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At times, a 22-year-old from Los Angeles believes he is “the greatest person on planet Earth”. Living with narcissistic personality disorder, his grandiose moments often turn “detached from reality”, he admits. You’re riding high and you tell yourself, ‘People will see that I surpass everyone else … I’m destined for greatness for the world’.”

In his case, these phases of exaggerated self-worth are typically coming after a “emotional downturn”, during which he feels deeply emotional and embarrassed about his behavior, rendering him especially susceptible to disapproval from external sources. He came to wonder he might have this personality condition after investigating his behaviors on the internet – and eventually confirmed by a specialist. Yet, he doubts he would have taken the label if he hadn’t already reached that conclusion by himself. “If you try to tell somebody that they have this disorder, {they’ll probably deny it|denial is a common response|they’re likely to reject it,” he says – most notably if they harbor feelings of superiority. “They’re in a delusional world that they made for themselves. And that world is like, I am superior and {nobody can question me|no one should doubt me|my authority is absolute.”

Clarifying NPD

While people have been identified with narcissism for decades, the meaning can be ambiguous what people refer to as the label. “Everyone calls everybody a narcissist,” says a psychology professor, who believes the word is “used more than it should be” – but when it comes to a formal diagnosis, he believes many people keep it private, because of widespread prejudice linked to the condition. An individual diagnosed will tend to have “an exaggerated self-image”, “difficulty understanding others’ feelings”, and “a tendency to exploit relationships to bolster one’s self-esteem through actions such as pursuing power,” the specialist explains. 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 adds.

I never truly valued about anyone really, so I didn’t invest in relationships seriously

Variations by Gender in NPD Presentation

Although three-quarters of people identified as having the condition are males, studies suggests this statistic does not mean there are less female narcissism, but that narcissism in women is more often presented in the vulnerable narcissism type, which is less commonly diagnosed. Narcissistic traits in men tends to be more socially permissible, as with everything in society,” notes a young adult who posts about her NPD and borderline personality disorder (BPD) on digital platforms. It is not uncommon, the two disorders co-occur.

Individual Challenges

“I really struggle with dealing with feedback and rejection,” she says, whenever it’s suggested that the problem is me, I either go into defence mode or I withdraw entirely.” Even with this reaction – which is often called “narcissistic injury”, she has been working to manage it and accept input from her support system, as she doesn’t want to slip into the harmful behaviour of her earlier years. I used to be manipulative to my partners in my youth,” she admits. Through dialectical behavioural therapy, she has been able to manage her condition better, and she notes she and her current boyfriend “have a dynamic where I’ve instructed him, ‘Should I make a harmful comment, when I use toxic language, address it {right then and there|immediately|in the moment’.”

She grew up mostly in the care of her father and explains there was an absence of positive role models during development. I’ve had to teach myself over the years which behaviors are and is not appropriate to say in conflicts because it wasn’t modeled for me growing up,” she says. Every insult was fair game when my family members were belittling me in my early years.”

Underlying Factors of NPD

Personality disorders tend to be associated with childhood challenges. Genetics play a role,” says a consultant psychiatrist. But, when someone shows signs of narcissism, it is often “linked to that specific childhood circumstances”. Those traits were “a survival tactic in some ways to cope in formative years”, he adds, when they may have been neglected, or only shown love that was dependent on meeting specific standards. They then “rely on those familiar tactics as adults”.

Similar to other of the individuals with NPD, one individual thinks his parents “could also have the disorder. The adult explains when he was a child, “their needs came first and their work and their social life. So it was like, don’t bother us.” When their attention turned to him, it came in the form of “significant demands to achieve good grades and professional advancement, he recalls, which made him feel that if he didn’t meet their standards, he wasn’t “good enough”.

In adulthood, none of his relationships lasted. I didn’t truly value about anyone really,” he admits. As a result, relationships weren’t relationships seriously.” He felt incapable of experiencing genuine affection, until he met his long-term relationship of three years, who is also dealing with a personality disorder, so, in a comparable situation, finds it hard to manage mood stability. She is “really understanding of the thoughts that occur in my head”, he notes – it was in fact, her who first suspected he might have NPD.

Pursuing Treatment

Following an appointment to his doctor, he was directed to a clinical psychologist for an assessment and was informed of his condition. He has been put forward for talking therapy via government-funded care (a long period of therapy is the primary approach that has been shown to help NPD patients, specialists note), but has been on the patient queue for a year and a half: “They said it is likely to occur maybe February or March next year.”

Disclosure was limited to a handful of people about his mental health status, because “prejudice is common that every person with NPD is harmful”, but, in his own mind, he has come to terms with it. The awareness assists me to gain insight into my behavior, which is positive,” he comments. All of the people have come to terms with NPD and are pursuing treatment for it – which is why they agree to talk about it – which is possibly not the norm of all people with the condition. But the existence of NPD content creators and the expansion of digital groups indicate that {more narcissists|a growing number