Written & Medically reviewed by
Dr.Sanjana.V.B. Bhms. Dbrm.Cdn

Narcissistic personality disorder (NPD)

Overview

Narcissistic personality disorder (NPD) is a personality disorder in which people have extreme self-importance and an inflated opinion of themselves. They crave for the admiration and attention of others and if it is not gratified it arouses their anger and behave very badly.

People with this personality have high self-esteem and they are arrogant, self -centered and demanding. It is a complex personality disorder often detected with other mood[ affective] and personality disorders. 

Impact of NPD

Impacts of NPD

NPD can cause problems in many areas of an individual’s life, including work, school and in relationships. NPD appears to be more prevalent in the population [6.2%].NPD shows male preponderance.

Men are more affected with this personality disorder Narcissistic personality disorder (NPD) is a pattern of grandiosity, need for admiration, and lack of empathy.

It is classified under Cluster B personality disorders, with overly emotional and unpredictable behavior.

Individuals with NPD may experience significant psychological distress related to interpersonal conflict.

It is an interesting fact to know that many types of Cluster B personality disorders, including NPD, have demonstrated significantly higher mortality rates due to cardiovascular disease than those without personality disorders.

Symptoms of Narcissistic personallity disorder

·        A persistent pattern of self-glorification and a need to highlight his exceptional uniqueness.

·        Feeling of extreme self- importance.

·        Tendency toward hypersensitivity or oversensitivity and negative automatic thought patterns regarding perceived insults from other people, who interacted with. 

·        Contradiction, criticism offends and it is perceived in a negative perspective of humiliation or insult. Even trifles make him or her offended and irritated. 

·        Unrealistic goal-setting, feelings of failure, and low mood 

·        Traits such as aggression, reduced tolerance to distress, and dysfunctional affect regulation is prominent in persons with NPD.That means, there is irritability, difficulty to cope with distresses in life.

      The emotional response is poorly regulated and it is not in accordance with the traditionally accepted range of emotional reaction.

      There is marked fluctuation of mood. It is manifested as outburst of anger, anxiety, depression, suicidal thoughts in severe cases.

      In severe cases of NPD self-harm and self-damaging behaviors are also manifested.

·         Person with NPD is often envious of others or believes that others are envious of them.

·        Shows arrogant, haughty behaviors and attitudes

·        NPD affects quality of life, social interactions and relationships.

·        Vulnerable to extensive substance abuse[use of drugs] also.

      Types of  narcissistic personality disorders [ NPD ]

There are two basic subtypes, including grandiose and vulnerable narcissistic personality disorders.

The grandiose subtype includes overt grandiosity, presence of aggression, and boldness. Aggression, lack of empathy, and exploitation of others. The aggression indicates the severity of the personality disorder. Exaggerates achievements, expects to be recognized as superior without actually completing the achievements. Has a sense of entitlement, such as an unreasonable expectation of favorable treatment.

 The vulnerable subtype presents with hypersensitivity and defensiveness and is often easy to miss.

What causes the development of narcissistic personality disorders?

Causes of NPD

·        Genetic predisposition

·        Negative experiences of childhood. Neglect from parents.

·        Excessive pampering of children.

      How to diagnose narcissistic personality disorders?

Diagnosis of NPD requires evaluation of long-term patterns of functioning of the person. One needs to be cautious not to jump to hasty conclusions.

Different aspects of a person's life and an understanding of the person's childhood development help to diagnose to some extent.

Treatment for narcissistic personality disorders

Conventional treatment:

No standardized pharmacological or psychological treatment has been established for persons with narcissistic personality disorder.

NPD is present, along with other mood disorders & need to be managed with medications; including anxiety, depression, mood lability, transient psychosis, and impulse control issues.

Antidepressants, including selective serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors, have been used.

Differential Diagnosis of NPD 

Various other forms of mental illnesses resemble NPD. Therefore it is crucial to differentiate NPD from them. Sometimes these illnesses coexist with NPD in individuals.

·        Mood disorders

·        Anxiety

·        Depression

·        Antisocial  personality disorder

·         Histrionic  personality disorder

·         Borderline  personality disorder

·        Obsessive-compulsive disorder

·        Substance-induced mood disorder

Npd needs to be differentiated from all these disorders by history taking, evaluation and clinical psychological examinations.

Alternative & complementary medicine treatment for NPD

Homeopathic treatment

Homeopathic treatment for Narcissistic personality disorder

Medicines:

Platina, sulphur ,veratrum alb top the list if egotistical behaviour is presented as the major symptom. Veratrum is used if manic episodes follow with aggressiveness.

Narcissistic personalities may have multiple other comorbidities coexisting like OCD, depression, anxiety etc. and their occurrence vary from person to person. Medicines are selected based on the total manifestations and associated other mental illnesses .Individualization is important in medicine prescription.

The acute manifestations can be tackled with some short acting drugs for the time being. But the whole case needs a deeper comprehensive individualized approach from both clinical and Homeopathic point of view.

Written by dr sanjanavb [copyright]

References

1.     https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5819598/

2.     Materia Medica by James Tyler Kent

3.      Materia Medica by John Henry Clarke

4.      Pocket Manual Of Homoeopathic Materia Medica & Repertory

5.      A Concise Repertory Of Homeopathic Medicines

6.      Homoeopathic Medical Repertory

7.     SIAHMSR clinical archive data