Personality disorders, particularly narcissistic personality disorder (NPD), tend to get a bad rap. All this is hardly surprising given the amount of conflicting information around today.
Nowadays, social media feeds, magazine articles and various other types of literature are awash with information on narcissism but is the information you read helpful or even fair?
What doesn’t help is how narcissism is often linked to mental health disorders such as psychopathy.
However, although various types of narcissism may include psychopathy, classic narcissists exhibit an entirely different set of symptoms and features.
What is narcissistic personality disorder?
Narcissistic personality disorder is a complex mental health condition that may be less common than you think.
For instance, studies show that around 0.5% of American citizens (or one in two hundred people) have narcissistic personality disorder in the United States.
Additionally, gender differences can significantly impact the prevalence rates of narcissism; for example, the research literature shows that 75% of people diagnosed with narcissistic personality disorder are men.
The type of people more likely to have narcissistic personality disorder
According to the literature, the prevalence rates of NPD are slightly higher in those belonging to specific demographic groups, including:
- People serving in the military (20%)
- Medical students in their first year (17%)
- People seeking treatment from mental health services (2-6%)
Moreover, research shows that narcissistic personality disorder symptoms tend to present in early adulthood.
Living with narcissistic personality disorder
Although narcissistic personality disorder has had its fair share of negative press over recent years, little has been written about what it’s like living with the condition.
If you were to type “narcissism” into an internet search bar, you’d likely be bombarded with information (some of it primarily negative) about the disorder, including the symptoms.
You are less likely to come across the daily challenges faced by those with NPD, how their condition impacts their perceptions and view of the world, and how this affects their relationships with others and themselves.
Unlike some mental health disorders like depression and anxiety, people with narcissistic personality disorder generally do not receive much empathy or compassion within society, including family, friends and broader communities.
In our experience, the opposite is often true.
Those with NPD are often shunned as manipulators and abusers and are generally viewed as outcasts by those who do not understand the condition.
There are various reasons why people with narcissistic personality disorder are often stigmatised so harshly, starting with how the condition presents itself.
The hallmarks of narcissism
If we examine the symptoms of narcissism, we might get a clearer picture of why people with this disorder are so often misunderstood and scrutinised.
Firstly, many mental health professionals believe narcissistic personality disorder is a spectrum condition, meaning that some narcissistic characteristics are often a part of other disorders.
Although the keyword to remember here is ‘spectrum’, which may suggest that we all have narcissistic traits to some degree where each of us sits somewhere on the spectrum.
However, people with narcissistic personality disorder tend to exhibit more pervasive symptoms than someone without the condition.
For instance, people with NPD may spend a significant amount of time comparing themselves to others and may even fantasise about wealth, brilliance and beauty.
It’s also not uncommon for narcissists to see themselves as superior to others – they may debase others to get what they want or to boost their [very fragile] egos.
Symptoms of narcissistic personality disorder
According to the diagnostic and statistical manual of mental disorders, fifth edition (DSM-5), the symptoms of NPD can be diverse depending on the individual but typically include the following:
- A strong sense of entitlement
- A tendency to exploit others
- A severe lack of empathy
- A pervasive sense of self-importance
- A constant need for admiration and attention
- A pervasive pattern of grandiosity
- Feeling superior to others and expecting ‘special treatment.’
- Fantasies about wealth, beauty, power, or control over others
- Haughty or arrogant behaviour
You may (or may not) know that people with narcissistic personality disorder are at higher risk of developing co-occurring conditions (particularly those with pathological narcissism).
Some of the more common co-occurring conditions associated with NPD include:
- Depression and anxiety
- Bipolar disorder
- Eating disorders
- Substance use disorders
According to the literature, concurrent disorders are prevalent among narcissistic client groups.
For instance, over 15% of those with NPD also suffer from depression, while others have co-occurring mental health conditions, such as anxiety (13.5%) and mood disorders (17%).
Other personality disorders
Studies show that various other personality disorders commonly co-occur with NPD, including:
- Antisocial personality disorder
- Paranoid personality disorder
- Histrionic personality disorder
- Borderline personality disorder
In addition, around 24% of people with narcissistic personality disorder abuse drugs, while approximately 14% have an alcohol use disorder.
Looking at these statistics, we might get a clearer picture of the underlying mechanics of narcissism and the profound suffering that many with the condition encounter daily.
Narcissism: a defence mechanism
In an interview about narcissism, a gentleman previously diagnosed with narcissistic personality disorder referred to the condition as a ‘defence mechanism’.
He explained that:
‘Narcissism is a defence mechanism.
Like everyone else, the narcissist has a career, goes to school and reacts to stuff that happens around them. The only difference is that the narcissistic brain sees the outside world as something they have created.
Therefore, the outside world for a narcissist looks different because they know this world as being something of their creation.
There might be imperfections the narcissist doesn’t want to see, so their brain prevents them from seeing them.
For instance, the narcissist’s partner may have imperfections they do not wish to know about because they need this person to fit into their ‘perfect’ world.
So, if their partner wants pizza for dinner, for example, and [the narcissist] wants Mexican food, this can cause much confusion. How can that perfect piece of the puzzle not want the same thing [the narcissist] wants?’
Thus the cracks begin to show.
Narcissistic personality disorder and the devaluation phase
When the people around them have different opinions, wants, needs and desires, this throws the narcissist off balance, and they may become disoriented and confused.
According to psychologists, this is usually when the devaluation phase begins – here, the narcissist discards anyone that does not fit into the perfect, idealised world they have created.
Primary and secondary narcissism
Austrian psychoanalyst Sigmund Freud is famous for his work on narcissism, particularly his concept of primary and secondary narcissism.
Freud believed that two primary forces fuel narcissists’, the first is a profound need for self-preservation, while the second is the sex drive.
In addition, Freud explained that individuals with narcissistic tendencies exhibit traits of self-love and disregard for others, which emerges as a misconstrued direction of love meant for others onto oneself.
According to Freud, as infants, we project our self-love onto external objects and other people.
However, in cases of trauma or a stunt in development, all that self-love returns (albeit neurotically) in the expression of narcissism.
Here, the love and affection meant for others are directed back to the infant in its most negative form, which may present as narcissism in later life.
Traumatised individuals are at higher risk of developing personality disorders such as NPD, with many believing they deserve ‘special treatment’ while lacking empathy and compassion for others.
Freud believed that the above is due to an imbalance in the expression of ego-libido and object-libido (self-love and love for others).
Taking care of yourself
Living with narcissistic personality disorder can often be a confusing and frustrating experience, but there are some things you can do to take care of yourself.
Maintaining healthy relationships can be challenging if you have NPD; however, having people you can turn to in times of stress or crisis may help you cope with your symptoms better.
Studies show that having a supportive network of family and friends can help you manage some of the stress of living with narcissism. Therapy is also vital in helping you cope with this condition.
Treating narcissistic personality disorder
Various treatments can help you manage your condition more effectively; studies show that those with narcissistic personality disorder may benefit from the following therapies:
- Cognitive behavioural therapy
- Dialectical behaviour therapy
- Trauma treatment
- Substance abuse treatment programs (for those with concurrent disorders)
These treatments aim to address maladjusted thought and behavioural patterns, allowing you to cope better and understand your condition.
In addition, talking to a mental health professional with knowledge and experience in treating narcissism may help you feel less isolated and, ultimately, more empowered.
Living with narcissism may bring various challenges, but finding recovery is possible, and your condition does not define you.
At Camino Recovery, we specialise in treating various mental health conditions, including personality disorders and addictions.
Our staff provide a trauma-informed, inclusive approach to treating mental health disorders where each client feels seen, heard and understood no matter their condition, experience or background.
Contact our friendly team today and let us be part of your journey to wellness and recovery.