Think You’re All That? You Might Be Putting Your Health at Risk

Why a narcissist's sense of self-love can do damage to the heart, especially for men.

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Everybody knows somebody like this: the self-obsessed, self-congratulatory type with an outsize sense of entitlement and a deluded sense of superiority. He turns every conversation back to himself, prattling on about his own opinions and thoughts, but never deigns to ask about you.

That narcissistic personality can take a toll — and not just on the listeners. It turns out that the more narcissistic a person is, the more likely he (and, yes, it’s especially true of men) is to have health problems like heart disease and hypertension.

Sara Konrath, a psychologist at University of Michigan, studied 106 male and female undergraduate students, measuring their levels of narcissism and the stress hormone cortisol. Previous studies have found that people who score high on the narcissism scale show elevated levels of cortisol when threatened. So Konrath and her colleagues wanted to plumb the cortisol connection more deeply, to see if narcissists have higher levels of the stress hormone overall.

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Indeed, that’s what they found. The researchers measured cortisol levels in the students’ saliva and then gave them a 40-item questionnaire to assess their narcissistic tendencies. The test assessed variously adaptive forms of narcissism: some narcissistic qualities can be useful, leading to stronger leadership and authority skills as well as self-confidence, while others are less so because they are more focused on exploitation and entitlement.

Interestingly, Konrath and her team found that people who scored higher on the exploitative aspects of narcissism showed higher levels of cortisol, while those who scored higher on the more positive aspects of narcissism did not. And the trend was more pronounced in men than in women, probably due to the fact that more men tend to be narcissistic.

The consequences of chronically high cortisol levels have been well documented in previous studies. Cortisol, which tends to rise when people feel threatened or anxious, activates the body’s stress response, elevating the heart rate, sharpening the senses and burning a lot of energy to keep the body on alert. Activating this system when it’s needed — if you’re being chased by a saber-toothed cat, for example — is critical for survival. But a constant flow of cortisol can take a toll on the body, stressing the heart and the blood vessels and setting the stage for heart disease.

People who are narcissistic tend to be defensive, becoming aggressive when their superiority is threatened, says Konrath, and that style of coping can elevate cortisol and make the heart more vulnerable to disease.

Biologically, she says, narcissists with negative personality traits looked very similar to people with anxiety disorders. But they differed in one respect that may make them even more susceptible to cortisol’s damaging health effects. “When people have anxiety disorders, they recognize [it] and talk about feeling anxious and under stress,” she says. “For people who are narcissistic, this seems to be happening at a physiological level but for some reason the people aren’t feeling stress, which makes it potentially more toxic because they don’t seek help.”

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The higher cortisol levels found among the higher-scoring narcissists suggest that they perceived even the task of filling out a questionnaire in the lab to be a potentially threatening situation, and one in which they needed to be on their guard in order to appear superior or in control, compared with the other participants.

Maintaining the narcissistic personality, in other words, is similar to keeping the body under stress, and Konrath says that’s particularly worrisome given the rising rates of narcissism in the U.S. “It makes me wonder what the long term health implications of this will be,” she says.

The findings also suggest that both primary care physicians and mental health professionals need to be more aware of the connection between mind and body, and appreciate that personality can influence our health in potentially serious ways. “People who work with mental health populations should realize that if people show signs of narcissism, then that personality is probably taking a toll on their body,” she says, and those individuals might benefit from some simple stress-relieving therapies.

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