Symptoms of Narcissistic Personality Disorder

Written by:Cynthia V. Catchings, LCSW-S

Published On: July 12, 2022

Medically reviewed by: Bisma Anwar, MA, MSc, LMHC

Reviewed On: July 12, 2022

Updated On: June 22, 2023


The word “narcissism” is often used to refer to someone who’s so self-involved that they ignore the needs of people around them. However, just because a person thinks about themselves a lot, doesn’t necessarily mean they have narcissistic personality disorder (NPD).

People with NPD can be extremely charming and charismatic, at least at the beginning of their relationships. They generally have a sense of grandiosity and a need for excessive admiration, dedication, and near-constant attention.

NPD commonly coexists with other conditions, such as borderline personality disorder, histrionic personality disorder, and anxiety and depressive disorders. The comorbidity factor means that it’s not always easy to determine if someone has NPD, and only a skilled, trained medical professional can truly make a narcissistic personality disorder diagnosis. That said, there are some distinct signs and symptoms that help if you suspect you or someone you know might have NPD.

Keep reading to learn more about narcissistic personality disorder symptoms you should be aware of.

Signs of Narcissistic Personality Disorder

Mental health professionals use criteria from The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) to diagnose NPD. There are 9 key traits identified in the DSM-5, five of which must be present to make a diagnosis. These traits include:

  • Having a grandiose, extreme sense of self-importance
  • Holding an intense belief they’re special and should only associate with people who are “worthy“ of their acquaintance
  • Being preoccupied with success, brilliance, power, or beauty
  • Having a desire and need for excessive admiration
  • Displaying manipulative or exploitative behaviors
  • Feeling entitled
  • Lacking empathy
  • Being envious of people around them, or believing others are envious of them
  • Seeming arrogant or above others

Some of the most common major NPD symptoms and signs follow.

A sense of entitlement

A common belief many people with NPD have is that they’re superior or more intelligent than virtually everyone else around them. As a result, they deeply feel they should have (and expect to have) special treatment. This intense belief that they’re better than others might make them feel that:

  • People should be obedient to them
  • Rules only apply to others
  • They’re special and deserve special treatment

Manipulative behavior

A person who would appear as a “narcissist” can be extremely manipulative and controlling. While they may do this with charm, it can eventually become clear that their needs always come first. Common narcissistic behavior includes:

  • Keep others at an emotional distance so they won’t get caught up in anyone else’s needs
  • Exploit others for their own gain
  • Initially try to please and impress others to gain trust

Need for admiration

It’s common for someone with NPD to have a strong need to be admired. While the need to be liked may, to a certain extent, be somewhat true for everyone, takes it to an extreme. People with NPD tend to:

  • Brag or boast to get praise from others
  • Exaggerate their achievements to make themselves look better
  • Like to feel appreciated to boost their egos

Lack of empathy

A hallmark of NPD is a lack of empathy and compassion toward others. Common narcissistic behavior includes:

  • Find it difficult, if not impossible, to understand or sympathize with the needs, wants, and feelings of others
  • Have difficulty taking responsibility for their own behavior


Another sign of NPD is arrogance. Because people with NPD see themselves as superior to others, they might:

  • Be abusive when they feel they aren’t receiving the treatment they think they deserve
  • Talk down to others, especially to those close to them
  • Act rudely to people who they feel are inferior to them

Common Traits Based On Each Type of Narcissism

There are two main narcissistic personality disorder types — grandiose and vulnerable (there are also several other subtypes). Each has its own set of NPD symptoms.

“Both forms of narcissism are commonly rooted in different types of childhood experiences. The 2 types have common traits, including putting themselves first and internal suffering that they typically don’t discuss for various reasons.”

Licensed Clinical Social Worker-Supervisor (LCSW-S), CIMHP, EMDR Cynthia Catchings


People with grandiose narcissism feel strongly that they’re superior to others. They were likely treated as if they were above others in childhood, and their feelings remained with them into adulthood. People with grandiose narcissism:

  • Tend to brag and be elitist
  • Are generally aggressive
  • Want to be dominant
  • Are self-confident to a fault


Individuals with vulnerable NPD were often neglected or abused as children. This can also be referred to as covert narcissism and people with this type of NPD can be more sensitive than those with grandiose NPD. Vulnerable narcissistic personality disorder symptoms can include:

  • Feeling anxious or offended when others fail to treat them like they’re special
  • Using narcissism to protect themselves from feelings of inadequacy
  • Vacillating between feeling inferior and feeling superior to others

When to Seek Help for Narcissistic Personality Disorder

One of the biggest challenges in treating narcissistic personality disorder is that a large percentage of people either fail to seek help, or they’ll self-terminate treatment. They often don’t believe they have anything that needs mental health treatment. However, there are many benefits to seeking narcissistic personality disorder treatment. Ultimately, getting help can improve the quality of life both for the person showing symptoms of narcissistic personality disorder and for those closest to them.

“There is no right or wrong time to look for help. People must look for help when they realize that their behaviors and emotions are affecting their daily life, relationships, or professional life.”

Licensed Clinical Social Worker-Supervisor (LCSW-S), CIMHP, EMDR Cynthia Catchings
  • If you suspect you have NPD (or if you’ve been diagnosed in the past) and are looking for narcissistic personality disorder treatment, you’re to be applauded. Many people with NPD find they can improve their relationships and communication skills in all parts of their life with narcissistic personality disorder medication and treatment.
  • If you’re in a close relationship with someone who has NPD, encouraging them to seek treatment can help both of you. It might actually challenge your partner to view your relationship differently. It’s not unusual for NPD treatment to eventually alter the entire relationship dynamic for the better.

It can be hard to learn how to help a narcissist but it is important to know that treatment can be very effective. Successful treatment plans can help change the course of someone’s life, allowing for mutually supportive and rewarding relationships and a healthy self-image.

Get Professional Help with Talkspace

Narcissistic personality disorder symptoms can be helped with the right course of treatment, which will often include a combination of medication and therapy for narcissistic personality disorder.

Psychotherapy — which is also known as talk therapy — is known to be beneficial in treating NPD. Various types of cognitive-behavioral therapy, such as dialectical behavior therapy (DBT), schema therapy, and others, can help flesh out the root cause of NPD symptoms. It can also teach someone new skills so they can relate better to others and be able to communicate more effectively.

To find a therapist in your area with experience in treating NPD, start first with your primary care physician. They should be able to connect you with someone skilled and trained in treating NPD.

If you’re looking for a convenient and effective way to access therapy, consider Talkspace. Talkspace’s platform offers online therapy that simplifies the process and offers incredible results. Find out how Talkspace can help you manage and treat NPD today.

See References

Cynthia V. Catchings, LCSW-S

Cynthia Catchings is a trilingual licensed clinical social worker-supervisor, mental health consultant, professor, and trainer for federal law enforcement agencies. Cynthia has over 15 years of experience in the mental health profession. She is passionate about women’s mental health, life transitions, and stress management. Her clinical work, advocacy, and volunteer service have focused on working with domestic violence survivors and conducting mental health research in over 30 countries.

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