What Is A Narcissistic Personality? Knowing The Signs And Symptoms

Medically reviewed by Paige Henry, LMSW, J.D.
Updated March 22, 2023by BetterHelp Editorial Team

The term narcissistic personality has gained a lot of popularity in the media lately. It is discussed so much in the media that a lot of people may readily apply it to someone they know, but what is the true meaning of a narcissistic personality?

According to the American Psychiatric Association, narcissistic personality disorder (NPD) is characterized by:

  • A pattern of grandiosity
  • A need for attention and admiration
  • A lack of empathy

Learn About Narcissistic Personality Disorder

People with NPD tend to excessively require others to give them attention and praise. These types of narcissists often believe that they are the smartest, most pretty or handsome humans to walk the face of the earth, or other such grandiose beliefs, and they may need other people to come to the same conclusion.

They sometimes set very high goals so that those around them can feel awed by how lofty their goals are. Alternatively, they might set low goals in certain areas because they have a sense of entitlement.

People with NPD sometimes find it challenging to understand the feelings and emotional needs of the people around them. Also, they may form relationships with other people only if they have something to gain. Without something to gain, they might not get involved with another person and may readily cut old ties without qualms.

Some people with NPD are low in agreeableness (one of the Big Five personality traits). They can be condescending toward other people, and they may have a sense of entitlement, which might make them believe others are beneath them. They may also expect others around them to look at them and admire them for their perceived greatness, and they can be prone to thinking that others must envy them for this greatness.

Symptoms Of Narcissistic Personality Disorder

The symptoms of narcissistic personality disorder are defined by a set of criteria presented by the American Psychiatric Association in its Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The criteria are as follows:

Grandiose sense of self-importance: People with NPD tend to feel more important than they are. Their sense of self-importance is often out of proportion to what they have achieved. Accompanying this sense of self-importance usually are actions such as boasting and showing off.

Preoccupation with fantasies of unlimited something: People with the disorder may sometimes fantasize about their levels of greatness, power, brilliance, and intelligence or their unparalleled beauty. When they do this, they often attach the fantasy to a mythical figure or a historical figure who had accomplished great things.

The belief that they are superior, special, or unique: People with NPD tend to feel that they are special and more important than those around them. This feeling may be linked to the belief that they can only be understood by people or institutions that are just as special and important as they are.

Need for excessive admiration: People with NPD may show off a lot in an attempt to get noticed and have praise heaped upon them. They often need praise and admiration to fuel their feelings that they are special. When they don’t get their dose of adoration, they may become falsely charming and flattering to get the needed dose of admiration.

Sense of entitlement: Since they may expect other people to notice how special they are, people with NPD may come off as condescending. They may feel like other people need to show them the proper respect they deserve. They often act in ways that show this sense of entitlement; for example, they might cut across lines and expect to be served first.

Exploitation of others: People with NPD might take advantage of those around them. For example, they might take sole credit for the work done by a group they are in. They tend to feel the ends justify the means.

Lack of empathy: People with NPD might sometimes be unable to understand and sense the emotional needs of other people. They may be too engrossed in thinking about themselves and often can’t relate to how people other people feel. They often genuinely don’t understand the viewpoint of other people.

Envy: People with NPD tend to believe that others are envious of them due to their special status. They often also envy others, especially if others have more things or are more successful. In cases like that, they may talk down to people and question the way they achieved success or try to make their success look commonplace.

Arrogant and haughty behaviors: Those with NPD may be snobbish, disdainful, and condescending. They tend to talk down to people who they believe are inferior to them.

To say a person has NPD, the person must have at least five of the symptoms of narcissism discussed above. Also, the symptoms must be unchanging, maladaptive, and continuous. They should be causing significant functional impairment or subjective distress to the individual.

Associated Features Of Narcissistic Personality Disorder

Some features point to NPD but are not diagnostic of it. They include the following:

  • Sensitivity to criticism or defeat

People with NPD may have a fragile self-esteem and be sensitive to “injury” from criticism or defeat. When they get defeated, they often react with anger or disdain or try to blame others. This can sometimes lead to social withdrawal.

  • Impaired interpersonal relationships

Because individuals with NPD tend to use those close to them, they are typically insensitive to the emotions of others. As many NPD individuals have a sense of entitlement and constant need for admiration, they tend to have few friends. They may also be likely to have strained relationships with those close to them.

  • Unwillingness to take risks

Individuals with NPD are sometimes unwilling to take a risk because they are worried about failing, and this can shatter their opinion that they are the best. They may also be unable to accept failures, may add to their unwillingness to take a risk.

NPD is associated with mood disorders such as hypomania, depression, and borderline personality disorder. It is also associated with other mental disorders such as anorexia nervosa and substance use disorders.

Narcissistic traits can be common in adolescence. Most people, however, don’t grow up to have NPD. Many people who have the symptoms in adolescence outgrow them and are well adjusted by adulthood. Also, most of the people who develop NPD are male (about 75%).

Differentials Of Narcissistic Personality Disorder

There are some disorders that can look so like NPD that they might be mistaken for each other. This is most likely with other personality disorders, such as histrionic personality disorder, antisocial personality disorder, and borderline personality disorder, which are often characterized by flirting, meanness, and neediness, respectively. These personality disorders can all be differentiated from NPD by the grandiosity seen in people with NPD.

Obsessive-compulsive personality disorder can also be a differential for NPD. People with both disorders may believe in perfection and may not like other people doing their work because other people might not do it well enough for them. People with obsessive-compulsive personality disorder may be more likely to be self-critical when they don’t attain the perfection they want and crave. In contrast, people with NPD tend to feel they have attained such perfection.

Suspiciousness and social withdrawal may also distinguish those with schizotypal or paranoid personality disorder from those with NPD. When people with NPD withdraw from social interaction, it might be because of fear that their imperfections have been discovered.

People who have substance use disorders might also show symptoms similar to those of people with NPD. These symptoms can be more apparent with persistent substance use.

Treatment Of Narcissistic Personality Disorder

NPD and its comorbidities can be treated in two main ways:

  • Psychotherapy
  • Pharmacotherapy


Learn About Narcissistic Personality Disorder

The main treatment type recommended for personality disorders, including NPD, tends to be psychotherapy. It involves an individual (or a group of individuals) with a disorder talking to and carrying out activities under the guidance of a therapist (or a group of therapists).


Thus far, medications have not been proven to be very effective in treating NPD. Medications can, however, be used to treat comorbidities. Comorbidities may include depression and anxiety, and antidepressants and anxiolytics can be used to treat anxiety. Also, mood stabilizers may be used to treat some impulsive behaviors seen in people with NPD.


If you are worried that you or someone you love has NPD, you can get further information and advice on what to do about the disorder from the experienced mental health professionals at BetterHelp. BetterHelp offers online therapy, which has been proven to be effective for several mental health concerns, including anxiety and depression. With online therapy, you can talk to a licensed therapist from your own home, and you gain contact to in-app messaging with your therapist in between sessions. Reach out to today to get started.

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