Narcissism describes personality traits, such as vanity and self-admiration. Narcissistic personality disorder is a mental health condition with traits that may include an excessive need for attention, an inflated sense of self-importance, and a lack of empathy.
Someone who is narcissistic may be excessively concerned with their appearance or have little time for focusing on others.
However, this is not necessarily a sign that someone has narcissistic personality disorder (NPD). Anyone can behave in a self-centered way at various points in their lives.
People with NPD find it difficult not to focus on themselves and may not recognize that they do this. NPD is a long-term condition that significantly affects a person’s relationships and emotional functioning.
In this article, we look at what NPD is, the signs of NPD, and how it affects relationships.
We also discuss whether narcissistic people can change and how they may go about doing this.
People with NPD may have a grandiose sense of self-importance and a sense of entitlement. They often lack empathy and may have little interest in developing intimate relationships with others.
While someone with NPD may appear overconfident, they often have low self-esteem. Depending on how severe their disorder is, they may react badly when a person or event challenges their sense of superiority.
An older 2008 study in the Journal of Clinical Psychiatry estimates that 6.2% of people experience NPD at some point in their lives. Rates are higher among males (7.7%) than females (4.8%).
The study also reports that NPD is significantly more prevalent among:
- black adults
- Hispanic females
- younger adults
- those separated, divorced, or widowed
- adults who never marry
The signs of NPD are wide-ranging and present differently, depending on the severity of individual cases.
People with NPD may be:
- self-admiring or self-loathing
- extroverted or socially isolated
- industry leaders or unemployed
- model citizens or people involved in antisocial activities
Therefore, it can be difficult to recognize a person with NPD. However, the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) provides the following symptoms:
1. An exaggerated sense of self-importance
Having a grandiose sense of self-importance is a defining characteristic of NPD. People with NPD have a sense of superiority over others.
It is not always obvious that someone with NPD feels superior to others. Some people with NPD appear confident and self-important, whereas others may appear to be insecure and self-deprecating.
In both cases, however, the person firmly believes they are better than others.
They may insist on having the best of everything or reject things that they feel are beneath them, such as a mundane job. Those with NPD may exaggerate or lie about their achievements.
2. A constant need for attention and admiration
People with NPD have a deep need for attention and admiration from people around them. This is because they typically rely on other people as a source of self-esteem and do not have a defined sense of self.
Someone with NPD may exhibit attention seeking behavior to get the admiration they feel they need or deserve.
3. The tendency to monopolize conversations
According to the DSM-5, people with NPD display little genuine interest in the experiences of others. As such, someone with NPD may dominate conversations or lose interest in conversations that do not revolve around them.
They may also use relationships for personal gain.
4. A lack of regard for other people’s feelings and needs
As those with NPD often lack empathy for others, they will consistently disregard the needs of other people. They often care very deeply what others think of them, but otherwise may find it difficult to understand or simply do not care about their feelings.
Individuals with NPD can also be antagonistic towards people due to this lack of empathy, or if someone challenges their feeling of superiority.
5. Difficulty receiving criticism and regulating behavior
Those with NPD struggle to accept anything they perceive as criticism, as this can damage their self-esteem and sense of identity. They may lash out at the person who has offended them.
It is important to note that for someone to have NPD, these signs must be consistent features of their personality in all situations. They may not be the result of their age, physical health conditions, or any medications they take.
People with NPD often also have other mental health conditions, such as:
People with NPD often have difficulties in interpersonal relationships. They can find relationships unfulfilling, especially when others do not give them the attention or admiration they think they deserve.
Family members have described loved ones with NPD as being:
- frequently dissatisfied with others
- quick tempered
- quick to blame others
- emotionally, physically, or sexually abusive
Other people may not enjoy being around those with NPD or narcissistic traits due to the way they behave in relationships.
Those with NPD may not apologize or accept blame when they are in the wrong. They may also be quick to anger, especially if they feel that their partner is criticizing them.
As a result, it can be challenging to remain in a relationship with someone who has NPD.
In some cases, narcissistic relationships can be unhealthy or even abusive.
While there is no cure for NPD, treatment can help people with the disorder to address the behaviors that negatively impact their relationships.
The treatment for NPD is psychotherapy. Individual therapy can help people to:
- understand their emotions and motivations
- regulate their feelings and behaviors
- recognize and accept their abilities and potential
- set realistic goals
- tolerate criticisms and failures
- relate better to others
- foster greater intimacy and enjoyment in relationships
- live in the present rather than in fantasy situations
- work on self-esteem issues
Sometimes, it can also be helpful for those with NPD to attend relationship counseling or family therapy with their loved ones.
A 2015 review found that relationship counseling varies in its effectiveness, however. Most experts agreed, it is too risky for someone with a partner who uses violence against them to attend relationship counseling.
It is important to note that, while narcissists can improve their lives and relationships, they must want to change.
If someone with NPD does not think there is anything wrong, they may not seek out or engage in treatment. They may not consider that therapy deserves their attention.
There are no medications to treat NPD, but people who have complications, such as depression or anxiety, may require antidepressants or anti-anxiety medications.
People with NPD have an inflated sense of importance, an excessive need for admiration and attention, and a lack of empathy for others. They often struggle to maintain healthy relationships and may experience difficulties in other aspects of their lives.
Therapy can help those with NPD to better manage their lives and engage with others in meaningful relationships. Individuals who believe they have NPD and who wish to seek treatment should speak to their doctor or a therapist.