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At times, a 22-year-old from Los Angeles feels he is “unmatched in his abilities”. Having received an NPD diagnosis, his periods of extreme self-importance frequently escalate into “highly unrealistic”, he explains. “You are on cloud nine and you tell yourself, ‘The world will recognize that I stand above others … I’m destined for greatness for the world’.”

Regarding his experience, these episodes of self-aggrandisement are usually followed by a “sudden low”, during which he feels overwhelmed and ashamed about his conduct, rendering him particularly vulnerable to negative feedback from others. He first suspected he might have NPD after investigating his behaviors through digital sources – and was later confirmed by a specialist. Yet, he is skeptical he would have accepted the diagnosis without having independently formed that realization 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 – especially if they experience a sense of being better. “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

Although people have been identified with narcissism for over 100 years, the meaning can be ambiguous what is meant by the term. People frequently term everybody a narcissist,” explains an expert in narcissism, who believes the word is “overused” – but when it comes to a formal diagnosis, he believes many people conceal it, because of widespread prejudice associated with the condition. A narcissist will tend to have “an inflated view of oneself”, “a lack of empathy”, and “a strategy of using people to enhance their social status through actions such as displaying material goods,” the expert 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’ve never cared about anyone really, so relationships weren’t a priority relationships seriously

Sex-Based Distinctions in The Disorder

Although a significant majority of people diagnosed with NPD are men, research suggests this number does not mean there are less female narcissism, but that narcissism in women is more often presented in the less obvious variety, which is under-identified. Narcissistic traits in men tends to be more socially permissible, just kind of like everything in society,” explains an individual who discusses her dual diagnosis on social media. It is not uncommon, the two disorders co-occur.

Individual Challenges

“I really struggle with dealing with feedback and being turned down,” she says, since when I’m told that I am at fault, I either go into defence mode or I withdraw entirely.” Although experiencing this reaction – which is sometimes referred to as “ego wounding”, she has been working to manage it and accept input from her support system, as she strives not to return into the harmful behaviour of her past. My past relationships were toxic to my partners as a teenager,” she admits. Through dialectical behavioural therapy, she has been able to reduce her narcissistic traits, and she explains she and her current boyfriend “operate with an understanding where I told him, ‘Should I make a harmful comment, if I say something manipulative, call it out {right then and there|immediately|in the moment’.”

Her upbringing mostly in the care of her father and explains there was an absence of healthy examples in her youth. “I’ve been learning all this time which behaviors are suitable or harmful to say during a fight because I lacked that guidance growing up,” she comments. Every insult was fair game when my family members were belittling me in my early years.”

Root Causes of The Condition

Personality disorders tend to be associated with early life adversity. Heredity is a factor,” notes a consultant psychiatrist. But, when someone develops narcissistic traits, it is often “linked to that specific childhood circumstances”. Those traits were “a survival tactic in some ways to survive at a very early age”, he adds, when they may have been neglected, or only shown love that was conditional on meeting particular demands. They then “rely on those same mechanisms as adults”.

In common with many of the individuals with NPD, one individual thinks his parents “may be narcissists themselves”. The individual says when he was a child, “everything was all about them and their work and their social life. So it was like, don’t bother us.” When their focus was on him, it came in the form of “a great amount of pressure” to achieve high marks and professional advancement, he recalls, which made him feel that if he didn’t meet their standards, he wasn’t “acceptable.

When he became an adult, none of his relationships ever worked out. “I’ve never cared about anyone really,” he admits. Therefore, I never treated relationships seriously.” He didn’t think loving someone, until he met his long-term relationship of three years, who is also dealing with a personality disorder, so, similar to his experience, struggles with feelings. She is “really understanding of the thoughts that occur in my head”, he explains – it was in fact, her who initially thought he might have NPD.

Accessing Support

Following an appointment to his general practitioner, an assessment was arranged to a mental health professional for an evaluation and was given the NPD label. He has been recommended for talking therapy via government-funded care (ongoing counseling is the only treatment that has been demonstrated to benefit NPD patients, clinicians explain), but has been on the waiting list for an extended period: “They said it is probably going to be maybe February or March next year.”

He has shared with a few individuals about his mental health status, because “there’s a big stigma that every person with NPD is harmful”, but, personally, he has come to terms with it. “It helps me to comprehend my actions, which is always a good thing,” he comments. Those interviewed have accepted their narcissism and are seeking help for it – which is why they agree to talk about it – which is possibly not the norm of all people with the disorder. But the existence of online advocates and the development of virtual networks suggest that {more narcissists|a growing number