Dementia and narcissistic rage

Adding Dementia to the Mix

Medically reviewed by Scientific Advisory Board — By Christine Hammond, MS, LMHC on January 12, 2017

Despite what a narcissist will pontificate, even they are subject to the effects of getting older. Becoming elderly is a normal part of the developmental stage of life for most people, but not for the narcissistic. They view aging as an ultimate evil. Some will engage in ridiculous plastic surgery in an effort to look as young as they feel. Others will begin a new career while their peers are retiring. And still, others will take on far younger partners.

But what the narcissist cant do is dodge the effects of dementia. As a progressive indiscriminate disorder which sometimes transforms into Alzheimer’s or other disorders, dementia affects every area of the brain in random order. What seemed natural and habitual now becomes foreign and difficult. Memory becomes scattered and unreliable. Familiar people become strangers or even enemies that are out to get them.

For the narcissist, this is completely unacceptable. Most narcissists rely heavily on their cognitive abilities as a way of constantly demonstrating superiority over others in performance, influence, power, beauty, or money. Any sign that is is deteriorating or diminishing is out of the question, something that cannot and will not be tolerated. This is when the narcissist is most at risk for suicidal behavior.

Make no mistake; narcissists dont threaten suicide just to get attention, they actually follow-through on the action especially when they begin to view their superior identity as slightly inferior. They would rather die than be revealed as fallible, vulnerable, or depending on someone else to do the basics of life. When a person has spent their entire life belittling and mocking those believed to be beneath them, they cannot, in the end, be revealed like them.

There are seven stages to the progression of dementia as listed below. However, how a narcissist responds to each stage is very different from other patients. This is because the narcissism is like a web inside their brain affecting more than one area.

No Dementia: No Cognitive Decline. This first stage is what pre-dementia looks like where there is no memory loss and a person, including the narcissist, functions normally.
No Dementia: Very Mild Cognitive Decline. As a person ages, forgetfulness becomes typical but it doesnt impair normal functioning. For the narcissist, their forgetfulness is often blamed on others.
No Dementia: Mild Cognitive Decline. Forgetfulness becomes more consistent and trouble concentrating for long periods of time increases as work performance declines. Narcissists begin to notice this stage but work very hard to hide it from others. It is typical for them to have increased aggravation over their perceived slowness which they frequently project onto others.
Early Stage: Moderate Cognitive Decline. Despite the best efforts of the narcissist, their decreased cognitive abilities become apparent to others. They typically struggle to remember even recent events, accidentally send too much money to the electrical company, or getting lost easily when in new locations. Complex work tasks become too difficult but the narcissist wont admit to it. Instead, they will blame others and distract with elaborate stories of past successes. To avoid embarrassment (the Achilles heel of the narcissist), they withdraw from family and friends. When needed, the narcissist can function at a select event for a short period of time but as soon as it is done, so are they. The disengagement is extreme and may even appear catatonic.
Mid-Stage: Moderately Severe Cognitive Decline. The memory deficiencies become significant as even common tasks such as cooking, dressing, or grooming require some sort of assistance. Some narcissists can weather this stage well if they have a caretaker who is willing to pamper them and tolerate their aggravation. But others slip rapidly into a depressive state which adds to the frustration. They may not remember major life events or people any longer. However, what the narcissist values is definitely revealed at this stage. If work over family was important, they wont remember family vacations but can still remember a major deal they negotiated.
Mid-Stage: Severe Cognitive Decline. This is when suicidality becomes a possibility if they are able to carry out the task. No longer able to care for themselves and having embarrassing problems such as eating or bowel control, narcissists shut down. For brief periods of time, the narcissism will disappear and what the person would be like without it appears. This becomes a hope that most family members cling to but the progression of the dementia is so advanced now that it becomes discouraging. It is also common for the narcissist to have delusional thinking such as watching something on TV and believing they are actually doing it. Anger outbursts are common as are paranoid delusions. The narcissist is so convincing even at this stage that they are able to draw in others into their delusional state.
Late-Stage: Very Severe Cognitive Decline. At the last stage, there is little to no communication, psychomotor skills, or walking. Everything requires assistance and the narcissist is a shell of what they once were. No longer able to recognize themselves or others, all of the narcissistic symptoms have disappeared along with their personality.

Watching any person go through these stages is traumatic; however, there is a glimmer of awareness that is unique to a narcissist who has dementia. The key lies in remembering the brief moments when the non-narcissistic side of them appeared. This is who they really were, instead of whom they became.

Planning Care for an Elderly Narcissistic Parent

Narcissism in the family is incredibly difficult to deal with. The narcissistic person is always right, nothing you do is good enough for them, and it’s always your fault. This can mean that as a child of a parent who is narcissistic, you have had to endure a lot. However, as our parents become older, fragile and more vulnerable, we can’t help but want to be there for them and help. So how do you go about planning care for an elderly narcissistic parent?

What is narcissism?

Narcissistic Personality Disorder (NPD) is a mental disorder and the person may exhibit superiority, and endless demands for attention, especially praise and recognition. The narcissistic parent may demonstrate a lack of empathy and be accustomed to manipulating others around them with little or no regard for their feelings or emotions. When it comes to caring for someone with this personality disorder, or planning and arranging their care, it can be an overwhelming thought.

Although personality disorders such as narcissism can become milder as the person ages, it can still be present enough to be an issue, especially in a parent that you are trying to help. It may bring back all sorts of memories and triggers that make it much harder for you to deal with. It could be that your elderly parent has developed narcissism in their old age, this can be due to a variety of reasons, including trauma, or depression. It could also be that they are exhibiting some narcissistic traits because of dementia.

Understanding narcissism, how it works, where it comes from and how it manifests is an important tool for you to survive. So, if you haven’t already, ensure that you know everything there is to know about it. It can help a great deal to see a therapist on a regular basis as support for you, as well as assistance in understanding how to navigate around an elderly narcissistic parent, especially if you are going to care for your parent yourself.

Caring for your narcissistic parent yourself

This can be a tough decision and much more draining than caring for the non-narcissistic parent. You will need to carefully consider your options here, thinking about your own mental health. If you have already made the decision to care for your parent yourself, ensure that you take regular breaks, set boundaries and get as much external support as you can to retain your self-esteem, sense of self, and perspective.

If you are within the narcissistic environment for too long without outside breaks, you will find it much harder to retain your own mental health. Have a good support network and you may also wish to engage regularly with a therapist.

Dealing with Gaslighting

If you were raised by a narcissist, this is behaviour you may already be familiar with, and if not then you need to be aware of it. A narcissist will often try to make you feel as though you are losing your mind, or that you are delusional and this behaviour has become known as ‘gaslighting’. This behaviour could develop with the onset of dementia if they have not previously exhibited gaslighting behaviour.

It might be that they tell you that you remember a situation incorrectly, or trying to tell you that your perceptions are not correct, or always insisting they are the victim and you are doing something wrong. They will make you doubt yourself and are attempts at manipulation. This can make it incredibly difficult to discuss that they need care, or you may feel forced into caring for them.

Dealing with ‘nothing is good enough and everything is your fault’

Narcissism can include irritability, they take a dig at you, along with a scolding. This can be incredibly difficult to navigate for adult children of narcissistic parents, especially while you are trying to care for your parent. It can be easy for you to slip into feeling like a scolded child again.

For example, you place a meal in front of your parent that you took care in preparing and your parent simply gets cross, saying ‘I don’t want you to use that plate, I TOLD you this.’ It’s important to keep yourself in the now, reminding yourself that you are an adult and in control of your own life. Keep calm and realise this is simply a manipulation tactic to help the narcissist feel superior or a projection of their own feelings of inadequacy. You can offer to change the plate in this example, or say that you will remember this for next time.

Arranging care for your narcissistic parent

Narcissists will very rarely seek care for themselves and will probably resent any form of ageing. If you decide that caring for your narcissistic parent is going to be, or already is too much, there is no shame in handing over the care of your parent to a care provider and even distancing yourself. Sometimes we have to preserve our own sanity and health from toxic relationships.

Having a talk about your parent needing care is not something that is going to go well with the narcissist, so it can be good to get help from a therapist in preparation for this. The discussion is likely to end up with you feeling guilty. You will need to be strong and explain what is going to happen, ensuring that you retain your boundaries and stick to your plan. If you have a support network or other members of the family to help with this, get them involved.

Getting external help will save you from a lot of heartache. An employed care worker will be able to treat your parent with dignity and care, but also be able to handle their personality. Your parent may be a difficult person to help, but a good carer will be able to help them despite this. It is much easier for a person without your emotional attachments to be able to deal with the narcissistic parent.

Narcissism and dementia - how can you tell?

It can be difficult to see dementia in a person who is narcissistic, especially in the early stages of cognitive decline. You may struggle to distinguish between actual memory problems and gaslighting behaviour, and they may use gaslighting to deal with it. In early stages of dementia, the narcissist will blame others for their forgetfulness, however this could also be a normal occurrence in ageing. So, how can you tell if a narcissistic parent is developing dementia?

As their cognitive abilities decline with dementia, it will become very much apparent, you will need to be observant in their behaviours to spot changes, as they will continue to blame others, but will be more likely to withdraw from others to save their ego, rather than thrive on the attention.

Once severe cognitive decline is in progress with the narcissist, this is a stage where they may be at risk of suicide; a narcissist is more likely to follow through, rather than use it as a tool for attention. When they are no longer able to look after themselves, narcissists shut down and may occasionally behave like a non-narcissist person. Family members may cling to this with hope but the progression of the dementia is too advanced. Anger outbursts will be common as well as paranoid delusions. The narcissist is so convincing even at this stage that they are able to draw in others into their delusional state.

If your parent has been otherwise non-narcissistic and seems to have suddenly developed some these traits, this may also be indicative of dementia.

You are not alone

There are plenty of support groups for this particular situation too, you are definitely not alone in this. The very reason this article has been written is because it is more common than you probably think. Have a look on Facebook and on the internet, you will find groups and forums where you can connect with others to get some additional help, advice and support.

Beware: narcissism! | PSYCHOLOGIES

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A person among peopleKnow thyself

“Maxim was witty, elegant, he looked after me beautifully, like a prince for a princess,” recalls 29-year-old Inessa. - We lived together for six months, he carried me in his arms both literally and figuratively. When I found out that I was pregnant, I flew to him as if on wings, I thought we would be even happier. And he left! He just walked out the door and didn't come back. I called him for three days, and finally he answered. I begged him to explain what was the matter. “You will become fat and ugly,” he said. Or you will have an abortion and cry. Yes, and still already tired, ”and turned off the phone.”

Unwillingness to deal with the everyday, boring side of life is one of the characteristic features of those who are called narcissists. “They have a high opinion of themselves and believe that their life should be bright and exceptional,” clinical psychologist Tatiana Voskresenskaya describes their traits. “If partners are unable to meet their requirements, narcissists part with them without regret.”

These features are manifested not only in personal life. At work, they are absolutely sure that all the best is theirs by right. “I was so confused that I didn’t even object when my colleague, presenting a joint project, attributed all the credit to herself and hinted that as a young employee she was much more promising than me,” recalls 36-year-old Elena. “But while we were working, she constantly asked me for advice.”

Considering themselves exceptional, narcissists are convinced that they deserve more than others. In all others, they see either an enthusiastic audience or a means to the goal, which can be forgotten when the goal is achieved. In a strange way, they do not immediately understand this. Because at first glance, the narcissist is charming, brilliant, effective. He knows how to entertain society, often smart and attractive. But once you get to know him better, the picture changes.

Internal void

You notice that he only talks about himself, about his successes and exploits, demanding special attention to himself. He idealizes all his deeds and achievements and often devalues the successes of other people. In response to the slightest criticism, he falls into a rage or pours winter cold.

Do not try to doubt his uniqueness, otherwise you will incur his wrath - he will turn away and erect a wall of silence between you. Such people often deny their need for someone else's participation, but in fact they need the admiration of others. Their self-esteem depends on the opinions of others.

“We all care to some extent about what people think of us, but for a narcissist it is a matter of life,” says Tatyana Voskresenskaya. He exists for himself only as a reflection in the eyes of other people. Therefore, when they turn away from him, he perceives the disappearance of the reflection as a threat to his existence. Hence his sharp reaction to criticism: he will fiercely defend himself, accusing others of complete insignificance.

In the place where most people have an idea of their "I", the narcissistic person has a feeling of emptiness. It is this that pushes him to exploits and accomplishments, sometimes really impressive and worthy of sincere admiration.

Narcissists are almost incapable of being aware of their own feelings and desires, so they have no basis for understanding the feelings and desires of others. “Hence the fatal lack of empathy,” continues Tatyana Voskresenskaya. “A narcissist is capable of inflicting severe pain on a loved one without even knowing it.”

Self-conceit, arrogance, resentment and brilliant manipulative abilities are the traits by which we can recognize narcissists. But among them there are those who are more difficult to recognize: at first glance, they seem modest and even downtrodden. It is vital for them to be able to control another person.

“Pushing, for example, her husband up the career ladder, a woman increases her own importance,” explains the psychologist. “To do this, it establishes control over the other, control unconditional and not subject to objection.”

The narcissist as a spouse

The narcissist as a spouse is a real test, he is constantly concerned about how to best present himself. He avoids intimacy, emphasizes his independence, but at the same time he is a terrible envious and possessive person. Like Narcissus, the beautiful youth of myth who is in love with his own reflection, the narcissist is incapable of understanding himself and truly loving.

An indispensable condition for love, according to Sigmund Freud in his book "I and It", is the meeting of two streams: "gentle" and "sensual". The sensual flow is sexuality, while the gentle flow combines such qualities as caring, interest in another person, gratitude, the ability to listen and find compromises. Narcissists do not know how to love "gently".

“They forget important events and dates in the life of their spouse,” says Tatyana Voskresenskaya, “they are not interested in his relatives, they are in no hurry to support him in a dispute, they do not know how to adapt their needs to changes in the states of another person.” In addition, they are vindictive and vengeful. For the time being, their vindictiveness is hidden behind a facade of composure and imaginary peacefulness. However, the anger hidden in the depths of the soul breaks through in sarcastic remarks or unwillingness to do something for the sake of another.

Many psychologists believe that a relationship with a narcissist is doomed from the start. “They cause a loved one a lot of pain, destroy his self-esteem and disorient him. And it’s almost impossible to change that,” emphasizes Tatyana Voskresenskaya. Tough sentence! Maybe these are the new pariahs in our society? However, narcissism also has its reasons. And they need to be known, because this is the only way to try to understand a partner with a narcissistic personality. And understanding is an opportunity to try to get along with it.

6 qualities that will help you get in touch with a narcissistic spouse

“Living with a narcissistic person is not easy: there is a danger of falling under his influence and forgetting your own needs and interests,” warns clinical psychologist Tatyana Voskresenskaya. If this relationship is important to you, work on the qualities that will make it easier for you to endure unpleasant moments.

1. Benevolent: arrogance and caustic remarks are easier to bear if you remember that the narcissist developed this behavior in childhood to protect himself. It is unlikely that he imagines how it affects others.

2. Imagination: imagine the face of a lonely little boy. Try to understand how he feels, his suffering from the realization of his shortcomings and shame, abandonment and longing. He has to endure it in order to earn attention, love or approval. Perhaps this image will help to understand that the anger of an adult is only a defense of a wounded child.

3. Empathy: it is useful to show that you understand his feelings. For example, the husband is angry that he came home, and you are talking on the phone. Do not be indignant, but explain: “I see that you do not like it when I talk on the phone. Perhaps you think that I am being indifferent to you. I can understand that."

4. Frankness: It is also important to show the narcissist how their behavior affects your feelings. In the same situation, openly explain to him how you feel: “Actually, I'm glad to see you. But it's hard for me to guess when you'll be back. Besides, I confess that it hurts me when you talk to me like that. I know you don't want to hurt me, but it hurts me."

5. Respect: the narcissist tends to decide for others without discussion. If you resent and reproach him for arbitrariness, he will not hear, because control is also included in the arsenal of his defenses. If the husband has decided that the family is vacationing at the sea, it is wise to first show that you understand him ("I know how much you love the sea"). Then ask him to listen to your arguments in favor of a holiday in the mountains and offer to make decisions together next time.

6. Self-respect: attempts to build a relationship with a narcissist still have a limit. If sympathy and understanding do not work, if the shell of egocentrism is impenetrable, it's time to turn on your defense mechanisms. Don't let anything be done to you. It is helpful to set boundaries: cut off contact if it becomes unbearable, or even end the relationship.

Cause and effect

“The drama of a person with a narcissistic disorder begins with the drama of his parents,” explains psychoanalyst René Roussillon. Because of their own problems or unfulfilled needs, they either pay too much attention to the child, or neglect him, leave him alone.

Spoiled. The child is the center of the world. It depends on the mood of the parents. If the child is witty, demonstrates success, they are satisfied and he can count on their love. If not, the parents are in despair: the world is collapsing.

Such parents exploit the child to satisfy their own sense of superiority. They believe that they are worthy of admiration, because they have such a beautiful, gifted child, they proudly talk about his successes, while with the child themselves they behave detached and cold.

Dependency. Children are not given independence. Parents regulate and decide everything. Therefore, children do not know their abilities, they simply do not have a chance to understand themselves.

“Our attitude towards ourselves is based on how others have treated us, especially our mother,” explains René Roussillon. “The problem with narcissistic people is that in childhood they had to be a means to satisfy the ambitions of their mother or other loved ones, they did not feel that they were simply loved, and therefore, even for themselves, they do not exist as an independent value.”

Spoiledness, like dependence, leads to the fact that the child understands that he cannot rely on other people. The most difficult results for the individual are obtained if the praise and indifference of the parents alternate for no apparent reason. Such a child is constantly insecure, but learns to hide his fears, because he knows that he will not find understanding.

He tries to become something extraordinary so as not to disappoint his parents, and develops a life strategy that will give him independence from parental love. “I don't need you. I do not need anyone. I rely only on myself." This attitude protects the narcissist from new trauma and disappointment.

He prefers a safe distance because close relationships scare him like hot milk scares a person with burned lips. However, narcissism has long ceased to be a personal problem, the cause of which is solely in negative childhood experiences. Louder voices are heard that emphasize the role of social tendencies in the emergence of narcissistic personality traits.

Is narcissism becoming an epidemic?

Nowadays, narcissistic behavior is “almost inevitable,” says psychotherapist Heinz-Peter Rehr. “The typical narcissist, self-sufficient and without regard for anything, perfectly fits the requirements of the economy, he has excellent chances for a career.” Therefore, in modern Western society, narcissism takes on the character of an epidemic.

This "virus" is infecting more and more people, psychologist Jean M. Twinge agrees. Together with colleagues, she analyzed questionnaires of 16,275 college students in the United States over 30 years (1976–2006). They contained statements such as: “I have a natural talent for influencing people”, “People are an open book for me”, “If I ruled the world, it would be a better place”, “I would like to write my own biography”, “I am completely unique personality."

Prior to 2000, the responses did not differ in anything special, but by 2006 the choice of self-centered statements increased by 30%! The researchers made a disappointing conclusion: "narcissism is spreading in the same way as obesity."

Growth Factors

Tvinge lists four factors that contribute to the spread of narcissism in modern Western society.

1. Upbringing: parents spoil their children and protect them from criticism. Today's fathers and mothers know how important self-confidence is, however, "unfortunately, many of the things that parents think build self-esteem - like praising a child for his talents and giving him whatever he wants - often leads to narcissism. We give too much to children and demand too little of them,” says Tvinge.

2. Media: the cult of fame, money, success plays an important role in the spread of narcissism. The tabloids, movies and advertisements tell us all the time about people full of self-satisfaction. No wonder young people aspire to become famous. According to a 2006 survey of children in England about "what is the best thing in the world", the top three places were taken by "being a star", "looking good" and "being rich".

3. The Internet is an ideal breeding ground for narcissism. Social media makes communication safer by allowing you to choose those who soothe the narcissistic wound. In addition, narcissists can advertise without restraint: narcissistic behavior is relevant and in demand here. The names of social networks speak for themselves: MySpace and Facebook (an extremist organization banned in Russia).

4. Life on credit. Easy access to loans, according to the psychologist, develops narcissism: it becomes very easy to feel successful and wealthy. Why work hard when you can instantly shine your position and image? “Each of us has narcissistic traits,” recalls Tatyana Voskresenskaya, “and since their demonstration brings success in society, it is not surprising that many begin to develop and emphasize them.”

If your colleague is a narcissist

The French psychotherapists Francois Lelor and Christophe André in their book How to Deal with Difficult People describe the peculiarities of dealing with those whose character is unpleasant or incomprehensible to us. Here are some tips for those who meet narcissistic people in their office.

What to do:

Express approval (sincerely) whenever possible.
Explain the reactions of others.
Strictly follow the rules of courtesy.
Criticize only when absolutely necessary and be very specific when doing so.
Be discreet about your own accomplishments or privileges.

What not to do:

Don't get into opposition.
Don't let yourself be manipulated.
Decide what you're willing to give in and what you're not, and don't make any exceptions.
Don't expect a quid pro quo relationship.
If this is a boss, be sincere and restrained with him.
If this is an employee, make sure that he does not take your place.

How to change the situation?

Can the epidemic of narcissism be stopped? Perhaps the economic crisis could be a turning point, says Jean M. Tvinge. In her opinion, the opposite of narcissism is modesty, thanks to which you can return to such values as social community, and stop sticking out your own "I".

“A modest person looks at himself realistically, can assess his strengths and weaknesses, and is interested in others. As for each person individually, it is important to realize that by moderating our own ambitions, we can live better and happier, ”Heinz-Peter Rer supports this point of view. This is not an easy process, because "you will have to revive the painful childhood experience that once forced a person to withdraw into the world of narcissism. "

Unfortunately, “narcissists usually don't seek help to break down the impenetrable emotional wall around them,” notes Tatyana Voskresenskaya. Still, she thinks that spouses, friends, and colleagues can make some changes for the better and maintain their own peace of mind if they manage to treat the narcissist "kindly and sympathetically."

In order not to see him as a monster, it is important to understand that behind an arrogant or self-deprecating adult lies a vulnerable, lonely child who once stopped believing in other people. All his life he struggles to win the recognition of others, and at the same time he himself voluntarily and involuntarily repels those who were ready to give him. He creates a beautiful reflection, but is unable to make himself fall in love.

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This understanding will help those who live near a narcissist or have discovered narcissistic traits to get rid of their inner dependence

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Narcissistic depression (narcissism syndrome) - treatment at the health center Summer

Many psychologists consider narcissism to be quite normal and an integral quality of any personality. It is thanks to a sense of self-worth that a person climbs the career “ladder”, achieves financial success, and builds interpersonal relationships in a certain way. But often behind the "facade" of unshakable self-confidence sometimes hides a vulnerable personality, low self-esteem and complexes, which is fraught with the development of narcissistic depression. This disease is difficult to diagnose, because being afraid of condemnation from others, a person carefully hides his feelings. Treatment is also difficult, because the psychotherapist has to work not only with depressive manifestations, but also with elements of narcissistic personality disorder. But the doctors of the specialized medical center "Leto" have a vast experience in practical work with even the most severe forms of depressive disorders, so we manage to achieve success in the vast majority of cases.

Narcissism and narcissistic personality disorder

The concepts of egoism, the uniqueness of each individual and narcissism are considered within the framework of a personality-oriented concept of happiness, which was formulated to varying degrees by Z. Freud, C. Jung, A. Maslow and others specialists in the field of psychology and psychiatry.

In modern culture, selfishness is usually interpreted as something negative, a negative character trait. This prejudice is associated with the fact that "benefit for oneself" is identified with "harm to others." But if you look at this problem from a different point of view, selfishness, by and large, is a motivation for certain actions and the achievement of a goal.

According to experts, the entire modern culture is built on the taboo of such feelings. Many are taught that it is wrong to show selfish aspirations, while real realities dictate quite the opposite. Some see the abandonment of their own aspirations and desires as a path to unhappiness, dissatisfaction with themselves and complexes.

The term "narcissism" comes from the Greek legend of Narcissus, who preferred to admire his own reflection of the love of a young girl. In psychology, this concept is used to describe excessive self-esteem and narcissism. But as statistics show, it is narcissists who are more likely to achieve career, financial and personal success. Their main character traits are selfishness and self-confidence, although others are convinced that their opinion of their own capabilities is clearly exaggerated.

Signs of narcissistic personality disorder

A distinctive feature of the disease is not an exaggerated sense of self-esteem (in this case, at least half of the world's population can be classified as ill), but a very acute perception of criticism. A person not only denies other people's objections, citing his own logical arguments, even an innocent remark infuriates him. He is dismissive of other people's interests and needs, and does not consider it necessary to hide it.

The main symptoms of narcissistic disorder are:

constant fixation on fantasies of unlimited success, achievement of power, own intelligence, beauty;

conviction that others are unable to understand desires and aspirations;
unreasonable notion of the right to "special" treatment, benefits and privileges;
the desire to exploit and use others to achieve their goals;
low capacity for empathy (emotional experiences, sympathy).

Characteristic is the disregard for generally accepted norms of morality in order to achieve the goal (in this, narcissistic disorder is similar to antisocial), if necessary, a willingness to "go over their heads" in order to get what they want. At the same time, the patient often experiences a feeling of envy, and its object is not only material wealth, but also personal, family well-being.

Causes of narcissistic depression

This form of depressive disorder occurs in a person prone to narcissism. Unlike narcissistic psychopathy, with this form of disorder, an internal conflict arises between a sense of superiority, inflated self-esteem and fear of defeat, fear of ridicule and mockery from others.

It is assumed that narcissistic depression is the result of an attempt to disguise certain complexes and a lack of self-confidence by boasting and demonstrative self-satisfaction. According to one theory, the cause of the disease is associated with the peculiarities of upbringing, excessive demands placed on the child, belittling his achievements, and indifference to his successes. Older children in large families often suffer from narcissistic depression when the parents' attention is "switched" to the younger child.

The trigger factors are:

problems or dismissal from work;
financial collapse, inability to pay off debts and loans;
rupture of relationships with a spouse, sexual partner, especially if the latter spoke impartially about the appearance, personal qualities of a person;
conflict with friends, relatives or colleagues;
failure to enter university, etc.

Clinical picture

The most common symptoms of narcissistic depression include:

gloomy, dreary, depressed mood;
feeling of dissatisfaction with one's appearance, actions;
apathy;

frank unwillingness to engage in daily activities, to perform professional duties;
emotional dryness;
mood swings;
pessimistic attitude towards the future;
loss of interest in usual activities, hobbies that used to give pleasure;
refusal to communicate with other people, the desire for solitude, social isolation;
increased anxiety.

Such a psycho-emotional state is also reflected in the patient's well-being. Narcissistic depression is characterized by complaints of poor sleep (typical early awakenings - 2-3 hours before the alarm), a feeling of heaviness in the chest, epigastric pain, loss of appetite. The patient looks older, haggard, the skin acquires an unhealthy shade, fine wrinkles appear.

When communicating with a patient, they pay attention to laconicism, monosyllabic, simple answers to questions, unwillingness to delve into the topic of conversation, to discuss their mental state.

Principles of treatment of narcissistic depression

Any form of depressive disorder (and narcissistic is no exception) is a strong indication for the prescription of antidepressants. The required drug and its dose are always selected on an individual basis, but the doctors of our clinic warn the patient and his relatives that the visible effect of this group of drugs appears after 2-4 weeks of regular use.

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