What Is Narcissistic Personality Disorder And How Can It Be Treated?

Updated December 9, 2022by BetterHelp Editorial Team

People often use the word “narcissist” without understanding what it means. Many people think narcissism means being arrogant or vain, but the truth is different from what most of us probably think. Narcissism is a diagnosable personality disorder that can significantly impact a person’s life and the lives of everyone around them. Narcissistic personality disorder can be challenging to diagnose, but with proper treatment, people with this condition can adapt and learn how to better relate to others.

Unpacking Negative Beliefs Caused By NPD Can Be Difficult

What Is Narcissistic Personality Disorder (NPD)?

There are a few types of narcissists, but they all have similar tendencies. Someone with a narcissistic personality disorder tends to be highly focused on their own importance and has little empathy or care for others, often believing other people are there only to make their life better or easier. At the same time, however, they have a fragile sense of self and react strongly to criticism.

Symptoms of Narcissistic Personality Disorder

Narcissistic personality disorder can be tough to diagnose and requires a thorough evaluation and assessment performed by a mental health professional. Psychotherapists often look at patterns of behavior and functioning. Like other personality disorders, narcissistic personality disorder is thought to develop due to a mix of environmental and biological factors, or both nature and nurture. Specifically, early rejection during childhood is linked with the development of narcissistic personality traits.

Although you should be careful not to jump to conclusions, knowing what symptoms to look for can help determine if you or someone you know may need help. According to the DSM-5, NPD includes a need for admiration and a pervasive pattern of grandiosity with a lack of empathy. For an NPD diagnosis, the person must exhibit at least five of the following:

  • A grandiose sense of self-importance

  • A preoccupation with fantasies of success, brilliance, power, beauty, or perfect love

  • A belief that they are special and only other special people can understand them

  • A need for excessive admiration

  • A sense of entitlement

  • A tendency to take advantage of others to achieve their own ends

  • A lack of empathy and being unwilling to identify with the needs of others

  • Envy for others or a belief that others are envious of them

  • Arrogant, haughty attitudes and behaviors

Arrogant or Narcissistic?

When is a person arrogant, and when have they crossed the line to narcissism? It can happen when they go from having confidence in themselves to believing that they are more important than others. An arrogant person may have an inflated sense of self-worth and difficulty with criticism, but they can recognize (and sometimes attempt to exploit) the feelings or needs of others.

Generally, arrogant people have cultivated their sense of superiority due to their achievements. A narcissistic person has an innate sense of superiority that even they may not be able to explain fully. For them, it is a simple fact, and those that disagree are frequently viewed as being at fault. 

Unpacking Negative Beliefs Caused By NPD Can Be Difficult

How NPD Is Diagnosed

Like other personality disorders, NPD is assessed through clinical interviews and formal assessments administered by a licensed mental health professional. They will get a family history and may refer the patient for a medical evaluation to rule out underlying medical issues that may contribute to certain behaviors.

The Treatment Process

Treatment may include psychotherapy, such as cognitive behavior therapy, that helps to uncover underlying beliefs that support the behaviors, thoughts, and feelings found to be upsetting to daily life with NPD. Therapy will also help support a person in repairing and building relationships with loved ones, which are often damaged by the traits of NPD. Many therapists advocate for people with this personality disorder to attend ongoing therapy sessions.

Medication can be beneficial with treatment as well. While there is no medication to treat the disorder, it can be highly effective at treating some underlying conditions that can worsen the problem. For example, medications can effectively treat depression and anxiety, which may appear along with narcissistic personality disorder. It is essential to look at all your treatment options and work out a path that works for you with your doctor.

Overcoming Narcissistic Personality Disorder

Like other personality disorders, overcoming narcissistic personality disorder is complicated because personality is an innate part of who you are. But treatment can help you recognize and manage how you interact with others and lead a healthy and productive life.

Online counseling can help narcissists with various aspects of NPD. Ongoing counseling can help people with this disorder gain more insight into their problems, develop healthy self-esteem, have more realistic expectations of others, and work on relating to others more positively. 

Online counseling has many benefits for people with NBD and those in their lives who are affected by it. It’s a highly convenient way to connect with someone who can shed light on NPD and is well-equipped to help, especially if you think it creates challenges for you and your loved ones. You can speak with someone from the comfort of your home, and you don’t have to worry about being put on a waiting list or struggling to find an open appointment slot.

Getting therapy online is also effective, especially if you’re dealing with anxiety and depression due to NBD. One review found that online treatment for depression and anxiety may be more effective than face-to-face counseling, and patients reported being equally satisfied with both. If you or someone you love is dealing with the effects of NPD, online therapy with BetterHelp might be a good treatment option.

“Jeffrey Owen has a wealth of knowledge and experience. He is clearly skilled in his guidance, enabling me to understand the complexities of narcissism and the impact of such lifelong abuse; that I had not fully understood. Reading on the subject matter is useful, but having counseling to explore in a different way is empowering for a survivor like myself. So thank you Jeff.”

“Busola is amazing, I've only had a few sessions with her but she makes me feel listened to. She understands what my primary needs are for each session and addresses them. Moreover, it doesn't feel like just time to talk and unload everything on someone, but she addresses negative behavioral patterns and helps create an action plan for them.”


Narcissistic personality disorder is challenging to diagnose and can be hard to deal with as it can drastically affect relationships. If you have NPD or are navigating a relationship with someone who does, online therapy can help.

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