This is an important essay, as the most conservative estimate of prevalence of narcissistic personality disorder (NPD) is 1.6% according to a 2010 study by Dhawan, Kunik, Oldham, & Coverdale at NIH. This statistic suggests your chances of meeting a person with NPD is 1 in every 62 persons in the U.S. The probability is more critical by participation in social media, particularly by empathic individuals that NPD types direct their attention.

The advice is critical, particularly, for humanitarians. Know the symptoms of NPD and once you detect them, follow the author's directive, and I quote:

" . . . cut off all contact with the person. . . Sever all ties immediately."

The reason you should follow this advice is because NPD is a serious mental illness without a cure. Sympathetic social support by well meaning, generous, and caring friends may fuel the disease without professional clinical management.

The only alternative is treatment with a trained professional.

In my personal experience, I have noticed that individuals with NPD express somatoform disorder when friends and companions sever contact. This may manifest as skin lesions, infection, pain, and a variety of dramatic symptoms that debilitate the patient stimulating caring individuals to reconnect. It seems so inhuman to abandon your associate when they have fallen so low. Simply remember this current manifestation is a facet of the disease that is the basis upon which you severed your relationship in the first place. Do not reestablish your association unless a professional therapist is supervising you and the patient. Otherwise, you place yourself in jeopardy.

My opinion in this matter may seem strikingly cold and uncaring at first glance. Who, of good character, would turn their back on an individual so profoundly ill? If you are ready to sacrifice your time, reputation, and health for another---and you believe you have the knowledge and energy to get the patient into therapy, with informed consent, I say more power to you with blessings; however, I will do my best to talk you out of it.

Where we might devote our humanitarian energy is in the political support for better mental health care in the U.S and for more open discussions about mental illness. One of the most harmful forces impacting mental health is privacy laws and the notion that "it is just in their head“ and "they" could make it go away if they tried hard enough. The laws of privacy prevent the public from having a practical understanding of the nature of mental illness, how you live and work with mental illness, and the healthy individual's relationship to a community's support for those who suffer from psychiatric disorders. Thus folk notions arise around words like insane, crazy, and nuts that create a world of misunderstanding that leads to a privacy of isolation.

Today, there are great scientists, musicians, poets, and writers withering away because their families, friends, and associates have rightfully severed all communication with them due to the profound social disorganization that attends NPD. There are those of modest talents no one ever cared to associate beyond the problem phase. We are talking about a total population 5,600,000 individuals that is suspected to be growing by 200K individuals a year according to Medline.

Thanks again to author for this timely essay.