Narcissistic personality disorder: Inflated sense of importance

This mental health disorder includes an inflated sense of importance, a deep need for excessive admiration, fragile self-esteem and troubled relationships.

Narcissistic personality disorder—one of several types of personality disorders—is a mental condition in which people have an inflated sense of their own importance, a deep need for excessive attention and admiration, troubled relationships, and a lack of empathy for others. But behind this mask of extreme confidence lies a fragile self-esteem that’s vulnerable to the slightest criticism.

A narcissistic personality disorder causes problems in many areas of life, such as relationships, work, school or financial affairs. People with narcissistic personality disorder may be generally unhappy and disappointed when they’re not given the special favors or admiration they believe they deserve. They may find their relationships unfulfilling, and others may not enjoy being around them.

Treatment for narcissistic personality disorder centers around talk therapy (psychotherapy).

Symptoms

Signs and symptoms of narcissistic personality disorder and the severity of symptoms vary. People with the disorder can:

  • Have an exaggerated sense of self-importance
  • Have a sense of entitlement and require constant, excessive admiration
  • Expect to be recognized as superior even without achievements that warrant it
  • Exaggerate achievements and talents
  • Be preoccupied with fantasies about success, power, brilliance, beauty or the perfect mate
  • Believe they are superior and can only associate with equally special people
  • Monopolize conversations and belittle or look down on people they perceive as inferior
  • Expect special favors and unquestioning compliance with their expectations
  • 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 or haughty manner, coming across as conceited, boastful and pretentious
  • 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 perceive as criticism, and they can:
  • Become impatient or angry when they don’t receive special treatment
  • Have significant interpersonal problems and easily feel slighted
  • React with rage or contempt and try to belittle the other person to make themselves appear superior
  • Have difficulty regulating emotions and behavior
  • Experience major problems dealing with stress and adapting to change
  • Feel depressed and moody because they fall short of perfection
  • Have secret feelings of insecurity, shame, vulnerability and humiliation

When To See A Health Care Provider

People with narcissistic personality disorder may not want to think that anything could be wrong, so they may be unlikely to seek treatment. If they do seek treatment, it’s more likely to be for symptoms of depression, drug or alcohol use, or another mental health problem. But perceived insults to self-esteem may make it difficult to accept and follow through with treatment.

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