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What is narcissistic personality disorder? - It's a mental health condition that affects how people view themselves and interact with others, going beyond just arrogance or selfishness.

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Origins -

The condition gets its name from Narcissus, a figure from Greek mythology. According to the myth, Narcissus was so obsessed with his own beauty that he couldn't stop staring at his reflection in a pool of water. Eventually, this self-obsession led to his decline and death.

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Not just looks -

Influenced by the Greek myth, people often associate narcissism with physical appearance. Yet, the disorder frequently involves a skewed view or obsession with other traits, such as intelligence, charisma, artistic skill, or even wealth and power.

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How common is it? -

While experts find it difficult to pinpoint an exact figure, NPD is estimated to affect up to 5% of the US population. It is also 50 to 75% more common in people assigned male at birth than assigned female at birth.

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Hiding it - Many people hide narcissistic beliefs or behaviors (informally known as "covert narcissism"), making it even more challenging to estimate the true prevalence of NPD.

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What are the symptoms? -

The symptoms of NPD revolve around thoughts, feelings, and actions. The American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR) outlines the following nine criteria.

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Grandiose sense of self-importance -

Specialists may analyze how people with this condition view themselves. Common indicators of NPD are overestimating their abilities or setting unreasonably high standards for themselves.

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Exaggeration -

Someone with NPD might boast about their accomplishments, even if they're exaggerated or not entirely true. They might talk themselves up and downplay the contributions of others.

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Fantasies -

People with NPD often have grandiose fantasies. They might imagine themselves as exceptionally successful, powerful, intelligent, or beautiful. They might also dream of unlimited love and admiration.

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Belief in superiority -

Individuals with NPD often feel special and unique. They might believe that they can only associate with high-status individuals and that ordinary people aren't good enough for them.

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Need for admiration -

Contrary to popular belief, some symptoms of NPD may stem from a lack of self-confidence. Individuals with NPD often have fragile self-esteem, leading to frequent self-doubt, self-criticism, and feelings of emptiness. This also manifests in a preoccupation with others' opinions and a constant need for validation.

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Entitlement -

Due to an inflated sense of self-worth, people with NPD may expect special treatment and become angry when others don't meet their unreasonable demands.

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Willingness to exploit others - People with NPD often have a pattern of, conscious or unconscious, exploitative behavior. They might manipulate others to get what they want, often without considering the other person's feelings. Seeking out relationships with people to elevate their own ego or social status can be another sign.

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Lack of empathy -

People with NPD often struggle with empathy, leading them to say hurtful things, view others' feelings as weaknesses, and fail to reciprocate kindness or interest shown by others.

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Frequent envy -

Often, people with NPD experience intense envy and resentment toward others, particularly those who are successful. They may downplay others' achievements and lead them to expect to be envied themselves.

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Arrogance -

Displaying arrogant and condescending behavior is also common in someone with NPD. They may act superior to others, talk down to them, or dismiss their ideas.

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Other behaviors -

People with NPD may also exhibit other behaviors related to the nine criteria, such as perfectionism, hypersensitivity to criticism, rejection, or failure, and withdrawal from others to avoid feeling vulnerable.

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It can be dangerous -

In severe cases, individuals with NPD may struggle with feelings of inadequacy or rejection, potentially harming their own well-being. Their tendency to react with anger or even rage when criticized or rejected can also lead to dangerous situations, where they might put themselves and others at risk.

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Are there different types of narcissism? -

While the DSM-5-TR doesn't officially categorize NPD subtypes, experts often group them into types like grandiose (need admiration) vs. vulnerable (need approval), overt (obvious) vs. covert (hidden), and benign (harmless) vs. malignant (harmful).

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What causes this disorder? -

The exact causes of NPD aren't fully understood. Many people with NPD hide their condition, making it difficult to study. While brain differences may play a role, current research suggests that genetics and the following factors may contribute to the development of NPD.

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Observation and imitation -

Children can learn and adopt narcissistic behaviors by observing and imitating narcissistic role models, such as parents or other significant figures.

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Negative childhood experiences -

Traumatic events, rejection, neglect, or lack of support during childhood can also contribute to the development of narcissistic traits.

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Parenting style -

Overindulgent or overprotective parenting styles can contribute to narcissistic traits by creating a sense of entitlement and hindering the development of emotional regulation skills.

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Culture -

Cultural factors, such as individualistic vs. collectivist values, can influence the development of narcissistic traits. Individualistic cultures that emphasize self-reliance and personal achievement may be more likely to foster narcissistic tendencies.

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How is it diagnosed? -

A mental health professional, such as a psychiatrist or psychologist, can diagnose NPD through a detailed evaluation. Out of the nine criteria outlined in the DSM-5-TR, a diagnosis requires meeting at least five. Currently, there are no specific medical tests for NPD.

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Social media impact -

Social media, especially TikTok, has fueled a trend of armchair diagnosing, with videos tagged #NarcTok gaining significant popularity. This trend has emerged alongside increased discussions about mental health, particularly among younger generations, and is also influenced by the rise of "therapy-speak."

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Social media impact - Clinical psychologist Dr. Ramani Durvasula warns against the dangers of self-diagnosis and diagnosing others without proper credentials. Only mental health professionals, such as psychiatrists and clinical psychologists, have the necessary education and experience to accurately diagnose NPD.

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Social media impact -

Dr. Ramani also highlights the dangers of trivializing this condition. If everyone's ex is labeled a narcissist, the true severity of the disorder is diminished. "A layperson can't diagnose schizophrenia or cancer, and this is no different," she explains.

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Treatment -

Treatment for NPD primarily involves psychotherapy. A mental health professional can recommend the most suitable approach, like CBT or psychodynamic therapy. While there's no specific medication for NPD, medications may help manage related conditions like anxiety or depression.

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Living with NPD -

For people with NPD, prioritizing mental health is crucial. This means regularly attending therapy sessions as recommended by a mental health provider, adhering to medication prescriptions as directed, and avoiding substance or alcohol use.

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Living with someone with NPD -

If you suspect someone you care about has NPD, remember that you can't change them. While you can encourage them to seek help, they must be willing to do so. To protect yourself, set healthy boundaries, document interactions, prioritize your own mental health, and seek help if you feel threatened or unsafe.

Sources: (Cleveland Clinic) (Men’s Health)

See also: Narcissistic figures throughout history

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