At middle age, we all face the fact that our place in the world is evolving as we get older and our bodies and faces change. Narcissists are confronted with the decline of their sense of importance in the world and the fading of their good looks in a way that can be particularly devastating to them. There may be a frantic grasp at staying young by narcissists who have lived their lives trading on their physical appearance to be relevant and noticed. It happens on blogs and in the media as (more often than not) women try to keep the attention they've always craved through plastic surgery, overt sexuality, provocative words and images and more. In some cases, it's not sexy at all - it's sad and desperate.

According to the Mayo Clinic, narcissism is:

...characterized by dramatic, emotional behavior, which is in the same category as antisocial and borderline personality disorders.
Some of the symptoms of narcissism include:

Believing that you're better than others
Fantasizing about power, success and attractiveness
Exaggerating your achievements or talents
Expecting constant praise and admiration
Believing that you're special and acting accordingly
As you can see, narcissists live in a fantasyland of their own sense of exaggerated self-importance. When the world acknowledges them as young beauties, they are given the kind of attention the believe they deserve without having to do much to attract it to them. As they grow older, the loss of attention can wreak havoc. Because they hold a mirror up to the world to see who they are, this lack of attention can very well obliterate their self-worth.

Narcissists are among the most difficult people with whom to have a relationship, be it personal or professional, because no matter what you do or say it isn't enough to feed their never-ending desire for admiration and applause. They expect to be praised simply for showing up, and watch out if you don't respond the way they think you should to their slightest effort. Narcissists are exhausting, and beware the narcissist whose anger is focused your way:

The anger of narcissists...can be more demeaning. Their criticism evolves from their conviction that others don't meet their lofty standards-or worse, aren't letting them get their own way. "Narcissistic injuries," or wounds to the ego, often pave the way for narcissistic rages, which can be passive-aggressive or planned out, as well as sudden. They are above you and you have displeased them and probably deserve punishment they will dole out. - Psychology Today