Narcissistic Personality Disorder – A Guide

What is Narcissistic personality disorder? How is NPD diagnosed? What are the nine characteristics of a narcissist? Can narcissistic personality disorder be treated or cured? If you are looking for answers to these and more questions related to NPD, this article is for you.

My name is Sean Galla, and I have been an online support group facilitator for over 10 years. In my years of work, I have overseen numerous support groups, including facilitating narcissist support groups for male survivors of narcissistic abuse. Part of the work we do in our support group is to offer information to help members better understand narcissism.

In this article, I will cover everything you need to know about narcissistic personality disorder.

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Sean Galla

An experienced facilitator, community builder and Peer Support Specialist, Sean has been running men's groups for 10+ years. Read Sean's Full Author Bio.

What is Narcissistic personality disorder?

In today’s world, words related to mental health issues are often thrown around as a form of expression. For instance, people will often use the word depression as a way of expressing sadness or stress even though they are not depressed.

Narcissism is another word commonly tossed around when describing a person who seems vain or full of themselves, or someone people assume is narcissistic based on their behavior. However, narcissism is much more than what people think.

Narcissistic personality disorder, NPD, is a diagnosable mental health condition that affects a person’s idea of self. An individual living with this borderline personality disorder often exhibits an unreasonable high self of self-worth of their own importance. They are always hungry for admiration and attention.

People with narcissistic personality disorder are in love with the idea of a grandiose personality and high self-esteem. They are often in love with this inflated sense of self-worth mostly because it allows them to ignore the deep-rooted feelings of insecurity and low self-esteem most narcissistic people struggle with.

It can also be termed as a never-ending pattern of behavior characterized by a lack of empathy and self-centeredness. It is one of five personality disorders listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) – the fifth edition manual used to diagnose this and other mental health conditions.

Other people will often use words like cocky, selfish, manipulative, demanding and patronizing to describe narcissistic traits.  

Living with NPD can significantly impair one’s personality, and the condition is often accompanied by other personality traits. Apart from negatively impacting the life of the person living with NPD, this condition also wreaks havoc in the lives of others around the narcissist.

Is my wife a narcissist? Find out in this article.

How common is NPD?

According to psychiatry and health care providers research, up to 5% of the U.S. population lives with NPD, with more than 50% of the prevalence affecting men.


Types of narcissism

Narcissism or symptoms of npd often manifests in different subtypes. The type of narcissism one is diagnosed with is often determined by their behavior.

Overt or grandiose narcissism

This type of narcissist is often extroverted, selfish, uncooperative and mostly overbearing. This is an exaggerated self-image they use to feel assertive and confident. An overt narc is highly likely to overestimate their emotional intelligence and imagines they are smarter than everyone else. They often result to gaslighting to get their way or gain control.

Vulnerable or covert narcissism

Not all narcissists are dominant or overwhelming socially. Some are introverts. Covert narcissists are often shy, suffer from low self-esteem and are often sensitive to criticism. They are also commonly diagnosed with antisocial personality disorder. However, they are also highly passive-aggressive and exhibit a lot of defensiveness.

Malignant narcissist

This is one of the more destructive forms of narcissism. A malignant narcissist is paranoid, aggressive, and sadistic, which makes them highly dangerous to the well-being of people around them. They are commonly anti-social and will often disregard the safety or rights of others to favor own ends.

Antagonistic narcissist

This type of narc is highly competitive even in social interactions. They will show signs of zero-sum thinking and believe that in every situation there has to be a winner and a loser. This makes them hostile and aggressive and will disparage others. They are often slow or incapable of forgiving and expect special treatment.

Communal narcissist

This is also referred to as pathological narcissism where the individual claims to care a lot about the feelings of others and will refer to themselves as altruistic. To others, they can come off as selfless or helpful even though their sense of helpfulness is driven by their need to control situations. They use this persona to get social power and a sense of entitlement and superiority.

Signs and symptoms of Narcissistic personality disorder

According to the DSM-5 manual and the American Psychiatric Association, diagnosis of NPD is done by observing five or more of nine characteristics in an individual. Often, these characteristics start to manifest in early childhood or early adulthood.

Grandiose sense of self-importance

This includes

  • Overestimating personal capabilities and holding oneself to an unreasonably high standard.
  • Exaggerating and excessive bragging about their achievements.

Fantasizing about deserving

  • Power
  • Success
  • Beauty
  • Intelligence
  • Self-fulfillment
  • Love

Unreasonable belief in superiority

  • They think they are unique or special
  • Only want to associate with the people they deem as worthy of their superiority

Unquenchable need for admiration

  • Fragile ego and self-esteem
  • Constant emptiness, self0criticism and self-doubt
  • Obsession over what others think of them
  • The constant hunger for admiration and compliments

Sense of entitlement

  • Expecting an unreasonable degree of favourable treatment
  • Anger outbursts when people fail to appease them
  • Inflated sense of self-worth

Highly exploitative

  • They will consciously or unconsciously use other people for personal gain
  • Only interested in friendships with people who admire them and commend them for their status or self-esteem
  • Will deliberately take advantage of others for selfish gains

They lack empathy

  • They have no regard for other people’s feelings
  • Will often purposely say things to injure another’s self-esteem
  • Seeing other people’s needs or desires as signs of weakness
  • Never return the kindness shown to them by others.

They are envious

  • Envious of others’ achievements or success.
  • Expecting others to be envious of them as this to them is a sign of dominance.
  • Diminishing or belittling other’s achievements.
  • They are highly competitive in every situation.

They are highly arrogant

  • They exhibit patronizing behavior.
  • They are disdainful and snobby.
  • They often talk down on others and use condescending behavior to intimidate.

Apart from these nine diagnostic criteria, people with NPD can also exhibit other addiction signs. These include:

  • Fear and avoidance of vulnerability.
  • Withdrawing from people to hide their vulnerability.
  • Hypersensitivity to rejection, criticism, or failure.
  • Perfectionism (with or without a fear of failure).
  • They experience severe depression whenever they are rejected or fail.
  • Rage and anger outbursts when they are criticized or rejected.
  • Substance use disorder.
  • Fake humility to hide their true feelings.
  • Avoiding situations where failure is possible or likely, therefore limiting achievements.

Is my girlfriend a narcissist? Find here are the telltale signs to look out for.


The causes of Narcissistic personality disorder

Like most other mental health conditions, mental health experts are still unsure of the actual cause of NPD. Science shows a subtle difference in the brain structure of a healthy brain and the brain of an individual with NPD.

Some of the attributing factors for NPD include:

Genetics – According to research, NPD is more common in families with a history of the condition.

Imitation and observation – children are highly capable of imitation, observing and learning behavior that can cause the development of NPD.

Negative childhood – rejection, trauma and lack of support in a person’s childhood can lead to the development of NPD.

Parenting styles – overprotective or helicopter parenting coupled with excessive praise or excessive admiration from family members often raises children who grow to demand or expect the same treatment as adults. Overindulging children can also stop children from learning emotional regulation, causing them to react negatively whenever something goes against their wishes.

Culture – the culture an individual grows up in is a risk factor for NPD. The risk of developing this mental health condition is higher in cultures where personal independence and individualism are encouraged. On the other hand, people will grow up in cultures that support a sense of collective action or community are less likely to develop the condition.

Narcissistic personality disorder – treatment and management

The treatment of NPD often encompasses the use of mental health therapy (psychotherapy). Common types of therapies used for different types of narcissism include:

  • Dialectical behavioral therapy (DBT).
  • Cognitive behavioral therapy (CBT).
  • Metacognitive therapy.
  • Group therapy.
  • Couples or family therapy.

A mental health professional is best placed to determine the best therapy option for a person’s needs.

Medication for NPD – there are not any specific medications to treat NPD. However, mental health professionals may prescribe medication to treat some of the health problems related to the condition. This includes medication to treat anxiety disorders, bipolar disorder, and depression, which are often exhibited in individuals with NPD.

Antidepressants, antianxiety medications (anxiolytics), antipsychotic medications, and anticonvulsant medications are also commonly prescribed to people with NPD.

Can a narcissist change?

It is possible to recover from NPD. However, it requires the effort and willingness of the narc to seek cognitive behavioral therapy for change to take place. People living with NPD generally do not seek help since most of them do not believe that they have the condition.

About MensGroup

As a man who has been a victim of narcissistic behavior, one of the toughest parts of recovery is finding someone to talk to about your feelings, emotions, and trauma. Most people do not believe that men, too, can be victims of toxic relationships. Whether you have narcissistic parents, a narcissistic loved one, or children with narcissism, MensGroup is an all-men online platform where you can get the support you need.

Mensgroup believes that anyone can heal, grow, and change with the right support. You will be placed in a group with other men who have been through narcissistic abuse and understand your situation. This gives you a free space to share and learn from others who have previously walked in your shoes. With a support system of fellow men, you can overcome your trauma and lead a healthy, successful, and happy life.


When someone in your life lives with Narcissistic Personality Disorder, taking time to learn and understand NPD can go a long way in making it easier for you to determine how best to protect yourself and deal with the narc.

It is often said that a problem shared is a problem solved. Joining a narcissist support group is the first step you can take towards healing. offers you a platform where you can share your story to inspire others and get support to overcome the trauma of being a survivor of narcissistic behavior.