Narcissistic personality disorder (NPD) refers to a mental state that is characterized by a a person’s unhealthy perception of themselves as superior to and more important than the people around them. People with this condition have an over-inflated sense of their dominance, entitlement and prestige.

However, beneath this exterior lies a very fragile self esteem and individuals with NPD are often very sensitive to criticism. They may react to criticism with contempt or rage and attempt to belittle others. These reactions are referred to as narcissistic rage. NPD is more common in men than women.

People with NPD are preoccupied with success, power and vanity and tend to think their achievements and capabilities far exceed those of the people around them. They may exaggerate or even lie about their experiences or accomplishments in order to bolster their self image. Affected individuals also believe their opinions, interests and feelings are more important than those of others and they find it difficult to empathise. Other features of this condition include patronising behaviour and an overpowering need to be admired and respected. Being contradicted or confronted by individuals who they consider inferior can trigger narcissistic rage in a person with NPD.

NPD is an ongoing pattern of abnormal behavior and affected individuals show signs of the condition across a wide range of interpersonal and social situations. Some signs of this condition are outlined below.

The typical symptoms include:

• Sense of superiority over others
• Craving for the attention of others
• Inflated sense of success, power and intelligence
• Setting unrealistic goals
• Boasting about accomplishments and skills
• Sense of entitlement to special treatment
• Tendency to be jealous of other people’s achievements
• Extreme sensitivity to being contradicted or criticized
• Response to criticism is anger, shame or humiliation
• Manipulative nature
• Problems maintaining healthy relationships
• Belief that people are jealous of them
• Wanting the “best” of everything
• Believing that others should follow their advice or recommendations
• Lack of empathy
• Self centred and self absorbed
• Expectation of praise and admiration

The exact cause of NPD is not yet understood, but is thought to involve a combination of genetic, environmental, psychological and social factors. The criteria that must be met for a diagnosis of NPD to be confirmed are outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM). There is no absolute cure for narcissism.

The main therapeutic approaches to this condition are counselling and psychotherapy. Medication may also be prescribed if patients demonstrate signs of depression or anxiety. Over time, individuals with this condition can start to construct new thought patterns to replace their distorted self-image and help them identify with more positive patterns of behavior.