4. NPD Treatments - SSRI

Narcissistic Personality Disorder (NPD) per se is NOT treated with medication. It is usually subjected to talk therapy. The underlying disorder is treated by long-term psychodynamic therapy. Other personality disorders (NPD rarely comes alone. It usually appears with other PDs) are treated separately and according to their own characteristics.

But phenomena which are often associated with NPD - such as depression or OCD (obsessive compulsive disorder) - ARE treated with medication. Recent research indicates that SSRI's (such as Fluoxetine, known as Prozac) might have adverse effects if the primary disorder is NPD. They sometimes lead to the serotonin syndrome which includes agitation and exacerbates the rage attacks typical of a narcissist. I didn't hear about the exacerbation of grandiosity due to SSRI consumption but I am keen on comparing notes. SSRI do lead at times to delirium and a manic phase and even to psychotic microepisodes, though.

This is not the case with the heterocyclics, MAO and mood stabilizers, such as lithium. Blockers and inhibitors are regularly applied without discernible adverse side-effects (as far as NPD is concerned).

Additional cognitive-behavioral therapies are often applied to OCD and sometimes to depression. To summarize:

Not enough is known about the biochemistry of NPD. There seems to be some vague link to serotonin but no one knows for sure. There isn't a reliable NON-INTRUSIVE method to measure brain and central nervous system serotonin levels anyhow, so it is mostly guesswork at this stage. Thus, as of now, the typical treatment is: Talk therapy (psychodynamic), Cognitive-behavioral therapy for OCD, and depression Antidepressants (with SSRI being currently under critical scrutiny)

5. Epidemiology of Narcissism

The figures seem to indicate that a minimum of 1% (probably 3% and perhaps up to 5%) of the population above the age of 10 are narcissists. Now, factor in the parents, spouses, colleagues, friends, children, the children's families ...

This is the biggest under-diagnosed mental health pathology ever. Many researchers also believe that all Cluster B personality disorders (Histrionic, Antisocial and Borderline) have a common thread of pathological narcissism. This is getting close to 10% of the adult population. Staggering numbers.

6. Rescue Fantasies

"It is true that he is a chauvinistic narcissist with repulsive behaviors. But all he needs is a little love and he will be straightened out. I will rescue him from his misery and misfortune. I will give him the love that he lacked as a kid. Then his narcissism will vanish and we will live happily ever after".

7. Loving a Narcissist

I believe in the possibility of loving narcissists if one accepts them unconditionally, in a disillusioned and expectation-free manner. Narcissists are narcissists. This is what they are. Take them or leave them. Some of them are lovable. Most of them are highly charming and intelligent. The source of the misery of the victims of the narcissist is their disappointment, their disillusionment, their abrupt and tearing and tearful realization that they fell in love with an ideal of their own invention, a phantasm, an illusion, a fata morgana. This "waking up" is traumatic. The narcissist is forever the same. It is the victim who changes.

It is true that narcissists present a facade in order to generate sources of narcissistic supply. But this facade is easy to penetrate because it is inconsistent. The cracks are evident from day one but often ignored. And what about all those who KNOWINGLY and WILLINGLY commit their wings to the burning narcissistic candle?

I, personally, always inform and warn other people that I am a Narcissist. Yet it never seemed to have dissuaded even one fervent lady from pursuing me (or, rather, my False Self). It did not deter one businessman from doing business with me. Frankly, it did not deter you from joining my list. Why is this? Because, having been forewarned, perhaps you stand to benefit without suffering. And, most probably, you do. But perhaps it is the irresistible attraction we all have to the "other", the "different" and, as a result, the "risky".

8. Hitler and Narcissism

I recommend Alan Bullock's book "Hitler and Stalin - Parallel Lives" (both deemed narcissists by Bullock and Hitler was judged to be NPD by Fromm).

Another FASCINATING study, secretly commissioned during the war years depicts Hitler as a severe case of NPD - when NPD was not even recognized as such: http://www1.ca.nizkor.org/hweb/people/h/hitler-adolf/oss-papers/text/profile-index.html