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
Arrogance
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.”
— Cynthia Catchings, Licensed Clinical Social Worker-Supervisor (LCSW-S), CIMHP, EMDR
Grandiose
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
Vulnerable
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
What Causes Narcissistic Personality Disorder?
It’s widely accepted that multiple causes can play a role in whether or not someone develops NPD in their lifetime. The following 4 aspects are considered the most likely contributors.
Genetics
Studies suggest that common personality traits linked to NPD—like entitlement and grandiosity—can be inherited. Genetics may also contribute to the type of narcissistic personality disorder someone might develop. Parents with NPD won’t definitely pass these traits on to their children, but their narcissistic personality disorder diagnosis could increase the risk of children developing it.
It’s also likely that some people are genetically predisposed to NPD. While they may not go on to develop narcissistic traits, they might be at increased risk for NPD if they’re exposed to certain risk factors.
Parenting
A wide range of parental behaviors have been linked in some studies to narcissistic personality disorder. While some parenting practices, such as neglect, maltreatment, and abuse, are actively harmful, other behaviors may come from parents who actually do have good intentions.
For example, over-protectiveness was shown in some studies to increase the risk for both grandiose and vulnerable narcissism. There’s also a correlation between narcissistic personality disorder and parental overvaluation or leniency. Children who receive disproportionate levels of praise for accomplishments, or who aren’t given boundaries, are more likely to show traits linked with NPD later in life.
Parenting influences children in many ways, but it’s important to note that there’s no single parenting style that can cause NPD. Thus, while certain parenting practices are linked to higher levels of narcissism, it’s clear that parental behaviors aren’t always what causes narcissistic personality disorder.
Environmental
The environment that a person grows up in — that is, their culture and upbringing — might also lead to NPD. Maltreatment during childhood appears to potentially increase the risk for NPD in early adulthood. Studies also suggest that narcissistic traits might be more common in individualistic cultures.
Parenting is a big part of a child’s environment, but other childhood experiences can also play a role in the likelihood of someone later developing NPD, too. For example, some people who experience high levels of bullying during childhood might be more likely to show narcissistic traits, particularly if the abuse continued for a long period of time. Excessive criticism from parents can increase the risk for NPD, but it’s been determined that criticism from other authority figures, like teachers, can have a similar effect.
“With a predisposition to need more from caregivers, individuals who suffer from NPD tend to be reared in environments where they’re constantly reinforced for everything (without rules, boundaries, or structure), or traumatized, or abused at an early age and left without the ability to process their environmental deficits.”
— Meaghan Rice, Doctor of Psychology (PsyD.), Licensed Professional Counselor (LPC)
Biology
Recent research has identified biological factors that may play a role in the development of NPD. Studies have found that people with NPD have elevated levels of oxidative stress, a molecular imbalance that can strain the body.
Brain scans show that people with NPD have less gray matter in the parts of the brain that are associated with empathy. Neuroscientists have also found a link between NPD and variations in prefrontal brain structure. More research must be done, but in the future, it might be possible to detect narcissistic personality traits just by looking at someone’s brain.
Some researchers believe that appearance or physical attributes might even contribute to NPD. Athletic abilities, physical attractiveness, and strength are all associated with higher levels of narcissism. Appearance is, after all, one of many things that are believed to shape someone’s personality.
Risk Factors of Narcissistic Personality Disorder
There are a range of factors that could potentially increase the risk of NPD. For instance, men are more likely to be diagnosed with NPD than women, suggesting that males might have an increased risk for the mental health condition. While research has linked NPD to certain parenting styles, experiences, and cultures, these factors aren’t consistent across all people with NPD.
Evidence suggests that narcissistic personality disorder doesn’t have a single cause. Instead, it’s likely that NPD is caused by a combination of factors. As an example, someone who’s genetically or biologically predisposed to narcissistic traits may be more likely to develop NPD if they’re also exposed to different risk factors.
Ultimately, even though experts have identified these risk factors, we simply don’t know what causes narcissistic personality disorder. It’s true that some risk factors can be avoided, but there’s no guaranteed way to prevent the condition. That said, despite us not knowing the causes and having a clear understanding that there’s no cure, people with NPD can improve their symptoms through long-term narcissistic personality disorder treatment.
What Are the Different Types of Narcissism?
There are 2 main types of narcissism: grandiose and vulnerable. Although both types share some traits, they also result in fairly distinct behaviors. In addition to these types of NPD, there are other subtypes of narcissism, like communal, antagonistic, malignant, and seductive narcissism. Each subtype has its unique characteristics and manifestations, adding to the complexity of understanding and treating narcissistic personality disorder. We’ll look more closely at each below.
“It’s important to recognize that narcissism can be seen in a few different ways. Not all people you meet who have narcissistic traits will have narcissistic personality disorder. People can present as either grandiose or vulnerable narcissists, which impacts their relationships differently.”
— Jill Daino, Licensed Clinical Social Worker (LCSW-R), BC-TMH
Grandiose (agentic and overt narcissism)
Narcissism is often seen in a negative light, but grandiose narcissists, or overt narcissists, are typically charming and well-liked. Also known as “agentic or “overt narcissism,” people with grandiose narcissism tend to have a very high sense of self-esteem. This can cause an overt narcissist to overestimate their capabilities. Grandiose narcissism can make people spread flattering rumors about themselves while trying to shut down any information that contradicts an overt narcissist’s illusions of greatness.
Experts believe that there are two categories of grandiose narcissism: adaptive and maladaptive.
- Adaptive narcissism causes people to build up their self-confidence in order to protect themselves. People with adaptive narcissism are natural leaders and are often drawn to careers that offer positions in leadership. These types of overt narcissists crave authority and prestige.
- Maladaptive narcissism means someone will have a naturally high self-esteem and believe that they’re entitled to take advantage of other people. This causes them to try to control or manipulate those around them. This type of grandiose narcissist may become angry or aggressive when someone disagrees with them or tries to set boundaries.
Vulnerable (closet or covert narcissism)
It’s commonly assumed that narcissism causes people to want to be the center of attention, but vulnerable narcissism typically results in behaviors that are introverted and withdrawn. Vulnerable narcissism is also referred to as “closet” or “covert narcissism,” and it would generally be seen in someone who has a low sense of self-worth and craves praise and admiration so they can feel better about themselves.
Vulnerable narcissistic personality disorder types often have elaborate fantasies of becoming successful. A covert narcissist believes that they deserve positive feedback from others, but usually won’t take steps to earn that praise. The lack of recognition can lead to emotional outbursts, which may cause a covert narcissist to feel intense levels of shame. A common personality trait of covert narcissists is playing the victim.
Research shows that vulnerable narcissism means someone is more likely to experience negative emotions, and they also may perceive compliments as insults. It’s also linked to high levels of neuroticism.
It’s common for people living with this type of narcissism to struggle with depression and paranoia. A vulnerable narcissist is often envious of the people around them and tends to blame others for their lack of success.
One important note is that studies show grandiose and vulnerable narcissism aren’t always mutually exclusive of one another. Personalities may fluctuate back and forth during various periods of time.
Communal
A common trait between many types of narcissistic personality disorders is a gap between the way one views themself and how one behaves. People with communal NPD perceive themselves as highly generous and altruistic, but behave in the opposite way. While they may become outraged when they witness injustice or see someone being mistreated, they don’t apply that same level of scrutiny to their own narcissistic behavior.
Antagonistic
Competitiveness is a personality trait that’s associated with many narcissistic personality disorder types, but it’s especially noticeable in those with antagonistic narcissism. A low level of trust in others creates a narcissistic tendency to see the people around them as rivals. It’s common for people with antagonistic NPD to argue with others and treat most social interactions as a competition.
Malignant
The narcissistic personality disorder symptoms of malignant narcissism are severe and can interfere with a person’s quality of life. They’re often paranoid and may obsess over perceived threats. It’s common for people with malignant narcissism to display vindictive or even sadistic behavior and show high levels of aggression when interacting with others.
Seductive
People with seductive NPD understand the power of flattery. Like some other types of NPD, this version makes someone crave positive attention. They’ll freely shower targets with compliments in order to get the admiration they desire. When they’re not getting enough praise from someone, they have no problem dropping that person and moving on to a new target.
“You will encounter challenging people throughout your life. Not all of them will have the degree of narcissism that constitutes narcissistic personality disorder, but they might have many of the narcissistic characteristics described. Knowing how to navigate these personalities and keep your boundaries steady is crucial in dealing with narcissism.”
— Jill Daino, Licensed Clinical Social Worker (LCSW-R), BC-TMH
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.”
— Cynthia Catchings, Licensed Clinical Social Worker-Supervisor (LCSW-S), CIMHP, EMDR
- 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.
