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What is the success rate for treating narcissism?

Narcissistic Personality Disorder Statistics

By The Recovery Village | Editor Megan Hull
Medically Reviewed By Dr. Anna Pickering, PhD A licensed behavioral health or medical professional on The Recovery Village Editorial Team has analyzed and confirmed every statistic, study and medical claim on this page. | Last Updated: September 13, 2022

Narcissistic personality disorder (NPD) may be more prevalent than you think. Familiarizing yourself with facts and statistics about NPD can reveal who is most at risk.

Many psychologists believe that narcissism is a spectrum, and narcissistic traits are often a part of other disorders. In other cases, narcissism is so extreme that it interferes with normal healthy functions. This is known as narcissistic personality disorder or NPD.

Narcissistic personality disorder exhibits some interesting trends in the population, which can be seen through facts and statistics about narcissistic personality disorder. This information can help people learn the difference between the disorder and regular narcissistic traits, discern if someone they know has NPD, and learn how to manage symptoms of the condition.

Prevalence of Narcissistic Personality Disorder

All people have narcissistic traits to some degree. In healthy individuals, a normal amount of narcissism helps them take pride in their accomplishments and find joy in their personal life. Even a high degree of narcissism is sometimes a common occurrence for certain individuals and age groups. Most teenagers display narcissistic qualities as a normal and healthy part of their development and personal growth. So, the answer to the question “how many people are narcissists?” is relatively ambiguous in nature, and instead, we need to look at rates of narcissistic personality disorder.

Narcissistic personality disorder, on the other hand, is much less common. Approximately 0.5% of the United States population, or one 1 in 200 people, has the disorder. There are significant gender differences when it comes to the prevalence of the disorder; about 75% of people with narcissistic personality disorder are men.

Who Has Narcissism? Prevalence and Rates 1 in 200 People

The prevalence of narcissistic personality disorder is higher in certain demographics, including:

  • 2–6% of those seeking help from mental health clinics
  • 6% of forensic analysts
  • 20% of people in the military
  • 17% of first-year medical students

Usually, narcissistic personality disorder first appears in early adulthood. It is not more common in any ethnicities than others.

Careers Most Prone to Narcissism 17 Percent First-Year Medical Students and 20 Percent of People in the Military

Diagnosing Narcissistic Personality Disorder

As the name implies, mental health professionals characterize narcissistic personality disorder as a type of personality disorder. The characteristics of people with narcissistic personality disorder are fairly diverse. However, there is a core set of features common to most people with this condition. The American Psychological Association has a set of guidelines on how to diagnose narcissistic personality disorder that psychologists refer to when they interview a patient. These symptoms are listed in their official book Diagnosis and Statistics of Mental Disorders (DSM 5):

  • A pervasive pattern of grandiosity (making themselves appear impressive)
  • Need for admiration
  • Fantasies about power, success, beauty or an idealized vision of love
  • Sense of entitlement
  • Belief of being special, unique or high-status
  • Lack of empathy for others
  • Tendency to exploit others
  • Arrogant behavior
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People with narcissistic personality disorder spend a significant amount of time comparing themselves to others. They often have fantasies about being exceptionally successful in their careers. Some individuals with this condition consider themselves to be superior to others, while others are overly critical of their own flaws. People with NPD may be highly resistant to criticism or highly sensitive to perceived slights.

Rates of Narcissism and Co-Occurring Conditions

Like other types of personality disorders, pathological narcissism frequently occurs along with other mental health conditions including depression, anxiety, eating disorders, bipolar disorder and substance use disorder.

Narcissistic Personality Disorder and Co-occurring Disorders - Depression, Anxiety, Bipolar, Substance Abuse, Eating Disorders

  • Depression and Anxiety. Subtypes of patients who are vulnerable to criticism from themselves or others have a higher risk of having symptoms of depression or anxiety. About 15% of people with narcissistic personality disorder also have depression, 13.5% have anxiety and around 17% have another mood disorder.
  • Bipolar Disorder.Bipolar disorder is also fairly common among people with narcissistic personality disorder. About 17% of people with pathological narcissism also have either bipolar I or bipolar II.
  • Eating Disorders. In some cases, people with narcissistic personality disorder obsess over their appearance. These individuals have a higher risk of developing an eating disorder because of their obsession with staying thin and meeting idealized beauty standards.
  • Other Personality Disorders. Different personality disorders commonly co-occur with narcissistic personality disorder. People with the condition, especially those who have a grandiose persona, may also have paranoid personality disorder and antisocial personality disorder. Histrionic, borderline and schizotypal personality disorders also sometimes co-occur with NPD.
  • Substance Use Disorders. People with narcissistic personality disorder frequently have a substance use disorder as well. They may use drugs or alcohol to self-medicate and cope with the frustration and anxiety that comes with the condition. About 14% of people with narcissistic personality disorder also have an alcohol use disorder, while 24% misuse other types of drugs.

Statistics on Narcissistic Personality Disorder Treatment

Treating narcissistic personality disorder can be challenging because people with the condition often don’t think that they have a problem. Prognosis is often poor as a result, and there currently is not a standard protocol for treatment. However, treatment usually consists of counseling or psychotherapy. Little research has been done on narcissistic personality disorder treatment, so its treatment success rate is not known yet.

If you believe that you or someone you love has narcissistic personality disorder along with a substance use disorder, contact us at The Recovery Village to discuss ways that we can help.

Could Ketamine Be a Treatment for Narcissistic Personality Disorder?

Most people have heard the term “narcissist” but few are familiar with narcissistic personality disorder (NPD). While some might label a person as a narcissist because they’re self-serving or put a lot of emphasis on their looks, that isn’t the true criteria for NPD. In fact, many people who are diagnosed with narcissistic personality disorder don’t seem narcissistic on the surface. They may even come across as very giving when you first meet them.

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Narcissistic personality disorder is a mental health condition that impacts self-worth and behavior. The condition causes an inflated sense of self importance and a lack of empathy for others while simultaneously contributing to fragile self-esteem that makes a person hypersensitive to criticism. The combination can cause significant inability to relate and interact with others in a positive, productive manner.

Let’s delve a little further into how a person is diagnosed with narcissistic personality disorder, how prevalent the disorder is and what treatments exist.

How Narcissistic Personality Disorder Develops

Narcissistic personality disorder affects a lot of people. Based on community samples, anywhere from 0.5% to 5% of the population has NPD. However, in clinical samples the rate of prevalence for NPD is 1% to 15% of the U.S. population. The lifetime rate of prevalence is 7.7% for men and 4.8% for women.

The disorder often coexists with other mental health conditions, which is why diagnosis can be challenging and the condition is likely underreported. It’s common for someone with NPD to have a mood disorder like depression or substance use disorder.

It’s not entirely known how NPD develops, but experts have zeroed in on contributing factors that could make someone more susceptible to the disorder. These potential contributing factors include:

  • Genetics
  • Trauma in childhood
  • Extreme praise in childhood
  • Extreme judgment or neglect in childhood
  • Exposure to a parent or caretaker with NPD

Doctors have determined that narcissistic personality disorder tends to begin early in life when children are developing a sense of self based on feedback from their surroundings and how they perceive others. Studies have shown that characteristics of narcissism can begin showing up as young as two years old and the disorder develops around age seven. It’s believed that NPD develops mainly due to an unsuccessful relationship with a parent in childhood that involves emotional neglect or attachment dysfunction that negatively impacts self-worth.

Research is also showing a connection between sense of self and self-worth that’s tied to expectations of perfection that begin early in life. People with NPD tend to be highly motivated to give off the perception of perfection at all times. This can lead to a number of issues such as lack of accountability for their actions, fragile ego, low self-esteem and extreme defensiveness.

Characteristics of NPD

There are some key characteristics of NPD that clinicians use to diagnose the disorder. The DSM-5 diagnostic criteria for NPD includes:

  • Lack of empathy for others
  • Grandiose sense of self-importance
  • Fantasies of unlimited power, success or beauty
  • Belief that they are special and can only be understood by other high-status or special people
  • Sense of entitlement
  • Need for excessive admiration or validation
  • Interpersonally exploitative
  • Envious of others and belief that others are envious of them
  • Behaves in an arrogant manner
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Clinical diagnosis of NPD is made when a person meets at least five of the criteria listed above.. Grandiosity, lack of empathy for others and seeking excessive admiration are the key characteristics that are present in virtually all instances of NPD.

It should be noted there are two primary types of narcissistic personality disorder, which influences the characteristics and behaviors that are exhibited.

Grandiose/Overt Narcissistic Personality Disorder — A person with clinical grandiose NPD is fairly easy to spot. They tend to act bold, aggressive, exaggerate their capabilities and are more openly exploitative. This type of NPD is what people usually associate with narcissism.

Vulnerable/Covert Narcissistic Personality Disorder — This is the type of NPD that is identified less often because unlike grandiose narcissists, people with vulnerable NPD behave in more defensive ways due to hypersensitivity and lack of self-esteem. They also don’t exhibit grandiosity and need for admiration as overtly. Instead, vulnerable narcissists tend to take on the role of a victim to illicit praise, validation and empathy from others.

Other subtypes of NPD have been defined, however, most people who are diagnosed with the disorder are one of the two types above.

Negative Effects of Narcissistic Personality Disorder

Often a person with NPD will know they have narcissistic traits, but that doesn’t mean they are seeking help or believe that their behavior is wrong. Unfortunately, many people with NPD are diagnosed due to having a co-occurring disorder or because NPD has caused major disruption in the person’s life, such as a divorce or job loss.

NPD can have profoundly negative effects for the person with the disorder and those around them. Negative consequences can include:

  • Difficulty with interpersonal relationships.
  • Feelings of isolation.
  • Creating disruptive, toxic environments at the workplace.
  • Job loss or limited career success.
  • Higher likelihood of self-harm.
  • Increased risk of alcohol abuse.
  • Higher risk of depression and anxiety.

These are serious consequences that can have a large ripple effect. Of late, a lot of attention has been given to how NPD affects the workplace. Negative short-term and long-term effects have been identified that can cause societal and economic harm on a large scale.

Available Treatment Options for NPD

Narcissistic personality disorder may not be a terminal illness, but it can feel equally hopeless when you learn about the diagnosis. Despite the prevalence of NPD, currently no standardized treatment options exist. The best that health professionals can offer at this time is talk therapy.

Talk therapy will make someone with NPD more aware of their actions and how they could affect others, but that’s a double-edged sword. Because of the nature of the disorder, someone with NPD is likely to quit therapy once these negative qualities are brought up and are perceived as criticism. The other issue is that talk therapy must be continued indefinitely. It’s a long-term treatment strategy with a very small response rate.

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Transference-focused psychotherapy is a new strategy that is being tried for NPD after first being used for borderline personality disorder. With this type of therapy the patient meets with their therapist twice a week and essentially projects their feelings onto the therapist. It primarily involves the patient expressing their perceptions and the emotions they feel in the moment.

The goal is to focus on the patient’s perception, since the emotions of a person with NPD are largely driven by their perception of how they are being treated. In doing so the therapist can identify destructive thinking patterns, and the patient can develop a more positive self-image and form constructive behaviors.

Co-Occurring Disorder Treatment

If a co-occuring disorder is diagnosed, then the other disorder may be the primary focus of treatment initially. That could involve medications, different types of psychotherapy or even psychedelic therapy depending on the situation.

Ketamine Shows Promise as a Possible Treatment for NPD

When you consider that there are no treatments beyond talk therapy and the response rate is low, it makes sense that psychiatrists want to explore the use of ketamine and other psychedelics to treat NPD. Ketamine is already used for treatment resistant depression, PTSD, OCD and anxiety.

Early clinical studies are showing promise for the therapy to be used as a treatment for NPD. It appears that ketamine could enhance the very things that a person with narcissistic personality disorder lacks that leads to the condition. A recent study published in Psychopharmacology showed strong evidence that psychedelic therapy can help people with NPD gain a greater sense of connection to others and improve empathic drive. The state of awe associated with psychedelic therapy is what led to a decrease in maladaptive narcissistic traits.

The research has been the catalyst for more ongoing studies in a clinical setting that are looking deeper into the use of psychedelic therapy for NPD. Ketamine is also being explored as a potential treatment for borderline personality disorder.

Researchers hope that ketamine’s ability to enhance neuroplasticity and change perception will help people with NPD correct maladaptive narcissistic personality traits. Since psychedelic therapies are able to neurologically rewire hardwired thought patterns and build new synaptic connections to shift a person’s viewpoint and thinking, they could be highly beneficial in curbing disruptive behaviors that are the result of NPD.

There is still a lot more to learn, but the latest research is giving millions of people hope that in the near future there could be an effective pharmacological treatment for NPD and other personality disorders.

Can a Narcissist Have a Happy and “Successful” Marriage?

There is no one-size-fits-all answer to this question, as the success of a narcissist depends on a variety of factors.

However, there are some things you should know about how narcissists function to make an informed decision about whether or not they can be happy and prosperous.

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In this blog post, we will explore the inner workings and discuss whether or not they can be pleased and successful.

Many people with narcissistic personality disorder appear to be in a successful and happy marriage. Their social media posts show them laughing together over a special dinner, walking hand-in-hand along the beach, and even renewing their wedding vows in front of friends and family. Should we believe the pictures? Can a narcissist have a happy marriage?

The answer is not a simple one. Narcissists are very good at hiding their true feelings and manipulating those around them. They often put on a persona in order to make themselves look good. So, it may be difficult to know what is going on inside of their head or how they truly feel about their spouse.

Generally speaking, however, narcissists do not have healthy relationships. They can be very demanding and controlling, which leads to a lot of conflict and unhappiness in the marriage. Studies show that narcissists are more likely to get divorced than people who do not have a narcissistic personality disorder.

However, if you can handle the challenges of being married to a narcissist and can find ways to make your relationship work, you may have a very happy marriage.

A narcissist can be highly successful in their career, but it is not always easy to maintain that success. They are often controlling and demanding of others at work. This means they tend to have high turnover rates among employees and conflicts with colleagues. Narcissists also tend to get fired from jobs more often than people without narcissistic personality disorder due to their inability to handle criticism or failure. This may lead them down the path of self-destruction rather than seeking help from mentors or supervisors who could offer constructive feedback on how they could improve themselves professionally or personally.

Narcissists who find professional success typically do so because they are talented at what they do (such as being a doctor, lawyer, or CEO) and have worked very hard to get where they are today. They may also be able to build strong relationships with others to keep their jobs despite having a narcissistic personality disorder.

The bottom line is that narcissists can be successful and happy, but it takes a lot of work on their part and the support from those around them who want this success for them too!

Narcissists’ happiness depends greatly on how much effort they put into maintaining healthy relationships at home or work.

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