A person with narcissistic personality disorder (NPD) may experience an excessive concern for prestige and power, as well as a lack of empathy for others.

A personality disorder affects how a person feels, thinks, acts, and relates to others. A high sense of self-importance is a hallmark of NPD.

To others, a person with NPD may seem to act selfishly, be manipulative and demanding, or have difficulty empathizing or considering others’ needs or feelings.

Read on to learn more about the symptoms of NPD, how doctors diagnose the condition, what treatments may help, and more.

Health professionals group personality disorders into different clusters. NPD is a cluster B personality disorder. People with cluster B disorders find it hard to manage emotions and may have unpredictable behavior.

NPD gets its name from a Greek myth in which a hunter named Narcissus saw his reflection in a pool of water and fell in love with it.

A person with NPD may have an idealized self-image and an unrealistic sense of superiority. These traits can mask a lack of self-confidence and a deep sense of insecurity.

The following are key features of NPD:

  • a need for admiration
  • a pattern of grandiosity
  • a lack of empathy for others

Around 1% to 2% of people in the United States have NPD.

How people with NPD see themselves can be very different from how others see them.

Features of the condition that may be noticeable to others includeTrusted Source:

  • craving attention and admiration
  • having fragile self-esteem and feeling disappointed when admiration is not forthcoming
  • having an excessive feeling of superiority
  • exaggerating achievements and talents
  • having a preoccupation with success, power, brilliance, beauty, or ideal love
  • believing in their own uniqueness
  • having a sense of entitlement
  • feeling envious or believing that others are envious of them
  • behaving in a way that seems arrogant or haughty to others
  • showing great charm but quickly becoming irritated or angry
  • talking at length about their concerns but lacking interest in the concerns of others
  • showing aggression when faced with a threat to their ego

Other features may have a less obvious link with narcissism, such as:

  • a sense of shame, humiliation, and emptiness when disappointed
  • unwillingness to try something for fear of defeat
  • difficulty maintaining relationships
  • a sense of alienation or emotional disconnect from others
  • high achievement due to overconfidence but poor performance in the face of defeat or criticism
  • suspiciousness
  • social withdrawal
  • difficulty managing emotions

While the causes of personality disorders are unclear, they may involve a combinationTrusted Source of genetic and environmental factors.

During childhood, the following may increase the risk of developing NPD:

  • excessive praise or criticism
  • rejection in childhood
  • trauma
  • fragile ego

Diagnosing NPD can be challenging, as it is one of several types of personality disorders, and some features may overlap. A person may also have NPD alongside another condition that affects their mood and behaviors.

In addition, a person with NPD may not recognize that problems in their life stem from their behavior and may blame others instead.

Someone with NPD may be highly sensitive to perceived criticisms or slights, making it difficult for others to talk with them about their behavior and how it can be harmful.

To diagnose NPD, a clinician needs to find at least fiveTrusted Source of the following criteria from the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, text revision (DSM-5-TR):

  • a grandiose sense of self-importance
  • a preoccupation with fantasies of unlimited success, power, brilliance, beauty, or ideal love
  • a belief that they are unique and can only be understood by, or should only associate with, other special or high-status people or institutions
  • a need for excessive admiration
  • an increased sense of entitlement
  • a tendency to take advantage of others to achieve their own ends
  • a lack of empathy and unwillingness to recognize or identify with the feelings and needs of others
  • envy of others and the belief that others are envious of them
  • arrogant, haughty attitudes or behaviors

NPD is a spectrum disorder, and the symptoms can range from mild to severe.

When diagnosing NPD, there are two subtypes health professionals look for:

  • The grandiose subtype: This includes overt grandiosity, aggression, and boldness.
  • The vulnerable subtype: This involves hypersensitivity and defensiveness, which may be easier to miss during a diagnosis.

There is no standard treatment for NPD. However, certain therapies may help a person manage the condition and replace negative behavioral patterns with more positive ones.

The Food and Drug Administration (FDA) has not approvedTrusted Source any medications for NPD. However, Medications may help certain symptoms if NPD occurs with another disorder, such as depression or anxiety.

Currently, the most useful treatment method is psychotherapy. This can help a person:

  • create a more realistic self-image
  • become more aware of the condition
  • understand what underlies their behavior
  • manage their emotions more effectively
  • learn to take responsibility for their actions
  • learn to build healthier relationships
  • build up their self-esteem
  • adjust their expectations of themselves and others
  • understand the impact of their behavior on others

Specific types of therapy that may help include:

If people with NPD are at risk of suicideTrusted Source, they will need to seek help from a health professional straight away.

Complications of NPD may come fromTrusted Source co-existing health conditions, such as mood disorders and substance use disorders.

It is also common for people with NPD to have other personality disorders. People with NPD may have a higher risk of completing suicide than those with other personality disorders.

Personality disorders may also cause relationship problems or difficulties at work or school.

It is not possible to prevent any genetic predisposition to NPD. In childhood, it may be possible to reduce certain risk factors of NPD, such asTrusted Source:

  • excessive praise or criticism from parents or caregivers
  • abuse or trauma
  • rejection

NPD can be challenging for a person and their loved ones. However, treatment and support can help improve the quality of life for everyone involved.

For someone in any relationship with a person who has NPD, if may help to:

  • prioritize their own mental and physical well-being
  • set clear boundaries
  • talk with a healthcare professional if in need of support
  • connect with others in a similar position by finding a local or online support group

Counseling services are also available for people who have experienced trauma in a relationship with a person who has NPD.

Narcissistic personality disorder (NPD) is a mental health condition characterized by a high sense of self-importance and a lack of empathy for others.

Diagnosing NPD can be challenging as some symptoms overlap with other personality disorders. People with NPD often feel a sense of superiority over others, can be grandiose, and need excessive admiration.

There is no standard treatment for NPD. However, talking therapy may help people to break negative thinking and behavioral patterns. Support is also available for families and loved ones of people with NPD.