What Is A Narcissistic Personality: Knowing The Signs And Symptoms?

By BetterHelp Editorial Team|Updated April 20, 2022
CheckedMedically Reviewed By Laura Angers, NCC, LPC

The term “Narcissistic personality” has gained a lot of popularity in the media lately. It is so much discussed in the media that a lot of people readily identify with it, but what is the true meaning of a narcissistic personality?

According to the American Psychiatric Association, “the essential feature of Narcissistic Personality Disorder is:

  • A pervasive pattern of grandiosity,
  • Need for admiration, and
  • Lack of empathy

That begins by early adulthood and is present in a variety of contexts”.

People with Narcissistic Personality Disorder (NPD) tend to excessively require other people around them to give them a self-appraisal. They often believe that they are the smartest, most pretty or handsome humans to walk the face of the earth, and they need other people to come to the same conclusion.

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

People with the disorder sometimes find it challenging to understand the feelings and emotional needs of the people around them. As such, they often 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 will readily cut old ties without qualms.

Some of the people with Narcissistic Personality Disorder are low in agreeableness (one of the big five personality traits). They can be very condescending towards other people. They have a sense of entitlement, which might make them believe others are beneath them. They also expect others around them to look at them and admire them for their perceived greatness, often with 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 put forward by the American Psychiatric Association in their Diagnostic and Statistical Manual of Mental Disorders. The criteria are:

Grandiose sense of self-importance: people with Narcissistic Personality Disorder tend to feel more important than they are. Their sense of self-importance is often out of proportion to what they have actually been able to achieve. Accompanying this sense of self-importance usually are boasting and showing off.

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

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

Requiring excessive admiration: People with NPD (Narcissistic Personality Disorder) often 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 can get falsely charming and flattering to get the needed dose of admiration.

Sense of Entitlement: Since they expect other people to notice how special they are, people with NPD may come off as condescending. They 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.

The exploitation of others: People with Narcissistic Personality Disorder 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 are often too engrossed in thinking about themselves. They often can’t relate to how people other people feel. The often genuinely don’t understand the viewpoint of other people.

Often envious of others or believe that others are envious of them: People with NPD often believe that others are envious of them due to their special status. They often also envy others, especially if such others have more things or are more successful. In cases like that, they may talk down such people questioning the means they acquired such or making their success look commonplace.

Arrogant and haughty behaviors: Those with Narcissistic Personality Disorder can be very snobbish, disdainful, and condescending. They often talk down to people that they believe are inferior to them.

To say a person has Narcissistic Personality Disorder, the person must have at least five of the discussed symptoms.

Also, the symptoms must be unchanging, maladaptive, and continuous. It should be causing significant functional impairment and or subjective distress to the individual.

Associated Features of Narcissistic Personality Disorder

Some features point to Narcissistic Personality Disorder but are not diagnostic of it. They are:

  • Sensitivity to Criticism or Defeat

Since people with the disorder have a fragile self-esteem, they are very sensitive to “injury” from criticism or defeat. When they get defeated, they often turn to react with anger, disdain, or blaming others. It can sometimes lead to social withdrawal.

  • Impaired interpersonal relationships

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

  • Unwillingness to take risks

They are sometimes unwilling to take a risk because they are worried about failing, and this will shatter their opinions that they are the best. They are also unable to accept defeat, which may add to their unwillingness to take a risk.

Narcissistic Personality Disorder is associated with mood disorders such as hypomania, depression, bipolar disorder. It is also associated with other mental disorders such as anorexia nervosa and substance use disorders (especially cocaine).

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

Differentials of Narcissistic Personality Disorder

Narcissistic Personality Disorder shares symptoms with some other personality disorders. These disorders can look so similar to Narcissistic Personality Disorder 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 characterized by flirting, meanness, and neediness, respectively. These personality disorders can all be differentiated from Narcissistic Personality Disorder by the grandiosity seen in people with Narcissistic Personality Disorder.

Obsessive-Compulsive Personality Disorder can also be a differential for Narcissistic Personality Disorder. People with both disorders believe in perfection and don’t like other people doing their work because other people might not do well the work they wish to do. People with Obsessive-Compulsive Personality Disorder are likely to be self-critical when they don’t attain the perfection they want and crave. In contrast, people with Narcissistic Personality Disorder feel they have attained such perfection.

Suspiciousness and social withdrawal may also distinguish those with Schizotypal or Paranoid Personality Disorder from those with Narcissistic Personality Disorder. When people with Narcissistic Personality Disorder 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 Narcissistic personality disorder. These symptoms are more apparent with persistent substance use.

Treatment of Narcissistic Personality Disorder

Narcissistic Personality Disorder and its comorbidities can be treated in two main ways:

  • Psychotherapy
  • Pharmacotherapy


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


Medications have not been proven to be very effective in treating Narcissistic Personality Disorder. Medications can, however, be used to treat co-morbidities. Comorbidities are like depression, and antidepressants and anxiolytics can be used to treat anxiety. Mood stabilizers can be used to treat some impulsive behaviors seen in Narcissistic Personality Disorder.

Disclaimer: Please don’t take any medication without first consulting your doctor.

Further Information

Narcissistic Personality Disorder is more complex than has been described in this piece. If you are worried that you or someone you love is Narcissistic, you can get further information and advice on what to do about the disorder from highly competent mental health professionals at BetterHelp.

American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM- 5) American Psychiatric Association, Washington, DC.

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