It can be difficult for someone with narcissistic personality disorder (NPD) to seek treatment since they generally do not recognise they have a problem. The first step to recovery is for the NPD sufferer to become aware that their behaviour is affecting their life and relationships.

Psychotherapy, or talking to a therapist, is the most useful treatment approach, although more research is required to determine the most effective therapies. The aim is to develop a more realistic self-image and enable the person to relate to others more positively. The type of therapy used can include:

• Psychodynamic therapy — long-term individual therapy that helps a person to understand their behaviours, moods and disruptive thoughts. These insights can help them find better ways to relate to others.
• Cognitive behaviour therapy (CBT) — helps people identify negative, unhelpful behaviour patterns and replace them with more productive and positive ones.
• Family or marital therapy — NPD can affect families. Coming together for a session can help people in dealing with relationships, with problem solving solutions and positive communication.

There’s no specific medicine to treat NPD. However, people with NPD sometimes also develop depression or anxiety, and in such cases antidepressant medications may help.

If you are concerned about suicide risk for a person with NPD, then seek medical advice urgently.