Understanding Narcissistic Personality Disorder

Let’s talk about Narcissistic Personality Disorder (abbreviated NPD). Unlike Borderline Personality Disorder, it is often easier to recognize NPD in others due to the more “obvious” pattern of symptoms. Like other personality disorders, people with NPD cannot control their symptoms. While you will likely be put off mb their behavior, remind yourself that it is beyond their control.

Clarification: People you might label as “conceited” or “full of themselves” do not necessarily have NPD.


Behind The Name

Narcissistic Personality Disorder gets the name from the Greek myth of Narcissus. Narcissus was a beautiful man who believed no one was worthy of his love, refusing the advances of others. He refused the advances of a nymph named Echo, causing the god Nemesis to seek revenge on Narcissus for his selfish and inconsiderate behavior. Nemesis lured him to a pool of water where Narcissus saw his own reflection and instantly fell in love with himself. Narcissus stayed by the pool for days, trapped in his infatuation. Eventually, Narcissus committed suicide when he realized his reflection could never return his love.
Why is this story important? This story basically summarizes the criteria for Narcissistic Personality Disorder.

Diagnostic Criteria

In order to be diagnosed with any personality disorder, you must meet criteria for both a general personality disorder, as well as the criteria for the specific personality disorder.

General Personality Disorder Criteria

Unlike other mental health disorders, personality disorders all have the same core criteria. There are 5 core criteria that must be met, as well as criteria for the specific personality disorder. The 5 core criteria are:

  • Significant impairments, problems with self-identity or self-direction, as well as interpersonal functioning (think intimacy or ability to empathize)
  • One or more pathological (“bad”) personality trait (detachment from others, disinhibition, antagonism, psychoticism, or negative affectivity)
  • The same impairments are relatively stable across situations and time
  • The impairments are not better explained by the normal developmental stage or the culture of the person
  • The impairments are not due specifically to drugs or another medical condition (such as trauma to the head)

Narcissistic Personality Disorder Criteria

To be diagnosed with Narcissistic Personality Disorder, you must have a continuous pattern of real or fantasized grandiosity (exaggerated belief of self-importance), a need for admiration, and a lack of empathy. This must also begin by early adulthood and must be present in across situations (church, home, work, etc.).
In addition, you must have 5 of the following:
1. Inflated sense of self-importance

  • Exaggerates achievements or talents, or expects superior recognition without necessary work or achievements

2. Preoccupation with fantasies of unlimited success, power, intellect, beauty, or ideal love
3. Belief that they are special or unique and can only be associated with, or understood by, high-status people
4. Requires excessive admiration
5. Has a sense of entitlement
6. Exploits others to meet their own needs or goals
7. Lacks empathy

  • Either does not recognize or acknowledge others’ feelings

8. Is often jealous of others and believes others are jealous of them
9. Shows arrogance, elitist behaviors and attitudes

Common Struggles

People with NPD often have fragile self-esteem, easily injured by criticisms and critiques. People with NPD will often change their opinion of others if they do not meet their desires of continuous praise. This may take the form of direct conflict with the person or degrading the person later.
Relationships are often one-sided due to a lack of empathy. People with NPD often make inappropriate and hurtful statements to others, such as boasting about a new relationship in front of their former lover or brag about exceptional health in front of a chronically ill person.


There is no definitive cause for Narcissistic Personality Disorder.  The primary theory of cause is the relationship a child has with their parents: excessive praise (“putting them on a pedestal”) and excessive criticism of the child have both been linked to NPD.


Medications are rarely effective in treating personality disorders.
I have previously mentioned Dialectical Behavioral Therapy, or DBT, as a treatment model for Borderline Personality Disorder. This model of therapy has been adapted for NPD.
In addition, individual and family therapy can be beneficial to both the individual and those close to them.
Finally, it is incredibly important for the supports of a person with NPD to educate themselves about Narcissistic Personality Disorder.


  • Narcissistic Personality Disorder is significantly more common in men than women. 50-75% of people diagnosed with NPD are male.
  • People with Narcissistic Personality Disorder often struggle with aging and increased limitations to completing tasks.
  • 0-6.2% of the U.S. adult population has NPD, according to random samples throughout the country.
  • People with Narcissistic Personality Disorder often have more than one mental health diagnosis.
    • Most common are substance abuse disorders, mood disorders, PTSD, and other personality disorders.
  • Narcissistic Personality Disorder is often not diagnosed until adulthood due to the normal presence of several of these traits during adolescence.

Understanding Narcissistic Personality Disorder

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2 thoughts on “Understanding Narcissistic Personality Disorder

  1. Lots of great information here on NPD! It is very difficult to handle people with these types of personalities. I have a family member with Dependent Personality Disorder, who refuses to take therapy so it’s been extremely hard. I don’t know if you know of this website, called Out of the Fog, it’s an informative site for family members and friends.
    Thanks for sharing,

    1. Lillian, you’re so right! Personality disorders are very difficult to handle because they’re so different from other mental health disorders and have such different treatment types. I’ve run across Out of the Fog before and it seems very helpful! I’ll definitely look more into it! Thanks for the recommendation!

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