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Is Narcissism a Mental Health Issue? Can It Be Diagnosed?


If you ask most people whether narcissism is bad, an overwhelming majority would probably say yes. However, narcissism is a normal human trait that exists on a spectrum, and some amount is necessary for a healthy ego. Without a little narcissism, we’d lack confidence and a solid sense of self. Too much and we feel superior to others, becoming convinced the world revolves around us (and only us).

While we’re all narcissistic to a certain extent, healthy narcissism is not a cause for concern. It’s distinctly different from narcissistic personality disorder, a mental health diagnosis characterized by traits such as an exaggerated sense of self-importance, grandiosity, low empathy and a constant need for praise or admiration.

Learning more about narcissism can help you discover how to foster positive traits in yourself and recognize the more negative ones associated with narcissistic personality disorder. If you find yourself at one end of the spectrum or the other, this can help you decide if you should pursue a formal diagnosis with a qualified mental health professional. 

Healthy Narcissism vs. Pathological Narcissism

First, let’s break down the differences between healthy narcissism and narcissistic personality disorder in more detail. Narcissism includes a range of traits that we all have the capacity to exhibit. We can be selfish, conceited or thoughtless at times, but most people feel bad after displaying this type of behavior. Narcissists do not. Other differences include:

Healthy Narcissism

  • Positive self-esteem and confidence
  • Emotional resilience
  • Can admire and also accept the admiration of others
  • A healthy sense of pride in one’s accomplishments
  • Appreciation of the needs of others
  • Can tolerate disappoints and failures
  • Feelings of self-worth that aren’t exaggerated
  • Ability to set boundaries
  • Invests love in oneself and other people

Pathological Narcissism 

  • Inflated ego and sense of self-worth
  • Entitlement
  • Requires constant admiration and praise
  • Exaggerates accomplishments
  • Feels superior to others 
  • Preoccupied with success, power, beauty, etc.
  • Unwilling or unable to recognize others’ needs
  • Uses manipulation to achieve goals
  • Emotional instability and frequent mood changes
  • Unable to handle criticism or rejection
  • Narcissistic behavior may mask feelings of insecurity or shame

It’s important to note that healthy narcissism is useful for a number of reasons. For example, it can be helpful to take pride in your accomplishments. Someone who is able to derive narcissistic pleasure in a job well done can better tolerate frustration and failure, reducing the likelihood of burnout. High self-esteem can also enhance our creativity, resilience and mood. 

Narcissistic Personality Disorder: Fixated on Oneself

There is a famous Greek myth in which a handsome young man named Narcissus falls in love with his own reflection. Unable to turn away, he continues to stare and pine after himself in despair, until he loses the will to live. A flower blooms in his absence.

His name gave us the term narcissist, meaning a person who is self-absorbed and has an excessive interest in themselves to the detriment of all else. According to Freud, narcissism is normal in childhood, but we soon learn we are not the center of the world and that other people have needs, too. Narcissism is considered a disorder when it persists after puberty.

Narcissism describes a cluster of traits that range in severity. On the one hand, people may appear to be confident, charming and well-adapted. But on the other, it can become a disorder that leads to selfish, manipulative and self-destructive behavior. 

Understanding Narcissistic Personality Disorder

Narcissistic personality disorder is a serious mental health diagnosis given to those with extremely narcissistic traits. An overinflated ego dominates their personality and causes problems in every facet of life. The symptoms are pervasive, dysfunctional and obvious in all activities, not just specific situations. For example, a movie star who only exhibits narcissistic behavior in front of the camera wouldn’t meet the diagnostic criteria. 

Compared to other mental health conditions, narcissistic personality disorder is relatively rare, estimated to affect 1% of the population. It tends to appear in men more than women. There are countless tests and quizzes online that can assess if someone exhibits narcissistic traits, but these are not meant to be diagnostic tools. Only an evaluation with a qualified psychiatrist, therapist or clinician can determine if someone has narcissistic personality disorder. 

Getting a Diagnosis

The internet is better at raising more questions than providing answers when it comes to your health. It can lead people into thinking that something completely benign is dangerous, causing unnecessary stress and worry. Mental health quizzes are no different, but they can be a useful starting point when followed up with an appointment with a therapist or psychiatrist.

Narcissistic personality disorder is diagnosed when there’s a long-standing pattern of self-centered behavior and arrogant thinking. Some people display more narcissistic traits than others, however, so clinicians use a variety of tools to get a more accurate picture. Often, this might involve psychiatric assessments and questionnaires to evaluate symptoms. 

Headlight’s Care Coordinators can connect you with our team of psychiatrists, clinicians, therapists and more to help you receive a diagnosis from the comfort of your own home. Our mental health services are available online, in person or through our mobile app and tailored to your exact needs, so you can build a mental wellness circle that works for you.

Treating Narcissistic Personality Disorder

Narcissistic personality disorder is a lifelong condition that affects the way you think, behave and relate to others. It cannot be cured, but it can be managed with the right support. There’s no standard treatment or medication for narcissistic personality disorder, but evidence-based therapies have been shown to help.

Some common psychotherapies used to treat narcissistic personality disorder include cognitive behavioral therapy, schema therapy and Gestalt therapy. The goal is to explore the reasons behind narcissistic feelings and behaviors, how they affect daily life, and what can be done to replace them with healthier coping mechanisms. Therapy can also help you see yourself more realistically, develop interpersonal skills and consider the needs of others. 

No medications have been specifically developed for narcissistic personality disorder, but those used to treat other mental health disorders such as anxiety or depression may be helpful in reducing some symptoms and addressing co-occurring disorders.

More than 50% of Americans struggle with mental health.

Headlight is now collaborating with health plans and companies to make therapy more accessible and affordable. Speak to a Care Coordinator today.