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At times, a 22-year-old from Los Angeles feels he is “the most exceptional individual alive”. As a diagnosed narcissist, his grandiose moments frequently escalate into “highly unrealistic”, he explains. “You are on cloud nine and you’re like, ‘Everyone’s going to know that I’m better than them … I’m destined for greatness for the world’.”

In his case, these episodes of self-aggrandisement are often succeeded by a “emotional downturn”, during which he feels overwhelmed and self-conscious about his actions, making him particularly vulnerable to criticism from those around him. He came to wonder he might have narcissistic personality disorder (NPD) after looking up his traits through digital sources – and was later evaluated by a clinician. However, he doubts he would have agreed with the assessment if he hadn’t previously arrived at that understanding by himself. Should you attempt to inform somebody that they have this disorder, {they’ll probably deny it|denial is a common response|they’re likely to reject it,” he says – especially if they feel beliefs of dominance. They inhabit a fantasy reality that they’ve constructed. And that world is like, I’m the greatest and {nobody can question me|no one should doubt me|my authority is absolute.”

Defining Narcissistic Personality Disorder

Although people have been labelled as narcissists for more than a century, it’s not always clear what is meant by the diagnosis. It’s common to label everybody a narcissist,” says a psychology professor, noting the word is “used more than it should be” – but when it comes to a professional assessment, he believes many people hide it, due to widespread prejudice associated with the disorder. A narcissist will tend to have “a heightened sense of self”, “a lack of empathy”, and “a tendency to exploit relationships to bolster one’s self-esteem through actions such as seeking admiration,” the professor clarifies. Those with NPD may be “extremely narcissistic”, to the point that {“they’re not able to hold down stable relationships|“their jobs are damaged|“they have a distorted view of reality,” he emphasizes.

I’ve never cared about anyone really, so I’ve never taken relationships seriously

Gender Differences in NPD Presentation

While three-quarters of people identified as having NPD are males, research suggests this number does not mean there are a lower rate among women, but that narcissism in women is typically appears in the less obvious variety, which is often overlooked. “Men’s narcissism tends to be more socially permissible, as with everything in society,” notes an individual who shares content on her dual diagnosis on online channels. It is not uncommon, the two disorders co-occur.

Individual Challenges

It’s hard for me with receiving negative comments and rejection,” she explains, “because if I hear that the issue lies with me, I often enter defence mode or I withdraw entirely.” Despite having this behavior – which is sometimes referred to as “self-esteem damage”, she has been working to manage it and take advice from her close relationships, as she doesn’t want to slip into the negative conduct of her earlier years. I used to be manipulative to my partners as a teenager,” she states. Via therapeutic interventions, she has been able to mitigate her NPD symptoms, and she says she and her current boyfriend “have a dynamic where I told him, ‘Should I make a harmful comment, if my words are controlling, point it out {right then and there|immediately|in the moment’.”

Her childhood mainly in the care of her father and notes she didn’t have supportive figures during development. “I’ve been learning continuously what is suitable or harmful to say when arguing because I lacked that guidance as a kid,” she comments. “Nothing was off-limits when my household were insulting me when I was growing up.”

Root Causes of NPD

Conditions like NPD tend to be connected with difficulties as a child. “There is a genetic component,” notes a consultant psychiatrist. But, when someone develops narcissistic traits, it is often “connected with that specific childhood circumstances”. Those traits were “their strategy in some ways to manage during childhood”, he continues, when they may have been ignored, or only shown love that was based on meeting certain expectations. They then “continue to use those familiar tactics as adults”.

Like several of the NPD-diagnosed people, one individual thinks his parents “could also have the disorder. The individual says when he was a child, “everything was all about them and their work and their social life. So it was like, keep your distance.” When their attention turned to him, it came in the form of “a great amount of pressure” to achieve academic success and professional advancement, he says, which made him feel that if he didn’t meet their standards, he wasn’t “good enough”.

In adulthood, none of his relationships ever worked out. I didn’t truly value about anyone really,” he admits. “So I’ve never taken relationships seriously.” He didn’t think experiencing genuine affection, until he met his present significant other of three years, who is diagnosed with BPD, so, similar to his experience, has difficulty with emotional regulation. She is “highly empathetic of the internal struggles in my head”, he says – it was surprisingly, she who first suspected he might have NPD.

Pursuing Treatment

After a visit to his GP, an assessment was arranged to a clinical psychologist for an assessment and was given the NPD label. He has been put forward for psychological counseling through national services (extended treatment is the primary approach that has been demonstrated to benefit NPD patients, specialists note), but has been on the waiting list for an extended period: It was indicated it is expected around maybe February or March next year.”

John has only told a handful of people about his mental health status, because “there’s a big stigma that every person with NPD is harmful”, but, in his own mind, he has come to terms with it. “It helps me to understand myself better, which is positive,” he explains. Those interviewed have come to terms with NPD and are looking for support for it – leading them to be open to talk about it – which is probably not representative of all people with the disorder. But the existence of individuals sharing their stories and the expansion of digital groups indicate that {more narcissists|a growing number