Narcissists tend to be paranoid

Psychiatry, Psychosomatics & Psychotherapy


Narcissistic personality disorder often combined with other disorders

Diseased narcissists suffer from low self-esteem, a pronounced sensitivity to criticism and fear of failure. Narcissistic personality disorder is a profound personality disorder that is often associated with other psychological disorders.

On the one hand, the term narcissism is associated with a character trait that is characterized by characteristics that are self-indulgent and in need of recognition. On the other hand, with a personality disorder, which includes a disorder that can have a significant disease value - also because those affected often have accompanying psychological disorders. Narcissistic personality disorder is a pervasive personality disorder. The focus is on a feeling of grandiosity, overestimation of oneself, a lack of empathy and egocentrism. “In the background, narcissists suffer from low self-esteem, a pronounced sensitivity to criticism and fear of failure. Affected people are always dependent on external confirmation in order to stabilize their own self and their sense of wellbeing, ”reports Prof. Sabine Herpertz from the German Society for Psychiatry and Psychotherapy, Psychosomatics and Neurology (DGPPN) in Berlin. “They experience criticism of themselves, doubts or rejection as extremely offensive and painful. In addition, they are constantly under stress because their excessive self-concept is a constant threat of failure. ”These different stresses can lead to further psychological disorders such as depression, anxiety disorders and addiction disorders.

Risk of suicide with pathological narcissism

No other personality disorder has the same high suicide rate as narcissistic personality disorder. Around one in ten people with pathological narcissism commits suicide. The failure of the compensation mechanisms, chronic overexertion and a feeling of inner emptiness can put a lot of strain on those affected. "The trigger for suicidal crises is often insults, defeats, combined with a breakdown of the excessive and at the same time unstable self-esteem," adds the psychiatrist and psychotherapist.

Crisis as an opportunity for change

Most people with personality disorders do not perceive their symptoms as such. They usually only experience the consequences as problematic. As a result, people with narcissistic personality disorder rarely seek help and often do so late. "In many cases, therapeutic help is sought only because of the existing concomitant illnesses that have led to high levels of suffering," adds Prof. Herpertz. Real crisis situations such as separation from a partner, professional failures or a job loss can also be reasons for therapy.

A narcissistic personality disorder cannot be cured, but it can be alleviated in such a way that those affected (and those around them) no longer suffer from it. However, those affected must seek specific psychiatric and psychotherapeutic help for this. “Narcissistic personality disorder is primarily treated with psychotherapy. Medicines can also be used for accompanying illnesses such as depression, ”reports Prof. Herpertz. In the course of therapy, work can be done to reduce narcissistic behavior and promote realistic self-perception. A central aspect is also to improve the interpersonal interaction problems that exist in the form of fear of negative evaluation by others and a lack of empathy.

A study carried out in Germany found that 9.4 percent of the population are affected by personality disorders. Narcissistic personality disorders affect up to 0.4 percent of the population.

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