What You Need to Know About Narcissism and Suicide Risk

Narcissists may have an increased risk of mental health issues, including suicidal thoughts and behaviors.

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If you’re experiencing suicidal thoughts or are in danger of harming yourself, this is a mental health emergency. Contact The Suicide & Crisis Lifeline 24/7 by calling or texting 988.

Narcissistic personality disorder (NPD) is a type of personality disorder that’s thought to affect 1-2% of the U.S. population. Similar to other personality disorders, NPD causes people to think, feel, and behave in a way that affects daily functioning and goes against societal norms. It can also increase the risk of co-occurring mental health issues, including conditions like anxiety, major depressive disorder, bipolar disorder, and substance use disorder (SUD). 

Importantly, NPD is also shown to have the highest suicide risk of all personality disorders, especially for people who are also struggling with depression. Read on to learn more about the link between narcissism and suicide risk, and how to treat both. 

What’s the link between narcissism and suicide?

“Narcissism can be both a protective factor and a risk factor [for suicide],” says Shawnna Punteney, LPC, NCC, MS, Senior Regional Clinical Director with Charlie Health. According to Punteney, there are two primary types of narcissism and each has distinct implications for a person’s mental health and risk of suicide. 

1. Vulnerable narcissism and suicide risk

Vulnerable narcissism, or covert narcissism, is characterized by hypersensitivity, insecurity, and an intense fear of failure and rejection. People with vulnerable narcissistic traits may experience deep feelings of inadequacy and shame, which makes them more susceptible to suicidal ideation and behaviors. Vulnerable narcissists are highly sensitive to criticism so any perceived slights or threats to their ego can cause major distress.  

2. Grandiose narcissism and suicide risk

Grandiose narcissism, or overt narcissism, is what most people think of when describing narcissistic traits. Grandiose narcissism involves an inflated sense of self-importance, entitlement, and a lack of empathy for others. “Grandiose narcissism is generally less associated with suicide,” explains Punteney. “However, a severe challenge to their grandiose self-image—such as failure or public humiliation—can increase the risk.”

Some other common narcissistic traits that may influence your risk of suicidal thoughts include: 

• Maladaptive coping mechanisms: Many narcissists resort to unhealthy coping methods, such as substance abuse and self-harm, which can exacerbate distress and other mental health concerns.
• Trouble managing shame: When someone with NPD feels like their image is insulted or criticized, they may experience a type of emotional trauma called severe narcissistic injury. This hit to their pride may increase their chances of suicidal thoughts and behaviors.
• Interpersonal strain: Narcissists often struggle to maintain healthy interpersonal relationships, possibly due to self-centeredness and lack of empathy. Unfortunately, these traits can lead to loneliness and isolation which can increase risk of suicidal ideation.

Can treating narcissism reduce a person’s risk of suicide?

The short answer is yes. “Identifying and addressing narcissistic vulnerabilities early can significantly reduce suicide risk,” explains Punteney. “Therapy empowers people to build resilience and lead more fulfilling lives.” 

Some common examples of narcissistic vulnerabilities include fear of rejection, shame, or losing control. Many narcissists also struggle with vulnerability and emotional dysregulation. As a result, they resort to coping tactics like denial and withdrawal. But with the support of a therapist, people can learn to address these vulnerabilities and decrease risk of suicide and other mental health concerns.

Many people with NPD struggle to admit that they need mental health support. However, therapy is one of the most effective ways to help people improve their mental health and reduce their risk of suicide. 

Some of the most common treatment options include:

• Cognitive behavioral therapy (CBT)
• Dialectical behavior therapy (DBT)
• Group therapy 
• Medication management 

How to recognize suicidal ideation

For some people, it may not be obvious that they’re struggling with their mental health. If you’re in the habit of denying or avoiding your issues, you might lack the self-awareness needed to challenge distressing thoughts and emotions in a healthy way. 

Here are some signs that you might be experiencing suicidal ideation:

• Feelings of hopelessness or worthlessness
• Feelings of sadness or loneliness
• Numbness
• Feeling trapped
• Feelings of helplessness
• Overwhelming emotional pain
• Wanting relief or escape
• Worry you’ll never feel better
• Preoccupation with death
• Thoughts of suicide or death

If you’re experiencing suicidal thoughts and thinking about harming yourself, it’s important to seek immediate help. One option is to contact The Suicide & Crisis Lifeline 24/7 by calling or texting 988. You can also call 911 or go to an emergency room for immediate care.

Three leading benefits of therapy for narcissism

“Individuals can move toward healing and healthier self-perception with early intervention and effective treatment,” says Punteney. Talk therapy can help people NPD and narcissistic traits learn to improve:

1. Emotional regulation

Therapy can show people how to manage intense emotions like anger and fear. It can also help people with NPD, especially covert narcissists, learn to reduce impulsive behaviors like suicidal actions.

2. Self-awareness 

Working with a therapist can help people better understand their thoughts and behaviors. For example, learning to recognize and reframe feelings of shame, inadequacy, and low self esteem may help people learn how to effectively manage their stress and avoid unhealthy coping methods. Therapy can also help people understand the root cause of their narcissistic traits, such as a history of emotional abuse. 

3. Interpersonal relationships

It’s not always easy for people with NPD to maintain fulfilling relationships but therapy can help them better relate to themselves and others. By learning how to cultivate empathy and manage conflict, you can create space to build more enjoyable and rewarding connections.

How Charlie Health can help

If you or a loved one are struggling with thoughts of suicide or suicidal behavior, Charlie Health is here to help. Charlie Health’s virtual Intensive Outpatient Program (IOP) provides more than once-weekly mental health treatment for people dealing with serious mental health issues, including mood disorders, personality disorders, a history of suicide attempts, and more.

Through individual counseling, family therapy, and group sessions, you can learn how to recognize harmful thought patterns and behaviors and replace them with healthier, more empowering alternatives. With evidence-based treatment, managing your mental health is possible. Fill out the form below or give us a call to start your healing journey today.