How Do I Know If Someone Has Narcissistic Personality Disorder?

Medically reviewed by Dr. April Brewer, DBH, LPC
Updated March 19, 2024by BetterHelp Editorial Team

The term narcissist is frequently misapplied and misinterpreted in casual conversation. By clinical definition, a narcissist is a person who has been diagnosed with narcissistic personality disorder, a mental health disorder characterized by symptoms of narcissism.

Narcissistic personality disorder is a clinical condition diagnosed by a mental health provider, while the term narcissist has become frequently used as a catch-all to describe individuals who exhibit extreme confidence and self-centered behavior or dismiss the needs of others. However, true pathological narcissism tends to involve a range of certain personality traits, such as low self-esteem, manipulative behavior, and lack of empathy, which often emerge in early adulthood and may require interventions like talk therapy or family therapy.
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Is a narcissistic person impacting your well-being?

The broad, often inconsistent definition of narcissism in popular culture can make it challenging to accurately identify narcissistic behaviors and warning signs. While narcissistic personality disorder (NPD) can only be accurately diagnosed by a mental health professional, understanding narcissistic traits as they appear in day-to-day life may help the average person better understand how those traits impact them.

Narcissistic personality disorder

In the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), narcissistic personality disorder (NPD) belongs to Cluster B personality disorders, which tend to be characterized by dramatic, impulsive, self-destructive, or emotional behaviors. 

To be diagnosed with NPD, a person must display five out of the following nine:

  • A grandiose sense of self-importance and self worth
  • Heightened perception of physical appearance
  • Belief they deserve privileges above others
  • Preoccupation with fantasies of success, power, beauty, or brilliance
  • A belief that they are unique and can only be understood by similarly unique individuals or institutions
  • Excessive need for admiration
  • Carries a sense of entitlement or unreasonable expectations of favorable treatment
  • Exploits others and takes advantage of others to their own ends
  • Lacks empathy and concern for the needs of others
  • Is often envious or thinks others are envious of them
  • Displays arrogant, self-aggrandizing behaviors

Researchers believe there is an overarching theme within NPD’s diagnostic criteria: self-esteem. Narcissism is frequently framed as characterized by a person’s inability to develop a positive self-image in a healthy way. Without a strong sense of self-esteem, a person may feel forced to rely on pathological narcissistic traits to feel positively about themselves.

It can be difficult to make sure NPD is the right diagnosis instead of other personality disorders. A person with narcissistic tendencies may or may not meet the diagnostic criteria for NPD, but their actions may affect others in the same way as those of someone with the diagnosis. Individuals should seek treatment from a clinical psychologist to receive a formal diagnosis and the right treatment to treat NPD and other mental health conditions.

Types of narcissism

Narcissism is often divided into two distinct subtypes: grandiose and vulnerable. A person with grandiose narcissistic tendencies tends to be outgoing, charming, and generally free from self-doubt and anxiety. A person in this category tends to have a very high opinion of themselves, considers themselves above their peers, and expects special treatment.

A person with vulnerable narcissistic tendencies may be self-absorbed, need constant reassurance, and be anxious about how they are perceived. They are rarely outgoing and may shy away from attention. While those with vulnerable narcissistic traits believe themselves superior to others, their fear of even the slightest criticism may lead them to keep that belief to themselves.

A person with narcissistic tendencies in either subtype can be deceitful and manipulative or disregard the needs of others to achieve their goals.

Where does narcissism come from?

The term narcissism stems from a mythological figure named Narcissus, who fell in love with his own reflection in the water and died staring at himself. The cause of narcissism is not fully understood, but some prominent theories point to childhood factors. Narcissism tends to be viewed as a core defect in developing a healthy self-image. This could stem from parents who praise their child with either too much adoration or too much criticism, or from unempathetic parents. Unempathetic parenting, which may be addressed through parenting classes, is commonly associated with the development of narcissistic tendencies, as unempathetic parents tend to provide few opportunities for a child to gain approval or understand other people’s perspectives.

On the other hand, empathetic parents tend to provide opportunities for a child to receive attention healthily and cater to their own needs. Compassionate parents may also model behaviors that encourage high self-esteem, such as resiliency when making mistakes, and help children develop a strong sense of self. They may teach children to face their own emotions head-on and not resort to the shame narcissists may experience.

Recognizing narcissistic tendencies and narcissistic traits

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Therapists often point to core features of narcissism to help people identify narcissistic tendencies in others.

Chronic entitlement

Those with narcissistic tendencies tend to believe they are superior to others, even when presented with evidence to the contrary, which can create a powerful sense of entitlement. This entitlement encourages the belief that the person should receive more money, credit, or respect for doing the same work as others. They may also demand special treatment or extra resources.

Lack of empathy

A person with narcissistic tendencies may be likely to disregard the feelings and needs of others. Generally, those with narcissistic tendencies tend to be worse at recognizing the emotions of others and responding appropriately. They may struggle to understand why someone is upset by their actions or why a person reacts negatively to having their boundaries violated.

Grandiosity

Grandiosity refers to a belief that a person is inherently superior to others. Grandiosity may be most visible in the egomaniacal behaviors often associated with grandiose narcissism, but grandiosity tends to be present in both subtypes. Those with grandiose narcissistic tendencies tend to put their inflated sense of themselves and expect others to align with their beliefs. Those with vulnerable narcissistic tendencies often still believe they are superior but may hide their grandiosity to avoid criticism.

Chronic validation-seeking

A person with narcissistic tendencies typically demands attention and validation from others. They may struggle to feel safe and require constant positive social feedback to maintain their self-image. A person with narcissistic tendencies may be likely to avoid or respond negatively to criticism and anything that does not validate their feelings of superiority.

When do narcissistic tendencies become narcissism?

Most people display some form of narcissistic behavior at some point in their lives. Nearly everyone has moments of arrogance, overconfidence, or insensitivity to others. The behaviors can become concerning when they are frequent or severe enough to impact the life of the person displaying them or the lives of those around them.

What do I do if I think I'm a narcissist

If you've identified traits in yourself that appear to coincide with narcissistic tendencies, it may be helpful to continue exploring these tendencies. Individuals who meet the criteria for narcissistic personality disorder may not be able to recognize their own narcissistic tendencies without a great deal of effort. 

You might consider seeking the help of a therapist to organize your thoughts and set realistic goals. It’s important for people with narcissistic personality disorder (people with NPD) to maintain self-esteem at a healthy level and develop healthy boundaries to manage their condition.

You might consider taking some time to write out the narcissistic tendencies that concern you. Do you worry you lack empathy? Are you constantly seeking attention or validation? Do you feel like you never get what you deserve? Taking some time to understand the source of your concerns may be beneficial when working with a professional.

What do I do if I think someone else is a narcissist? Recognizing symptoms of narcissism

If you think that someone else may have narcissistic personality disorder, it may help to assess the impact of their narcissistic tendencies, but with caution, given that only a professional can make a diagnosis. Regardless, you might look for certain signs in a person’s relationships. For example, a person in a committed relationship with a narcissist may experience significant emotional turmoil in their relationship.

If you’re in a relationship with someone who may have narcissistic personality disorder (NPD) or shows signs they will develop NPD or related conditions, it may help to consider ways to boost your self-esteem to combat some of the emotionally draining effects of being around someone with NPD.  You may also find it beneficial to set clear boundaries, as those with narcissistic tendencies often fail to recognize them. 

If a person's narcissistic tendencies are limited in severity, you may be able to form a positive working or social relationship with them. The key may be to recognize how you feel around the person. If a person regularly drains your energy or makes you feel inferior, it may help to limit contact with that person as much as possible.

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Is a narcissistic person impacting your well-being?

How can therapy help?

If you're worried that someone in your life may have narcissistic tendencies, you may benefit from speaking with a licensed counselor. If you don’t feel comfortable with in-office therapy at this time, you might consider online therapy, which research has shown to be just as effective as in-person therapy.  

If someone displaying narcissistic tendencies is affecting your well-being, online therapy may help you set boundaries, build your self-confidence, or develop resiliency using empirically supported techniques. With online therapy, you can choose how you’d like to communicate with a therapist, whether by audio, video, or live chat. You can also message your therapist at any time through in-app messaging, and they’ll respond as soon as they can. 

Takeaway

Narcissism is a complex and nuanced topic that is often poorly defined in day-to-day conversations. Narcissistic personality disorder is a clinical psychopathology characterized by grandiosity, a need for validation, a lack of empathy, and sensitivity to criticism. While very few people meet the criteria for NPD, some people may display some form of narcissistic behavior or have narcissistic tendencies that can affect those around them.
In some cases, the assistance of a licensed online therapist could be beneficial during this process. It’s essential for mental health professionals to assess the individual's history, including any risk factors or inherited characteristics for mental health conditions, to understand signs someone is developing NPD. With BetterHelp, you can be matched with a therapist who has experience helping people recover from a traumatic event. Take the first step toward healing and reach out to BetterHelp today.

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