He believes he is the most important person in the room. He thinks he deserves special treatment. He’ll never admit he’s wrong and is quick to blame others. He needs constant admiration and attention. He is hypersensitive to criticism. He is so preoccupied with himself that nobody else seems to matter.

Have you ever met someone like this?

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), individuals with narcissistic personality disorder (NPD) exhibit five or more of the following:

1. Grandiose sense of self-importance
2. Preoccupation with fantasies of success and power
3. Belief that one is special and can only relate to other “special” people
4. Need for excessive admiration and praise
5. Sense of entitlement
6. Exploitation of others
7. Lack of empathy for others
8. Envious of others or belief that one is the object of envy
9. Arrogant and haughty behaviors or attitudes

A person with narcissistic personality disorder believes that they are more valuable and important than other people. They have limited interest in the feelings of others. They believe their opinions are the only ones that really matter, and that they deserve special treatment.

Many people with NPD are relentless. They may take advantage of others. They don’t admit fault. They expect others to automatically go along with all their plans and ideas. They may try to belittle others to make themselves appear superior.

Although they appear to have extreme confidence, people with NPD often have a fragile self-esteem and a deep sense of insecurity, inadequacy and vulnerability. They may feel depressed and moody because they fall short of perfection.

People with NPD also tend to be easily hurt or rejected, and are quick to become angry or irritated. They are adverse to the slightest criticism and may get enraged when confronted or challenged. To protect themselves from feelings of inferiority, they will deny mistakes and blame others.

When upset, the narcissist will often withdraw from others, give the “silent treatment” and hold grudges. They may feel easily slighted and become impatient or angry when they don’t receive special treatment.

NPD causes problems in many areas of life, including relationships, work and school. A person with untreated NPD may have a higher risk of impulsive behaviors, abusing drugs and alcohol, mood and anxiety disorders, and suicidal behaviors or thoughts.

What causes NPD?

The cause of NPD is unknown. Early life experiences, such as an unhealthy parent-child relationship (e.g., neglect, over-pampering) are thought to play a role in developing this disorder. For instance, a young child who has an unempathetic, distant and hypercritical mother may create an internalized grandiose self as a defense against this perceived lack of love. To avoid being vulnerable, they become unable to tune into other people's feelings and needs.

When you first meet someone with NPD, you may be taken in by him. He can be charismatic and charming. But over time, you feel like you’re not being heard, not being noticed and being criticized and rejected daily. And, because the narcissist may seem so certain of what he says and does, you may second guess yourself.

How is NPD treated?

Treatment for NPD consists primarly of talk therapy (psychotherapy) and medication. That being said, to make any changes, the narcissist has to see a problem and be motivated to change. Yet, people with NPD shun self-examination. They are defensive and have a difficult time acknowledging vulnerabilities. They often have to hit rock bottom, such as a spouse leaving or losing a job, before seeking treatment.

What if your loved one is a narcissist?

Living with someone who has NPD can be challenging. Family members have described their loved one as controlling and quick to lose their temper at the slightest provocation. You may feel like you’re walking on eggshells all the time.

Narcissists aren’t capable of a give-and-take relationship, it’s all one-sided. They aren’t looking for partners, but rather obedient admirers.

You will never be enough for the narcissist, so stop exhausting yourself to try to be so. The best you can do is to focus on taking care of yourself, set healthy boundaries, and stop expecting that your love can change the narcissist. It ultimately takes professional help for a narcisstic to improve their empathy and relate to others in a healthier way.

Do you think you know a narcissist? Get support from Linden Oaks Behavioral Health.