Bipolar4LifeSupport

test and diagnosis

Narcissistic personality disorder is diagnosed based on signs and symptoms, as well as a thorough psychological evaluation that may include filling out questionnaires.

Although there’s no laboratory test to diagnose narcissistic personality disorder, you may also have a physical exam to make sure you don’t have a physical problem causing your symptoms.

Some features of narcissistic personality disorder are similar to those of other personality disorders. It’s possible to be diagnosed with more than one personality disorder at the same time.

To be diagnosed with narcissistic personality disorder, you must meet criteria spelled out in the Diagnostic and Statistical Manual of Mental Disorders (DSM). This manual is published by the American Psychiatric Association and is used by mental health providers to diagnose mental conditions and by insurance companies to reimburse for treatment.

Criteria for narcissistic personality disorder to be diagnosed include:
•Having an exaggerated sense of self-importance
•Being preoccupied with fantasies about success, power or beauty
•Believing that you are special and can associate only with equally special people
•Requiring constant admiration
•Having a sense of entitlement
•Taking advantage of others
•Having an inability to recognize needs and feelings of others
•Being envious of others
•Behaving in an arrogant or haughty manner

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preparing for your appointment

People with narcissistic personality disorder are most likely to seek treatment when they develop symptoms of depression — often because of perceived criticisms or rejections. If you recognize that aspects of your personality are common to narcissistic personality disorder or you’re feeling overwhelmed by sadness, talk with your doctor. Whatever your diagnosis, your symptoms signal a need for medical care.

When you call to make an appointment, your doctor may immediately refer you to a mental health provider, such as a psychiatrist.

Use the information below to prepare for your first appointment and learn what to expect from the mental health provider.

What you can do
•Write down any symptoms you’re experiencing and for how long. It will help the mental health provider to know what kinds of events are likely to make you feel angry or defeated.
•Write down key personal information, including traumatic events in your past and any current, major stressors.
•Make a list of your medical information, including other physical or mental health conditions with which you’ve been diagnosed. Also write down the names of any medications or supplements you’re taking.
•Take a family member or friend along, if possible. Someone who has known you for a long time may be able to ask questions or share information with the mental health provider that you don’t mention.
•Write down questions to ask your mental health provider in advance so that you can make the most of your appointment.

For narcissistic personality disorder, some basic questions to ask your mental health provider include:
•What exactly is narcissistic personality disorder?
•Could I have different mental health conditions?
•What is the goal of treatment in my case?
•What treatments are most likely to be effective for me?
•How much do you expect my quality of life may improve with treatment?
•How frequently will I need therapy sessions and for how long?
•Would family or group therapy be helpful in my case?
•Are there medications that can help?
•I have these other health conditions. How can I best manage them together?
•Are there any brochures or other printed material that I can take home with me? What websites do you recommend visiting?

In addition to the questions that you’ve prepared to ask your mental health provider, don’t hesitate to ask any additional questions that may come up during your appointment.

What to expect from your mental health provider

The mental health provider is likely to ask you a number of questions to gain an understanding of your symptoms and how they’re affecting your life. The mental health provider may ask:
•What are your symptoms?
•When do these symptoms occur, and how long do they last?
•How do you feel — and act — when others seem to criticize or reject you?
•Do you have any close personal relationships? If not, how do you explain that lack?
•What are your accomplishments?
•What do you plan to accomplish in the future?
•How do you feel when someone needs your help?
•How do you feel when someone expresses difficult feelings, such as fear or sadness, to you?
•How would you describe your childhood, including your relationship with your parents?
•How would you say your symptoms are affecting your life, including school, work and personal relationships?
•Have any of your close relatives been diagnosed with a mental health problem, including a personality disorder?
•Have you been treated for any other mental health problems? If yes, what treatments were most effective?
•Do you use alcohol or illegal drugs? How often?
•Are you currently being treated for any other medical conditions?

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COMPLICATIONS

Complications of narcissistic personality disorder, if left untreated, can include:
•Substance abuse
•Alcohol abuse
•Depression
•Suicidal thoughts or behavior
•Relationship difficulties
•Problems at work or school

RISK FACTORS

Narcissistic personality disorder is rare. It affects more men than women. Narcissistic personality disorder often begins in early adulthood. Although some adolescents may seem to have traits of narcissism, this may simply be typical of the age and doesn’t mean they’ll go on to develop narcissistic personality disorder.

Although the cause of narcissistic personality disorder isn’t known, some researchers think that extreme parenting behaviors, such as neglect or excessive indulgent praise, may be partially responsible.

Risk factors for narcissistic personality disorder may include:
•Parental disdain for fears and needs expressed during childhood
•Lack of affection and praise during childhood
•Neglect and emotional abuse in childhood
•Excessive praise and overindulgence
•Unpredictable or unreliable caregiving from parents
•Learning manipulative behaviors from parents

Children who learn from their parents that vulnerability is unacceptable may lose their ability to empathize with others’ needs. They may also mask their emotional needs with grandiose, egotistical behavior that’s calculated to make them seem emotionally “bulletproof.”

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Symptoms
By Mayo Clinic Staff

Narcissistic personality disorder is characterized by dramatic, emotional behavior, which is in the same category as antisocial and borderline personality disorders.

Narcissistic personality disorder symptoms may include:
•Believing that you’re better than others
•Fantasizing about power, success and attractiveness
•Exaggerating your achievements or talents
•Expecting constant praise and admiration
•Believing that you’re special and acting accordingly
•Failing to recognize other people’s emotions and feelings
•Expecting others to go along with your ideas and plans
•Taking advantage of others
•Expressing disdain for those you feel are inferior
•Being jealous of others
•Believing that others are jealous of you
•Trouble keeping healthy relationships
•Setting unrealistic goals
•Being easily hurt and rejected
•Having a fragile self-esteem
•Appearing as tough-minded or unemotional

Although some features of narcissistic personality disorder may seem like having confidence or strong self-esteem, it’s not the same. Narcissistic personality disorder crosses the border of healthy confidence and self-esteem into thinking so highly of yourself that you put yourself on a pedestal. In contrast, people who have healthy confidence and self-esteem don’t value themselves more than they value others.

When you have narcissistic personality disorder, you may come across as conceited, boastful or pretentious. You often monopolize conversations. You may belittle or look down on people you perceive as inferior. You may have a sense of entitlement. And when you don’t receive the special treatment to which you feel entitled, you may become very impatient or angry. You may insist on having “the best” of everything — the best car, athletic club, medical care or social circles, for instance.

But underneath all this behavior often lies a fragile self-esteem. You have trouble handling anything that may be perceived as criticism. You may have a sense of secret shame and humiliation. And in order to make yourself feel better, you may react with rage or contempt and efforts to belittle the other person to make yourself appear better.

When to see a doctor

When you have narcissistic personality disorder, you may not want to think that anything could be wrong — doing so wouldn’t fit with your self-image of power and perfection. But by definition, a narcissistic personality disorder causes problems in many areas of your life, such as relationships, work, school or your financial affairs. You may be generally unhappy and confused by a mix of seemingly contradictory emotions. Others may not enjoy being around you, and you may find your relationships unfulfilling.

If you notice any of these problems in your life, consider reaching out to a trusted doctor or mental health provider. Getting the right treatment can help make your life more rewarding and enjoyable.

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