On the other extreme, persons with vulnerable narcissism may present with salient features of dysthymia, depression, and anhedonia. However, the grandiosity and need for admiration would be prominent despite the affective symptoms, which would differentiate it from a major depressive disorder.
Answer: NPD (Narcissistic Personality Disorder) is often diagnosed with other mental health disorders (such as the Borderline, Histrionic, or Antisocial personality disorders).
NPD Brains Work Differently
According to research, people with narcissistic personality disorder have reduced gray matter volume in areas of the brain related to empathy and increased activity on baseline images in brain regions associated with self-directed and self-absorbed thinking.
People with narcissistic personality disorder tend not to perceive that they themselves may have a mental health problem, and thus may be less likely to seek evaluation or treatment.
"Narcissism has never been about self-love – it is almost entirely about self-loathing." It's long been established that there are two types of narcissists: "vulnerable" ones, who have low self-esteem and crave affirmation, and "grandiose" ones, who have a genuinely overinflated sense of self.
Cerebral narcissists, also known as intellectual narcissists, are individuals who try to fulfill their narcissistic supply through their perceived intelligence. While intellectual narcissists are generally smart, they may present as if they are more educated than they really are.
The researchers found that while many narcissists may perceive themselves as highly intelligent, critical thinkers, they are less likely to use important reflective thinking strategies when solving problems, Therefore, the high levels of confidence they have in their intellectual abilities are often misplaced.
The damage to the amygdala of the victims of narcissistic abuse become trapped in a permanent state of fear and anxiety and react badly to environmental triggers that remind them of the violation by the narcissist. This means that victims of narcissistic abuse are constantly alert to the danger that does not exist now.
Type As can also be dangerous to narcissists
Although they can be targeted, type A people can also become a narcissist's worst nightmare. One of the most important defenses against dark personalities is having strong boundaries yourself, and type A people are usually aware they have the right to build them.
What causes NPD? As with many personality disorders, the exact cause of NPD is unknown. It is probably a mixture of genes, early childhood experiences and psychological factors. Early childhood risk factors include excessive praise or judgement by parents, trauma or abuse.
Most recent theories have focused on the link between narcissism and negative childhood experiences, such as physical or sexual violence, neglect, or rejection [10,11].
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.
Narcissists' Greatest Fear
To narcissists, ordinary people (i.e., nearly everybody around them) aren't worthy of attention, so being ordinary would leave them unworthy of the spotlight and left to suffocate. Narcissists also need to feel special and superior to others.
The root of the disorder is actually a strict resistance to feeling vulnerable with anyone at any time. Here's a lay description of how it works: The narcissist does not truly trust others in close relationships.
Participants who had high levels of narcissism were more mentally tough and resilient than participants who had low levels of narcissism. Subclinical psychopathy and Machiavellianism were largely unrelated to mental toughness and resilience.
Perhaps it is not surprising, but researchers found that narcissists tend be more physically attractive than average.
Narcissists can sometimes be helpful and caring. However, more often than not, they only pretend to have these qualities. Moreover, even when they act giving and helping, they are not motivated by empathy because they severely lack it, and as a result, their help is often not very productive.
Narcissists over-estimate their ability to read social cues, misunderstand how others perceive them, and lack perspective-taking abilities.
Narcissists never develop the ability to identify with the feelings of others—to put themselves in other people's shoes. In other words, they lack empathy. In many ways, they view the people in their lives as objects—there to serve their needs.
Recent research has identified a structural abnormality in the brains of those with NPD, specifically noting less volume of grey matter in the left anterior insula. This brain region relates to empathy, compassion, emotional regulation, and cognitive function.
Narcissists feel entitled to get what they want from others regardless of their behavior. Their sense of entitlement masks their inner shame and insecurity. They convince themselves that they're superior and it follows that they deserve special treatment.
According to Thomaes & Brummelman, the development of narcissism begins at around the ages of 7 or 8.