Guide To Diagnosing And Treating Narcissistic Personality Disorder

Narcissistic personality disorder is a personality disorder that occurs when an individual has an inflated sense of self-importance that covers a very fragile sense of self-esteem. A person with this disorder creates a sense of superiority and self-importance to avoid dealing with their fears and insecurities. They tend to require large amounts of external validation, admiration, and praise. Patients with narcissistic personality disorder also struggle to cope with criticism, because they can't acknowledge themselves as flawed individuals without also needing to acknowledge their insecurities. Though narcissistic behavior can occur in many different types of people, a hallmark of narcissistic personality disorder is that the affected individual experiences deep unhappiness, disappointment, and dissatisfaction in their life. They may also experience issues with their day-to-day functioning, interpersonal relationships, and career due to their behavior.

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Thorough Psychological Evaluation

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The first step to diagnosing narcissistic personality disorder is through a thorough psychological evaluation. Personality disorders are defined by a distortion in thought patterns, emotions, and behaviors that affects an individual's whole sense of self, which can make diagnosing and treating them difficult. Patients with narcissistic personality disorder oftentimes don't realize that anything is wrong, or if they do, they blame others for the problems instead of themselves. A big issue with narcissistic personality disorder is an inability to understand that the self is flawed, which can make it difficult to get a patient with this condition to seek treatment. Individuals with narcissistic personality disorder often receive a diagnosis only after they've been given an ultimatum by people or institutions in their lives. It's sometimes difficult for them to accept the diagnosis. However, proceeding with treatment is the only way to achieve equilibrium and happiness. The symptoms of narcissistic personality disorder can sometimes be similar to those of personality disorders like avoidant personality disorder, obsessive-compulsive disorder, or antisocial personality disorder. For this reason, a skilled mental health practitioner must consider all aspects of the patient's behavior and mental health history.

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Physical Exam

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Another aspect of the diagnostic process is a physical exam. Most mental health disorders require a physical exam to rule out physical causes of symptoms. For example, there are neurological disorders that can cause problems with the way individuals think and process emotions. Any damage or pressure against certain areas of the brain will affect the way individuals interpret reality. In addition to neurological issues, the doctor may also do tests to rule out certain physical illnesses. Behaviors and personality disorders are not often caused by non-neurological physical issues. However, feelings of deep sadness and dissatisfaction in life can be caused by a myriad of conditions. For example, hypothyroidism can make patients feel lethargic and depressed for no reason. This condition is treated through medication to supplement low thyroid hormones. If the physician takes blood tests and does a physical examination without finding anything amiss, they can then attribute the patient's behavioral and emotional symptoms to mental health issues.

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Psychotherapy

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One reason treatment for personality disorders is difficult is because personality disorders aren't typically treatable with medication. These disruptions in behavior and sense of self aren't caused by a chemical imbalance, so treatment isn't as simple as filling a prescription and taking a pill each day. Some medications might be used to supplement treatment, but psychotherapy is the main way of treating narcissistic personality disorder. Talk therapy can consist of a few different components. One of the most common is cognitive behavioral therapy, which helps patients learn to recognize their irrational emotions and deal with them in healthy ways. It can also help with interpersonal relationships. Family therapy and counseling can sometimes help mediate conflicts and fix issues in a patient's interpersonal relationships. Another key component of talk therapy is coming to a better understanding of the self. Patients will learn what causes their emotions and impulses, why they have a low sense of self-esteem, and why they feel the need to seek validation from others. Understanding the root of these issues can help patients begin creating a healthier outlook on the world.

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Prescription Medication

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Prescription medication is not the first-line treatment for narcissistic personality disorder, though it may be used as a supplemental form of treatment if patients have other underlying mental health conditions. For example, if the patient's inability to cope with criticism or accept their flaws is caused by chemically-imbalanced anxiety, medication might be able to help with that. Medication might also be able to help with feelings of depression, low self-esteem, and insecurity caused by chemical imbalances. However, patients will still need talk therapy to work through their behaviors, thoughts, and how to become more aware of their emotions and actions. No medications are specifically approved by the Food and Drug Administration for the treatment of narcissistic personality disorder. Antidepressants and anti-anxiety medications are the most common supplemental medications used to deal with underlying insecurity and fear. Sometimes mental health medication can make it easier to approach difficult topics in therapy. Balancing their neurochemistry is essential if patients are going to tackle difficult questions about themselves.

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Treatment For Other Health Issues

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After a patient has been diagnosed, the treatment plan will likely have a heavy focus on psychotherapy with the potential of supplemental mental health medications. In addition, patients must receive treatment for other health issues, particularly ones that can be contributing to their mental health problems. Anxiety and depression are often part of the root of narcissistic personality disorder, and when they are treated, patients will have an easier time facing their flaws and becoming self-aware. Some individuals develop the behaviors seen in narcissistic personality disorder as a defense mechanism so they don't have to acknowledge their stress, anxiety, depression, and fear of inadequacy. It's also common for patients with narcissistic personality disorder to self-medicate their negative feelings with drugs or alcohol. Seeking treatment for any substance abuse issues patients have will help them have a clearer head and clearer goals when they go through therapy for their personality disorder, which is vitally important.

Katherine MacAulay