How to Recognize the Signs of Narcissistic Personality Disorder

According to the National Institute of Mental Health (NIMH), about 9% of adults in the United States experience some type of personality disorder. A personality disorder can have a profound impact on the way people think, behave, feel, and interact with other people. Narcissistic personality disorder (NPD) may impede people’s ability to build healthy, fulfilling relationships with others.

NPD is a complex personality disorder but one that people must understand to cope with. How can NPD negatively impact lives and relationships?

What Is Narcissistic Personality Disorder?

According to a 2022 book by Paroma Mitra and Dimy Fluyau, NPD “is a pattern of grandiosity, need for admiration, and lack of empathy.” Moreover, within NPD, there are two subtypes: grandiose and vulnerable NPD. The symptoms of each include:

  • Grandiose narcissistic personality disorder
    • Overt sense of self-importance
    • Blatant aggression
    • Boldness
    • Lack of empathy
    • Exploitation of others
  • Vulnerable narcissistic personality disorder
    • Hypersensitivity
    • Defensiveness

While vulnerable NPD may be more difficult to detect, both subtypes can make daily life and interactions difficult. As Mitra and Dimy note, NPD can negatively impact interpersonal relationships and lead to extreme emotions like flattery and admiration or inadequacy and low self-worth.

Signs and Symptoms of Narcissistic Personality Disorder

According to Mitra and Dimy, in the United States alone, one to 15% of people have NPD. While the percentage of those who live with NPD may seem small, it still negatively impacts daily life and relationships. Moreover, as noted in a 2017 article from the Behavioral Medicine Journal, NPD is more prevalent among men, as 50% to 75% of those diagnosed with this disorder are male

MedlinePlus lists some of the signs of NPD. These include:

  • Appearing to have an excessive sense of self-importance
  • An extreme preoccupation with themselves
  • A lack of empathy for others

Similarly, MedlinePlus lists the following symptoms of NPD:

  • Reacts to criticism negatively: rage, shame, or humiliation
  • Takes advantage of other people
  • Focused only on achieving personal goals
  • Does not consider the feelings of others
  • Little ability to feel empathy
  • May have excessive feelings of self-importance
  • Is obsessed with own self-interest
  • Will exaggerate achievements and talents
  • Is preoccupied with fantasies of success, power, beauty, intelligence, or idealized notions of love
  • May have unreasonable expectations for favorable treatment
  • Needs constant attention and admiration
  • Will pursue mainly self-interested goals

Co-Occurring Disorders

The Behavioral Medicine Journal article notes that people living with NPD will likely experience a co-occurring disorder. Over 40% of those diagnosed with NPD have substance use disorder (SUD), a little over 28% experience mood disorders, and 40% are diagnosed with an anxiety disorder. Almost 4% of adults in the United States experience a co-occurring disorder, and NPD is not exempt from this number. 

Living with NPD and other co-occurring disorders can impact physical and mental health, as well as social relationships. The core features of NPD play a major role in which comorbidities individuals may experience in their daily life.

Another article, from the Journal of Clinical Psychiatry, notes that the co-occurrence of other mental health disorders with NPD was higher than the prevalence of NPD for people with other mental health disorders. Moreover, while the prevalence of NPD is higher for men, they also have a higher instance of co-occurring disorders like SUD, mood, and anxiety disorders.

These co-occurring disorders can make managing relationships and maintaining work difficult. The patterns of thinking and behavior that characterize NPD encourage a preoccupation with oneself and one’s own interests. These symptoms run contrary to healthy relationships and settings that require consideration for group needs and well-being.

Core Features

As noted in the Behavioral Medicine Journal article, some of the co-occurring features found with NPD and other mental health disorders include:

  • Psychological symptoms
    • Higher frequency of specific emotions such as shame, helplessness, anger directed at the self, higher self-admiration, and impulsivity
    • Likelihood of multiple suicide attempts
    • Increased likelihood of using lethal means to attempt suicide
    • More instances of attempted suicide in the wake of job loss, domestic problems, financial problems, or health-related problems
  • Physical symptoms
    • An increased mortality rate for cardiovascular disease
    • More gastrointestinal conditions
    • Higher utilization of health care services
  • Behavioral symptoms
    • Increased likelihood of a criminal conviction
    • Higher chance to have spent time in prison
    • Potential history of interpersonal violence
    • Causing emotional harm to others
    • More impairment in social functioning

Treating Narcissistic Personality Disorder

While the core features of NPD pose difficulties for treatment, there is hope for recovery with support services. According to the Behavioral Medicine Journal article, the relationship between client and clinician is an important factor in the continuum of care for NPD, as relationships play an important role in thinking and behavior patterns. Building a relationship based on trust with a clinician allows individuals to feel safe and supported on their recovery journey. 

At 12 South Recovery, we believe in the importance of client-centered care because every individual’s mental health needs are unique. We are committed to providing our clients with therapeutic support that considers their individual needs. There is no “one-size-fits-all” way to treat mental health disorders. Through a multitude of therapy modalities, we can support clients’ long-term well-being from NPD and co-occurring diagnoses as our evidence-based practices are designed to treat the whole person.

When mental health disorders like narcissistic personality disorder are left untreated, they can negatively impact your daily life. If you live with NPD, co-occurring disorders like anxiety and substance use disorder may impede your ability to lead a fulfilling life with meaningful relationships. However, with support, you can develop skills to build healthier thinking and behavior patterns about yourself and others. At 12 South Recovery, we believe in client-centered care because everyone’s experiences are different. As mental health professionals, we cannot put mental health recovery in a box. Therefore, with our evidence-based modalities, we focus on building treatment plans that care for the unique needs of each individual. To learn more, call us at (888) 830-8374.

We're here to help.

At Twelve South Recovery, we accept most health insurance.

Get you or your loved one help for addiction or mental health issues today.

CALL 24/7 866-839-6876


Bluecross Blueshield Insurance Icon Cigna Insurance Icon HealthNet Insurance Icon HPHC Insurance Logo Beachstreet Insurance Logo Magellan Health Insurance Logo Multiplan Network Insurance Logo Prime Health Services Insurance Logo Tufts Health Plan Insurance Logo Aetna Insurance Logo Amerihealth Insurance Logo Anthem Insurance Logo Beacon Insurance Logo

National Association of Addiction Treatment Providers

Legitscript Certified Treatment Center California Department of Healthcare Services Logo Accredited By The Joint Comission - Gold Seal Better Business Bureau - Accredited Business