Narcissistic personality disorder (NPD) is often a stigmatized mental health diagnosis.

It’s also become a common topic. You might have even heard other people casually, and often inaccurately, include it in their conversations:

“What a narcissist!”

“They’re absolutely a narcissist, no question.”

The symptoms of narcissistic personality, however, are usually complex and can only be diagnosed by a mental health professional.

These symptoms can make it difficult to maintain healthy relationships, a fact that earns people living with narcissistic personality plenty of stigma.

Personality disorders are not a personal choice, however. Common misconceptions about them can complicate recovery for people who might want to reach out for help.

In fact, the idea that narcissism can’t be treated is just another myth.

Learning more about narcissistic personality, and the complex processes underlying its symptoms, can help.

NPD is a formal mental health condition. That means you’ll find specific criteria for diagnosis in the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).

Only trained mental health professionals can diagnose narcissistic personality, or any other personality disorder.

A mental health professional will look for at least five of these nine symptoms to reach a formal diagnosis:

  • grandiosity and self-importance
  • fantasies of success, perfection, or power
  • a strong conviction of being special and unique
  • a need for admiration and praise
  • entitlement
  • a pattern of exploiting others for personal gain
  • low empathy
  • envy, jealousy, and distrust
  • arrogance, haughtiness, and scorn

Diagnosis criteria require these symptoms to remain consistent over time and show up in most domains of life. These symptoms impair a person’s ability to function in society.

In other words, these behaviors won’t just affect romantic relationships. They’ll also show up in the workplace and with family and friends.

Experts typically diagnose the condition in adulthood. Many adults have a narcissistic trait or two, though. This does not automatically mean they have narcissistic personality, especially when these traits only show up in specific situations.

For example:

  • wanting admiration from a romantic partner
  • holding a proud attitude at work or school
  • showing entitled behavior at home but nowhere else

Narcissistic personality as a mental health condition occurs on a spectrum.

Some people experience a handful of symptoms that have a severe impact on interpersonal relationships and functioning. Others have several mild traits that nonetheless affect daily life.

The DSM-5 doesn’t detail different types of narcissistic personality, but some experts recognize four main presentations:

  • grandiose (overt) narcissism
  • vulnerable (covert) narcissism, also called closet narcissism
  • high-functioning narcissism
  • malignant narcissism

An important aspect of personality disorders is that typical condition behaviors or symptoms usually cause a great deal of distress to the person. They might also make functioning in the world difficult.

So, how do you know if you’re a “narcissist,” so to speak? Wondering whether a loved one’s behavior goes beyond simple self-centeredness?

A closer look at the nine symptoms can offer more insight. As a reminder, the formal diagnosis can only be offered by a mental health professional because it entails more than a few behaviors.

Generally speaking, grandiosity is the defining characteristic of narcissistic personality.

If the term grandiosity calls to mind “grand,” you’re not far from the mark.

People with narcissistic personality tend to consider themselves grand, important, and better than others.

Grandiose behavior, which helps establish this sense of personal importance, might involve:

  • bragging about personal achievements and skills
  • exaggerating or lying about past accomplishments
  • devaluing or criticizing others
  • anger or rage when achievements go unrecognized
  • regularly describing personal attributes, such as intelligence, power, strength, wealth, and attractiveness or sex appeal

A strong sense of self-importance can make it difficult to recognize that others don’t necessarily share the same perspective.

If you have narcissistic personality, you might expect people to recognize you as superior and feel confused or frustrated when they don’t acknowledge your accomplishments.

When others achieve something admirable, you might feel the need to challenge them. For example, you would point out where they went wrong or how they could have done better.

When it comes to covert narcissism, grandiose behavior often goes unrecognized.

Instead of openly boasting or describing the traits that make them superior, people might dwell on these achievements internally. They would also spend a lot of time fantasizing about their own importance.

People with narcissistic personality might spend a lot of time imagining scenarios where they receive the recognition and acceptance they believe they deserve.

These fantasies might center on things like:

  • a supervisor singling out your “flawless” work in front of your co-workers
  • attractive celebrities falling in love with you and begging for a date
  • meeting and becoming friends with famous people you admire
  • winning prestigious awards for your creative work
  • earning praise and admiration for rescuing someone from danger

Anyone with narcissistic personality might spend time fantasizing about personal accomplishments, as well as their own desirability, intelligence, or success.

That said, people with vulnerable narcissism might spend more time thinking about their own abilities.

People with more overt narcissistic traits, on the other hand, might openly share these fantasies with others. They might also present them as reality, not dreams.

Many experts believe early childhood experiences help shape narcissistic traits. Parenting tactics can certainly play a part.

Most parents believe their children are unique and special. However, in the case of someone with narcissistic personality, maybe one of the parents regularly insisted they were perfect, excused mistakes, and denied shortcomings.

This might lead to someone growing up convinced of their own specialness.

Consequently, a person with narcissistic personality may believe only other special and superior people are worthy of their company.

For example, someone with narcissistic personality might ignore what they consider “ordinary” people. Instead, they might pursue connections only with those who can boost their status.

Other instances in which this need to be special and unique might manifest include:

  • only choosing services others consider “the best” (e.g., fly first class, stay in five-star hotels, and eat at top restaurants)
  • purchasing only name-brand items
  • insisting on seeing prestigious specialists, even for minor health concerns
  • seeking out friendships with distinguished or famous people
  • dating only people that others find attractive, intelligent, or powerful

When people fail to recognize them, someone with narcissistic personality may decide their opinion simply doesn’t matter. This can be justified by stating these people don’t understand how unique and special they are.

People with narcissistic personality often appear to have a high opinion of themselves. This may lead others to not realize this self-importance is a front.

The sense of superiority that some people with narcissistic personality show to others might help disguise deep-seated internal insecurities and a fragile self-concept. This is why they still need and require praise from others.

This relates to another key component of narcissistic personality: difficulty with whole object relations. Whole object relations refers to the ability to see people and situations as integrated and complex.

Someone with narcissistic personality might have a difficult time recognizing that everyone, including themselves, has a mix of traits. Instead, they often assume one flaw means someone is wholly flawed.

This defense mechanism is called splitting, or all-or-nothing thinking.

The praise and attention someone with narcissistic personality earns from others help reinforce their sense of superiority.

They might, for example:

  • expect people to admire their style, looks, or abilities
  • feel enraged when they don’t receive praise for accomplishments
  • hint for compliments if they aren’t offered automatically
  • spend a lot of time wondering how others perceive them
  • expect others to envy them and desire their status, life, or belongings
  • make public gestures, like financial donations or acts of kindness, to earn praise

When someone with narcissistic personality doesn’t receive this admiration and praise, they might feel conflicted and frustrated. They might sometimes even begin to doubt that people consider them unique or important.

For someone without whole object relations, failing to achieve perfection implies “you’re nothing.”

If a single flaw can redefine you as a whole as inadequate, you’ll probably find it extremely difficult to accept criticism. This is typical in some people with narcissistic personality.

For example, when a mistake is pointed out, someone with narcissistic personality might protect their vulnerabilities by:

  • angrily lashing out and criticizing or devaluing the other person
  • making passive-aggressive or snide remarks
  • subtly twisting or shifting blame to make themselves look better
  • ignoring the other person to show how little they think of them
  • privately nursing hurts and grudges, and planning some kind of vendetta

If you believe you’re special and superior to others, you might expect to receive special treatment and privileges to match.

In the case of someone with narcissistic personality, entitlement can show up in various ways and across situations. For example:

  • When waiting to get into a club, they might expect to move straight to the front of the line. After all, they’re more attractive than anyone else.
  • Their romantic partner shouldn’t waste time talking with friends when they want company. Don’t their needs come first?
  • They work harder and do a better job than anyone else, so they deserve to set their own schedule.
  • How can their roommates make noise in the living room while they’re working on their novel? Don’t they realize how inconsiderate that is?

With covert narcissism, a person might internally fixate on what they consider their due instead of outright insisting on special treatment. Failing to receive these privileges might lead to feelings of anger and resentment.

Someone with narcissistic personality might feel that if people don’t show enough dedication to their needs, they need other ways to get their way.

Manipulation might become a tool to get others to fulfill such needs.

Here’s an example of how manipulation can sometimes manifest:

You want to spend time with your partner, but they went out with a friend. You might feel jealous but don’t want to say so.

When your partner gets home, you ask how they could be so inconsiderate of your feelings, especially after you’ve had such a rough week at work.

“You’re never here when I need you. Clearly, you don’t care about me at all, since you never consider what I need. Don’t my feelings matter?”

Your partner apologizes profusely, telling you how awful they feel and assuring you of how much your feelings do matter.

As a result, you get more time and attention from them.

Someone with narcissistic personality might also use other exploitive or manipulative tactics, such as:

  • putting themselves down so people recognize their abilities
  • insisting others help and support them before taking care of themselves
  • complimenting someone to receive praise back
  • failing to recognize when they’ve made unrealistic demands of others
  • treating people unkindly when they’re unwilling to do things for them
  • lying or deceiving others to get their needs met

Empathy, in basic terms, describes the ability to understand how others think and feel. Low empathy can make it difficult to connect with others on an emotional level.

Someone with narcissistic personality might:

  • focus on their own problems and feelings without realizing that others have important needs, too
  • expect others to put them first
  • have trouble understanding other people’s feelings and experiences
  • have little interest in other people’s difficulties
  • consider expressing feelings a sign of weakness
  • avoid doing things for others unless it benefits them

Keep in mind that low empathy isn’t the same as no empathy.

Some people with narcissistic personality may have a greater capacity for empathy than others, but it’s a myth that all people with narcissistic personality are incapable of ever understanding how others feel.

Narcissistic personality commonly involves feelings of envy and jealousy.

If a person with narcissistic personality notices others receiving the praise, admiration, or status they desire, they might envy them.

Envy might then prompt criticism or covertly harbor bitterness and resentment.

At the same time, a person living with narcissistic personality might believe others envy their superiority and unique abilities.

They might even assume others are working behind their back to undermine or steal opportunities they deserve.

This suspicion or lack of trust in others might lead someone with narcissistic personality to take action. This can manifest as discrediting co-workers before they can succeed, for example.

Jealousy also often shows up in relationships with others.

Someone with narcissistic personality might feel uneasy or upset if their partner or friend receives attention.

This sense of not being the center of admiration might trigger feelings of insecurity and anger.

Arrogance and haughtiness generally accompany a sense of superiority, and people with narcissistic personality can behave in condescending ways.

This disdain for others might show up as:

  • a “high and mighty” attitude or snobbishness
  • contempt for people who make mistakes
  • scorn for those who don’t recognize their superiority
  • a tendency to patronize “ordinary” people
  • aggressive or sharp responses to perceived criticism

Having narcissistic personality doesn’t make anyone a bad person. It’s not a personal choice. It results from a complex intersection of factors.

Change is possible, however.

Connecting with a trained mental health professional can offer benefits. This type of support might be particularly helpful when:

  • You live with several key signs or symptoms of narcissistic personality.
  • These symptoms remain constant over time or worsen.
  • You have trouble functioning in multiple areas of life.
  • There’s a high level of distress and friction in your life.

An interest in the early signs of narcissistic personality is a great first step toward addressing those symptoms.

Lasting change requires time and effort, but it’s absolutely possible.

A skilled therapist can also offer guidance with:

  • understanding actions and emotions
  • exploring new patterns of behavior
  • replacing manipulation tactics with other coping behaviors
  • developing greater empathy
  • improving interpersonal skills

To find more information on narcissistic personality and seek support from a therapist, consider visiting these resources: