Individuals with enhanced levels of vulnerable narcissism tend to express high self-doubts and anxiety, and to be hypersensitive with respect to social evaluations.
Withdrawing into their own corner, they will also have their own kinds of rituals, distressing thoughts, grievances, anger, and general moodiness. In some sense, those with narcissism can have anxiety as well.
Vulnerable narcissists tend to be most at risk of developing depression. They're often introverted, sensitive, and prone to experiencing anxiety and shame.
Patients with personality disorders are often anxious. Narcissists for instance, are preoccupied with the need to secure social approval or attention (narcissistic supply). The narcissist cannot control this need and the attendant anxiety because he requires external feedback to regulate his labile sense of self-worth.
Often narcissistic personalities are vulnerable to hypochondria because they transform their psychological frailty into physical fragility. Narcissistic personalities may fear falling apart physically because they sometimes know that their sense of self can be abruptly shattered.
On the other extreme, persons with vulnerable narcissism may present with salient features of dysthymia, depression, and anhedonia. However, the grandiosity and need for admiration would be prominent despite the affective symptoms, which would differentiate it from a major depressive disorder.
Narcissists' Greatest Fear
Although narcissists act superior, entitled and boastful, underneath their larger-than-life facade lies their greatest fear: That they are ordinary. For narcissists, attention is like oxygen. Narcissists believe only special people get attention.
To narcissists, ordinary people (i.e., nearly everybody around them) aren't worthy of attention, so being ordinary would leave them unworthy of the spotlight and left to suffocate.
A monumental weakness in the narcissist is the failure to look internally and flesh out what needs to be worked on. Then, of course, the next step is to spend time improving. The narcissist sabotages any possibility of looking deep within.
Rumour has it 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.
Mental Breakdowns
A narcissist may have a breakdown if their supply is cut off and they feel vulnerable, embarrassed, or out of control.
People with narcissistic personality disorder frequently have co-existing mental health conditions, including: Substance abuse—more than 40% use drugs or alcohol. Anxiety—40% have an anxiety disorder too. Mood disorders—nearly 29% also have a mood disorder, such as depression or bipolar II disorder.
Mental health experts have observed that, sometimes, when a narcissistic person doesn't receive the external validation they believe they deserve, it can result in a high level of stress and hurt. This emotional pain may turn into narcissistic rage.
Narcissists are frightened, fragile people.
They believe that how they are viewed by others, and how they view themselves, will shield them against realities of life that few of us like but most of us come to accept.
Indeed, individuals experience higher levels of narcissism after positive events, and lower levels of narcissism during times of stress. Moreover, mounting evidence that narcissists aren't all they thought they were is stressful.
"They often struggle to regulate their emotions, so reacting calmly isn't within their purview." Narcissists when offended accuse their partner of being "disrespectful" or "selfish." The world should revolve around them in their eyes, so focusing on anything else is taken as a direct attack.
Narcissistic Vulnerability
Psychotherapists consider them to be “fragile.” They suffer from profound alienation, emptiness, powerlessness, and lack of meaning. Due to their extreme vulnerability, they crave power and vigilantly must control their environment, people around them, and their feelings.
Although they can be targeted, type A people can also become a narcissist's worst nightmare. One of the most important defenses against dark personalities is having strong boundaries yourself, and type A people are usually aware they have the right to build them.
The most effective weapon to fend off a narcissist is self-love. Narcissists do not want to feel like you don't need them, that you are better off without them, and that you love yourself exactly as you are.
They like people who are strong
In fact, narcissists prefer to target someone who is strong-willed, and who has talents or characteristics they admire, because they believe it makes them shine too.