The term narcissistic personality disorder replaces megalomania in professional settings.
Feelings of Importance
You have many lofty qualities. Perhaps you excel in sales, ingenuity, or have a heightened fashion sense. Abilities in several other areas often surpass peers. Likely, you have a position of authority. This sounds appealing but is your view of this position problematic?
Narcissistic personality disorder (NPD) is a long-term pattern of abnormal behavior characterized by exaggerated feelings of self-importance or self-love. This accompanies an excessive need for admiration and a lack of understanding of others’ feelings. You might consider such persons vain, conceited, or self-absorbing.
In the field of psychology, megalomania, which literally means large great madness, is NPD.  This personality flaw is evident by personal grandiosity or deification among the traits listed below:
- Aggression towards others
- Mood swings
- Bad temperament
- Lack of empathy
- Need to be feared
- Feeling infallible
Beneath the superficial ultraconfidence is a fragile self-esteem, vulnerable to the slightest criticism. Therapy is often difficult, as people with NPD do not consider themselves to have a problem. At least some of the symptoms are positive attributes.
There is evidence of both environmental and genetic causation. Possible factors that promote the development of NPD include [1,2]:
- Oversensitive temperament at birth.
- Excessive praise or criticism for childhood good or bad behaviors.
- Frequent praise for attractiveness or abilities by adults.
- Severe emotional childhood abuse.
- Unpredictable or unreliable parental caregiving.
- Environment of familial manipulative behaviors.
- Valued by parents as a means to regulate their own self-esteem.
Psychologists differ over the number of subtypes (which are not recognized in the DSM-5 or ICD). Theodore Millon (August 18, 1928 – January 29, 2014) identified five, ranging from Amorous Narcissist to Malignant Narcissist. DSM-5 suggests a dimensional approach to diagnosis based upon the severity of the dysfunctional-personality-trait domains. [1,3]
Common anti-social behavior includes disloyalty, guiltlessness, vindictiveness and exploitive tendencies. Lack of real intimacy or empathy is popular.
The Malignant Narcissist may be suicidal or homicidal. NPD often overlaps Bipolar Disorder, Paranoid Personality Disorder, Histrionic Personality Disorder, and/or other depressive disorders. 
French psychoanalyst André Green (March 12, 1927 – January 22, 2012) saw moral narcissism as the attempt to elevate oneself above ordinary human needs and attachments—an ascetic attempt at creating an impregnable sense of moral superiority. 
An estimated 6% of the population has NPD. In a company of 1,000 employees, 60 manifest this trait. It causes problems in many areas of life, such as relationships, work, school, and financial affairs. Often, people with NPD feel disappointment when special favors or adoration is absent.
Living and Working With a Narcissist
The basic narrative of narcissists is that others are inferior. Do not try influencing a narcissist with emotional tears or sadness. They will delight in your display of weakness. As hard as it can be, you should not try to compete with a narcissist. They do not take loss well and hold onto grudges.
An estimated 6% of the population has narcissistic personality disorder.
Narcissists can surprise people with their meanness. “They’re not in touch with their own feelings, so if they’re having a bad day, they’ll project that onto other people,” explains Karyl McBride, PhD, licensed marriage and family therapist. 
In a work setting, a narcissist, similar to someone with obsessive compulsive personality disorder (OCPD), is more likely to request more than the usual of others. Projects can go over budget from an obsession with minutiae.
Without an “off switch,” a narcissist is prone to continually make extreme demands upon workmates without regard for time or budgets. (S)he may be a workaholic and expect no less from others.  Without intervention by a trusted companion, (s)he can micromanage the joy out of coworkers.
The negative feelings projected on others can have terrible consequences for a narcissist. The same is true of those with whom (s)he comes in contact. It wastes precious mental energy and takes a toll “on the body in the form of high blood pressure, stress, anxiety, headaches, and poor circulation.
Research also shows that even one five-minute episode of anger is so stressful that it can impair the immune system for more than six hours. These health issues can lead to more serious problems such as heart attacks and stroke,” explains cardiologist Dr. Cynthia Thaik. 
Avoid these outcomes by being alert to the tell-tale signs published by John White in Inc. online before accepting employment. The first of seven is your future boss speaks poorly about current staff in the interview. 
NPD has several differentials. For example, symptoms overlap OCPD. Those with elevated IQs may frequently denigrate others. Social interaction difficulties could be the result of a poor sleep routine.
According to the National Alliance on Mental Illness, Borderline Personality Disorder (BPD) is characterized by emotional deregulation.  This difficulty leads to severe, unstable mood swings, impulsivity, poor self-image, and troublesome personal relationships.
When You’re the Narcissist
Are you a narcissist?  Complete a 23-question quiz at Scientific American to discover your level of narcissism. NPD may have its roots in childhood experiences and character development.
Don’t be misled by a public persona. In the 90s, psychologist Paul Wink analyzed a variety of narcissism scales and confirmed two distinct faces of narcissism, labeled “Grandiosity-Exhibitonism” and “Vulnerability-Sensitivity.” [11,12] For better or worse, NPD is an ingrained personality.
To improve social acceptance, use your wit in a self-deprecating manner rather than belittling others. Instead of elaborating on personal successes, pretend you are a talk-show host and query others about their likes, dislikes, and successes. The next time you feel the urge to tell everyone about your outstanding accomplishment, look for someone else to whom you can say, “I’m proud of you.”
A disproportionately large amount of selfies may support the notion of self-admiration. But this scratches the surface of analysis. Seek appropriate medical attention if you feel pervasive alienation from others. A happy balance is to think less of yourself and more of others while remaining productive.
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