The self-focus of narcissism may make it seem like a person exudes confidence or knows exactly what they want. But depression can be behind the surface.

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Narcissistic personality disorder (NPD) is a complex condition characterized by expressions of self-importance, a lack of empathy, and a persistent need for admiration.

Symptoms can include grandiosity, a victim mentality, arrogance, and manipulation. The disorder can stem from childhood emotional neglect, abuse, or overbearing parenting, according to research.

When the real world doesn’t reflect or respond in kind to their self-projections, folks with NPD can become depressed.

But it might not present like clinical depression.

We do know that clinical narcissism increases the likelihood of depression, though researchers don’t know why exactly.

There are a few speculations for the cause for co-occurring depression:

  • Self-esteem challenges. Research has shown this occurring in people with vulnerable narcissism.
  • Perceived lack of attention and validation. Those with NPD may not have the proper coping skills to manage inattention and shame, as one study finds.
  • Differences in perception. They may become confused and discouraged when others don’t see them as positively as they see themselves or don’t recognize or agree with their perceived victimization.
  • Chronic stress. They may become stressed over interpersonal problems associated with their behaviors (this study points to romantic relationships, for example).

Phenomena like love and admiration are organic and reciprocal. In contrast, people with NPD tend to continually seek or demand praise, but they often don’t receive the praise they believe they deserve.

This can lead to feelings of emptiness, loneliness, and isolation consistent with the symptoms of depression.

Types of narcissism

There are two subtypes of narcissism: grandiose (overt) and vulnerable (covert). Both types include a lack of empathy, an exaggerated sense of self, and a strong negative reaction to criticism.

Grandiose narcissism features a more assertive expression of narcissism. People with grandiose narcissism are more outgoing and openly express their feelings of superiority.

Vulnerable narcissism features a more self-deprecating superiority. People with this type tend to have low self-esteem and need constant reassurance. Their deep aversion to criticism can cause them to retreat from people and attention.

Do people with covert narcissism have depressive episodes?

One study looked at the differences in depressive symptoms alongside grandiose and vulnerable narcissism. The researchers found that those with vulnerable narcissism were more likely to experience depression due to unprocessed emotions.

Unprocessed emotions are difficult emotions that remain in response to unresolved situations. They can lead to additional negative emotions.

The study findings suggest that narcissistic vulnerability may lead to persistent and intrusive negative feelings, which in turn can contribute to greater symptoms of depression.

Another study found that perfectionism may be at least partially responsible for depressive symptoms in those with covert narcissism. This wasn’t the case in those with grandiose narcissism.

People with narcissistic traits could experience many of the same depressive symptoms as those diagnosed with depression, such as:

  • persistent low mood
  • emptiness
  • hopelessness
  • pessimism
  • irritability
  • loss of pleasure in previously enjoyed hobbies and interests
  • low energy or fatigue
  • moving or talking more slowly
  • restlessness
  • lack of concentration, poor memory
  • aches or digestive problems without a clear physical cause
  • not wanting to live anymore
  • suicidal thoughts or attempts

However, people with NPD may be more likely to react with anger or denial if their worldview and self-perception are challenged.

One study looked at depressive symptoms among 117 people who were being treated in outpatient clinics. Of these, 61 had NPD and 56 didn’t have a personality disorder.

The results showed a significant difference between the two groups in how they expressed depressive symptoms. The NPD group showed more of the following characteristics:

In other words, people with narcissism’s depression symptoms could be directed toward others as well as inwardly — and might be closely tied to circumstances and other people.

People without a personality disorder appeared to experience more persistent self-directed symptoms that may be observable by others.

Narcissistic injury and rage

Negative feelings often manifest as rage in people with NPD.

While most of us have felt criticized, disappointed, or rejected at some point in our lives, those with healthy levels of self-esteem and emotional intelligence are able to overcome these negative emotions and move on.

But a person with NPD can experience debilitating feelings of defeat and emptiness in a phenomenon known as “narcissistic injury.”

According to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5), narcissistic injury is defined as

They can often blame others for their feelings of inadequacy; otherwise, they might feel their self-image is at stake when faced with their own failures and shortcomings.

While these reactions don’t look like depression, they can be driven by similar symptoms of helplessness and despair.

If you believe that you have traits of narcissism and symptoms of depression, you can reach out to a mental health expert. A therapist can help you work through your symptoms and identify your best self.

There are several types of therapy that are effective in helping people with symptoms of depression.

Since narcissism largely hinges on others’ attention and admiration for maintaining self-esteem, learning to self-validate can also be pivotal.

Narcissistic personality disorder can carry a likelihood for developing depression along the way, but both conditions are manageable with therapy and treatment.

Both overt and covert narcissism can manifest depression symptoms and nuanced symptoms related to NPD such as rage, insomnia, hostile sentiments, and narcissistic injury. Covert narcissistic depression symptoms can also include depression due to unprocessed emotions.

You can live your best life and recover from symptoms of narcissism and depression by learning to validate yourself and by speaking with a mental health professional.