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Exploring Narcissistic Personality Disorder

Apr 4, 2024 | Abuse, Addiction, Adolescent Treatment, Adult Treatment, Depression, Family Issues, Helping a Loved One

At some point, you may have heard the term narcissist used to describe another person, but this is a rather serious disorder that affects a small portion of the population. Narcissistic Personality Disorder, or NPD, is a complex and often misunderstood condition that is characterized by a long-term pattern of exaggerated self-importance, the need for excessive attention and admiration, and a lack of empathy for others. In this blog, we provide a comprehensive overview of NPD, focusing on its characteristics and its impact.

Defining NPD

Narcissistic Personality Disorder is just one of several types of personality disorders. It’s defined by the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders as encompassing a pervasive pattern of grandiosity, a constant need for admiration, and a complete lack of empathy. These traits often begin in early adulthood, though they are sometimes first observed in childhood or adolescence.

Symptoms and Traits

People who are diagnosed with NPD will exhibit a range of symptoms and behaviors, including:

  • A grandiose sense of self-importance.
  • Preoccupation with fantasies of unlimited success, power, brilliance, beauty, or love.
  • A belief that they are special and unique and can only be understood by or associate with other “special” or high-status people.
  • Need for excessive admiration.
  • A sense of entitlement.
  • Interpersonally exploitative behavior.
  • Lack of empathy.
  • Envy of others or a belief that others are envious of them.
  • Arrogant behaviors or attitudes.
Impact of NPD on Individuals and Relationships
Challenges in Personal Relationships

NPD can wreak havoc on personal relationships, whether that be romantic or otherwise. Those with NPD struggle with maintaining healthy relationships due to their lack of empathy, their tendency to prioritize their own needs over others, and their sensitivity to criticism, which often leads to conflicts and strained interactions. Dating or being romantically involved with someone who has NPD can be especially challenging. Small disagreements can quickly result in large-scale fights. 

Conflicts can be difficult to resolve because people with NPD often believe that they are “right” and that their reactions, no matter how extreme, are justified because they were wounded by their partner. This can be incredibly draining over time and may cause the relationship to end.

Effect on Work and Social Life

In a work setting, people who cope with NPD might either appear as high achievers or struggle due to their interpersonal issues. Their need for admiration and superiority can make teamwork and collaboration challenging or uncomfortable. On top of this, they are less likely to respect their superiors, which can cause major conflict. Any feedback from a leader in the workspace will either be shrugged off or met with a disgruntled attitude. Understandably, this makes work relationships difficult to maintain.

Narcissism and Its Link to Addiction and Substance Abuse

The relationship between NPD and addiction is quite complex. No one condition has been known to cause the other, but those who suffer from NPD and addiction comorbidly find it much more difficult to recover than those who do not. Narcissistic traits can lead to a higher risk of developing substance abuse problems for several reasons:

  • Self-Medication: Those with NPD might use drugs or alcohol to self-medicate their feelings of emptiness, depression, or inadequacy.
  • Risk-Taking Behaviors: The grandiosity and sense of invulnerability seen in NPD can lead to risk-taking behaviors, including substance use.
  • Coping Mechanism: Substance use might be a way to cope with the stress of maintaining their facade or dealing with the negative aspects of the disorder.
Challenges in Treatment

Treating addiction in individuals with NPD poses unique challenges. The lack of empathy and a strong sense of entitlement can make it difficult for them to acknowledge their problem and seek help. Additionally, their sensitivity to criticism hinders the therapeutic process. Recovery is largely centered around accepting one’s faults, surrendering to the need for help, and doing self-reflection. Unfortunately, those with NPD frequently struggle to do all of these.

Treatment Approaches for NPD and Co-Occurring Addiction
  • Psychotherapy: Psychotherapy, particularly cognitive behavioral therapy, is effective in treating NPD. Therapy focuses on helping individuals understand the causes of their emotions and what drives their behavior, develop better empathy, and learn healthier ways to interact with others.
  • Medication: While there are no specific medications for NPD, medications may be prescribed to treat co-occurring issues such as depression or anxiety. In many cases, SSRIs are prescribed to manage symptoms. Some common medications are Zoloft, Wellbutrin, Lexapro, and Prozac.
  • Treating Co-Occurring Addiction: Addressing addiction in individuals with NPD requires an integrated approach that considers both the addiction and the personality disorder. This may include specialized therapy sessions focused on addiction and the development of coping strategies.
Final Thoughts

Narcissistic Personality Disorder has a way of affecting not only those who have the condition but also those around them. Its impact on relationships, work, and quality of life is life-altering for many. Knowing the signs and symptoms of NPD can help those who feel they or someone they know is suffering to find help. With therapy, medication, and a willingness to do the work, improving quality of life is possible.

New Dimensions Can Help!

If you are struggling with a personality disorder and using chemicals to address your pain, New Dimensions can help.  We have Intensive Outpatient and Partial Day Treatment Programs for adolescents and adults to address mental health issues and chemical dependency.  To learn more about our services, including Psychological Testing, Partial Hospitalization Programs (PHP), Intensive Outpatient Programs (IOP), and Interventions for Substance Abuse, contact us at 800-685-9796 or visit our website at www.nddtreatment.com.  To learn more about individual, family, and couples counseling visit www.mhthrive.com.

 

Keywords: NPD; Narcissistic personality disorder; Co-occurring addiction; Personality disorder

References

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Mitra P, Fluyau D. Narcissistic Personality Disorder. [Updated 2023 Mar 13]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK556001/

Weinberg I, Ronningstam E. Narcissistic Personality Disorder: Progress in Understanding and Treatment. Focus (Am Psychiatr Publ). 2022 Oct;20(4):368-377. doi: 10.1176/appi.focus.20220052. Epub 2022 Oct 25. PMID: 37200887; PMCID: PMC10187400.