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At times, a 22-year-old from Los Angeles is convinced he is “the greatest person on planet Earth”. Having received an NPD diagnosis, his periods of extreme self-importance can become “highly unrealistic”, he explains. “You are on cloud nine and you’re like, ‘The world will recognize that I stand above others … I’m destined for greatness for the world’.”

For Spring, these episodes of self-aggrandisement are typically succeeded by a “sudden low”, during which he feels overwhelmed and ashamed about his actions, rendering him particularly vulnerable to criticism from others. He came to wonder he might have NPD after investigating his behaviors online – and subsequently diagnosed by a professional. Yet, he doubts he would have accepted the diagnosis without having independently formed that realization on his own. “If you try to tell somebody that they have the condition, {they’ll probably deny it|denial is a common response|they’re likely to reject it,” he notes – particularly if they feel beliefs of dominance. They inhabit a fantasy reality that they’ve constructed. And that world is like, I am superior and {nobody can question me|no one should doubt me|my authority is absolute.”

Defining Narcissistic Personality Disorder

While people have been labelled as narcissists for over 100 years, definitions vary what people refer to as the label. People frequently term everybody a narcissist,” explains a psychology professor, noting the word is “used more than it should be” – but when it comes to a professional assessment, he suggests many people keep it private, due to significant negative perception around the condition. Someone with NPD will tend to have “a heightened sense of self”, “difficulty understanding others’ feelings”, and “a pattern of manipulating others to seek admiration through behaviors including pursuing power,” the specialist says. Those with NPD may be “highly self-focused”, 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 states.

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

Gender Differences in The Disorder

While three-quarters of people found to have NPD are males, findings indicates this figure does not mean there are less female narcissism, but that female narcissism is more often presented in the vulnerable narcissism type, which is often overlooked. “Men’s narcissism tends to be somewhat tolerated, similar to everything in society,” explains a 23-year-old who discusses her dual diagnosis on online channels. It is not uncommon, the two disorders are comorbid.

Individual Challenges

I find it difficult with dealing with feedback and not being accepted,” she says, since when I’m told that I am at fault, I either go into self-protection or I withdraw entirely.” Despite having this behavior – which is sometimes referred to as “narcissistic injury”, she has been working to manage it and take advice from her close relationships, as she aims to avoid falling into the negative conduct of her earlier years. “I was very emotionally abusive to my partners as a teenager,” she states. With professional help, she has been able to mitigate her NPD symptoms, and she notes she and her partner “maintain an agreement where I told him, ‘If I say something messed up, if I say something manipulative, address it {right then and there|immediately|in the moment’.”

Her upbringing mainly in the care of her father and says she lacked supportive figures during development. I’ve had to teach myself continuously which behaviors are acceptable versus unacceptable to say during a fight because I never had that growing up,” she shares. Every insult was fair game when my household were insulting me during my childhood.”

Root Causes of The Condition

Conditions like NPD tend to be linked to early life adversity. “There is a genetic component,” says a mental health specialist. But, when someone develops narcissistic traits, it is often “connected with that specific childhood circumstances”. Those traits were “a coping mechanism in some ways to manage during childhood”, he continues, when they may have been overlooked, or only shown love that was dependent on meeting certain expectations. They then “persist in applying those same mechanisms as adults”.

In common with many of the individuals with NPD, a person from Leeds thinks his parents “could also have the disorder. The 38-year-old explains when he was a child, “the focus was always on them and their work and their social life. So it was like, stay out of our way.” When their focus was on him, it came in the form of “significant demands to achieve good grades and career success, he notes, which made him feel that if he didn’t achieve their goals, he wasn’t “worthy.

When he became an adult, none of his relationships were successful. “I’ve never cared about anyone really,” he states. Therefore, I never treated relationships seriously.” He believed he wasn’t experiencing genuine affection, until he met his current partner of three years, who is also dealing with a personality disorder, so, like him, struggles with mood stability. She is “very supportive of the stuff that goes on in my head”, he explains – it was actually she who first suspected he might have NPD.

Pursuing Treatment

Following an appointment to his general practitioner, he was directed to a therapist for an assessment and was given the NPD label. He has been recommended for psychological counseling on the public health system (extended treatment is the only treatment that has been proven effective NPD patients, clinicians explain), but has been on the patient queue for an extended period: The estimate was it is probably going to be early next year.”

Disclosure was limited to a small circle about his mental health status, because “prejudice is common that the disorder equates to toxicity”, but, in his own mind, he has accepted it. This understanding allows me to gain insight into my behavior, which is always a good thing,” he comments. Each individual have accepted their narcissism and are seeking help for it – hence being willing to talk about it – which is possibly not the norm of all people with the diagnosis. But the presence of individuals sharing their stories and the rise of digital groups suggest that {more narcissists|a growing number