with NPD may feel criticized, judged, or mistreated by healthcare professionals even if this is not true. They have trouble forming a trusting relationship with a therapist, so they do not pursue more treatment.

Resources to get help include:

• Reaching out to your primary care provider
• Finding a local therapist
• Finding local support groups
  

Medications

A therapist may recommend medications to treat specific symptoms. However, there is no medication that can cure NPD.

Medications may include:

• Mood stabilizers
• Antidepressants
• Antipsychotic drugs
  

Coping

Coping with NPD can be difficult since the person who has the condition usually does not realize it.

Narcissistic Relationships

Dating or being married to someone with NPD can be difficult. People with NPD struggle to maintain intimate relationships, friendships, and interactions with colleagues at work. There is a risk of abuse in these relationships.

In a relationship, a person with NPD typically puts their partner through the following cycles:

• Idealizing: In this stage, usually at the beginning of the relationship, the person with NPD puts their partner on a pedestal, smothering them with affection, praise, gifts, and promises about the future.
• Criticizing: Also called the devaluation stage, this is the period when the relationship has settled into a comfortable rhythm, and the person with NPD stops valuing their partner. Instead, they pull back on affection and may subject their partner to emotionally abusive tactics, such as gaslighting, putdowns, blaming, and projection.
• Discarding: Eventually, the person with NPD pushes their partner away entirely, breaking off the relationship, often in favor of a new one that fulfills their need for validation.
  

Protecting Yourself

If you or someone you know is romantically involved with a person who has NPD, it is important to recognize the symptoms of abuse and get help right away. Abuse may be:

• Physical
• Sexual
• Emotional
• Psychological
• Financial
• Verbal
  

Frequently Asked Questions

What are common traits of narcissistic personality disorder?

The most common traits of NPD are:

• Selfishness
• Arrogance
• Being self-centered
• Lacking empathy
• Needing admiration
• Fragile self-worth
  

What are the signs of a narcissistic relationship?

If a person with NPD makes you feel like the center of their universe at first but later criticizes and discards you, then you may have been in a narcissistic relationship.

Can people with NPD be good parents?

Every person with NPD is different, and the severity of the condition can vary. However, they often have trouble parenting. Some parents with NPD may be abusive toward their children.

Why are men more likely to develop NPD?

It is not clear why men are more likely to have NPD. It is possible that cultural and social influences play a part.

Do people with NPD have other mental health conditions?

A person with NPD is more likely to struggle with:

• Anxiety
• Depression
• Substance abuse
• Impulse control
  

Summary

Narcissistic personality disorder can affect many aspects of a person's life, including relationships, family, and work. Psychotherapy is the most common treatment and has the potential to help.

A Word From Verywell

If you think you may have narcissistic personality disorder, seek help and find a therapist you can trust. Therapy can have a long-term positive impact on your well-being and relationships. It is worth investing time, effort, and money in counseling.