Published On: February 21, 2023
Reviewed On: February 21, 2023
Updated On: June 22, 2023
Narcissistic personality disorder (NPD) is a mental health condition that can wreak havoc on relationships, impede career paths, and make it incredibly difficult to have a healthy, productive sense of self.
Hallmarks of the condition are having an inability to show empathy, being self-absorbed or boastful, coming across as arrogant, and feeling a persistent need for praise and admiration.
You might be thinking that these narcissistic personality disorder symptoms describe a lot of people you know, and that’s probably true. It’s one of the reasons that getting an accurate NPD diagnosis can be difficult. Add to this the fact that several other mental health conditions share similar symptoms with NPD, and it becomes clear that you must get a diagnosis from a trained and licensed mental health professional.
If you’re looking for more information on how to diagnose someone with narcissistic personality disorder, we’ll help you sort through everything you should know, and figure out the next steps to take.
There are multiple diagnostic techniques used by the mental health community to diagnose NPD.
The most commonly used method of arriving at an NPD diagnosis is by using the criteria set in The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5).
The DSM-5 requires that someone meet at least 5 of the following 9 criteria to get a narcissistic personality disorder diagnosis. Someone with NPD might:
An alternative in the DSM-5 supports a diagnosis of NPD if someone is impaired in at least 2 of these 4 areas of their life:
“It may not be common for a person with a narcissistic personality to seek a diagnosis on their own. Many of the symptoms of this disorder might not allow them to seek counseling voluntarily. Grandiosity and self-importance, along with a lack of self-reflection, are a few of the attributes of NPD that hinder someone from seeking treatment.”
There are also several written tests that can be used to make a narcissistic personality disorder diagnosis. These are not “black and white” tests and are subject to interpretation only by a trained mental health professional. These tests include:
Each of these tests is made up of simple, easy-to-answer questions. You only need to respond honestly for them to offer accurate insight.
One of the major challenges when learning how to diagnose someone with narcissistic personality disorder is the fact that other mental health conditions share similar symptoms. NPD is also commonly misdiagnosed as several other conditions, including:
To make things even more complex, it’s incredibly common for people to also have one or more other mental health conditions. In fact, it’s actually somewhat rare for someone diagnosed with NPD to not have a comorbid condition (when two conditions co-exist).
Some of the conditions and comorbidities that share symptoms with NPD follow.
Although genetics may play a role in histrionic personality disorder, it’s believed to be largely the result of childhood abuse and neglect.
Key symptoms of BPD can include:
BPD is also believed to stem from childhood experiences and is especially common in adults who were abandoned physically or emotionally during childhood.
People with avoidant personality disorder feel inadequate and believe they’re always being judged by others. It’s estimated that 36% of people diagnosed with NPD might also have avoidant personality disorder. Symptoms can include:
It’s also common for people with NPD to have anxiety and depressive disorders. Additionally, in cases where this is true, symptoms are typically more severe than when these conditions occur on their own.
Being diagnosed with NPD, or having someone you love receive this diagnosis, is not the end of the world. The good news is there are many ways for treating narcissistic personality disorder that can be effective in helping both the person living with narcissism, as well as those around them, increase their quality of life and form stronger, healthier relationships.
You can also educate yourself about NPD. If you want to know more about how to diagnose someone with narcissistic personality disorder, it’s important to ignore the large volume of “pop” information you might encounter on social media or casual websites. Instead, dig deeper, reading articles from reputable medical journals and studies. There are also a number of support groups for people in a relationship with someone who has NPD. Through your own therapy and support, you can learn to cope better and support your loved one.
You don’t have to just put up with the symptoms of NPD — whether you’re the person diagnosed with it, or you’re someone close to them. Treatment, which usually involves therapy for narcissistic personality disorder and possibly medication, can be effective if you stay with it and are committed to success.
“The therapist’s relationship to the person with NPD is key in any form of treatment provided. There needs to be trust and an ability to identify manipulations and inconsistent verbal and behavioral communications.”
Talkspace is an online therapy platform that can provide you with the help and support you or your loved one needs.
Ambardar, MD S, Bienenfeld, MD D. Medscape.com. Published 2018. Accessed June 21, 2022.
American Psychiatric Association. Washington, DC: American Psychiatric Publishing, Inc; 2013.
American Psychiatric Association. Washington, DC: American Psychiatric Publishing, Inc; 2013. 761-81.
Barth M. Appstate.edu. Published 2001. Accessed June 21, 2022.
Dr. Karmen Smith is a board-certified Clinical Social Worker in the state of Nevada. She has worked over 20 years for Clark County Family Services with abused and neglected children in the shelter, adolescents in juvenile detention, and adults who have suffered severe trauma. Dr. Smith is a shamanic teacher and minister of metaphysics and her doctorate is in Pastoral Counseling.