Both are dysfunctional and weighed down by a history of personal failure on the job and in the family. But the narcissist is ego-dystonic: he is proud and happy of who he is. The anxious patient is distressed and is looking for help and a way out of his or her predicament. Hence the differential diagnosis.
It is easy to mistake the presenting symptoms of certain anxiety disorders with pathological narcissism. Both types of patients are worried about social approbation and seek it actively. Both present a haughty or impervious facade to the world.
Grandiosity is the defining characteristic of narcissism. More than just arrogance or vanity, grandiosity is an unrealistic sense of superiority. Narcissists believe they are unique or “special” and can only be understood by other special people. What's more, they are too good for anything average or ordinary.
Patients with personality disorders are often anxious. Narcissists for instance, are preoccupied with the need to secure social approval or attention (narcissistic supply). The narcissist cannot control this need and the attendant anxiety because he requires external feedback to regulate his labile sense of self-worth.
Here are some narcissism red flags to look out for: Lacking empathy. They seem unable or unwilling to have empathy for others, and they appear to have no desire for emotional intimacy. Unrealistic sense of entitlement.
They sometimes lead to the Serotonin syndrome, which includes agitation and exacerbates the rage attacks typical of a narcissist. SSRIs do lead at times to delirium and a manic phase and even to psychotic microepisodes. This is not the case with the heterocyclics, MAO and mood stabilisers, such as lithium.
Narcissistic collapse happens when a person with narcissistic personality disorder experiences a failure, humiliation, or other blow to their secretly fragile self-esteem. Depending on the type of narcissist, collapse may look different and happen more frequently.
Some narcissists have supreme confidence in themselves, and also have the emotional intelligence — the ability to read people and to act accordingly — to nurture lasting allies. At the extreme of both, such a person could be a presidential candidate or a manipulative sociopath — or both.
An inadvertent narcissist is a person who behaves in highly egocentric and self-focused ways without having any insight into the source of these behaviors as coming from one's own personality. One very obvious route to gaining this understanding comes from listening to yourself speak.
Treatment for narcissistic personality disorder is talk therapy, also called psychotherapy. Medicines may be included in your treatment if you have other mental health conditions, such as depression.
Based on overlapping symptoms, Borderline Personality Disorder (BPD) and Narcissistic Personality Disorder (NPD) are often mistaken for one another.
For the person on the receiving end, someone experiencing a narcissistic collapse may look out of control, extremely angry, and vindictive. In some cases, it may look like someone withdrawing altogether and giving them the silent treatment.
According to Julie L. Hall, author of “The Narcissist in Your Life: Recognizing the Patterns and Learning to Break Free,” narcissists become more extreme versions of their worst selves as they age, which includes becoming more desperate, deluded, paranoid, angry, abusive, and isolated.
Believe they are superior to others and can only spend time with or be understood by equally special people. Be critical of and look down on people they feel are not important. Expect special favors and expect other people to do what they want without questioning them. Take advantage of others to get what they want.
Grandiosity: They will act as though they are superior to everyone else. This is not always based on evidence, but they will believe themselves to be special. They need to be admired and adored, and will seek out people who mirror this specialness.
Both overt and covert narcissism can manifest depression symptoms and nuanced symptoms related to NPD such as rage, insomnia, hostile sentiments, and narcissistic injury. Covert narcissistic depression symptoms can also include depression due to unprocessed emotions.