Narcissistic Behavior Disorder

What is Narcissistic Personality Disorder?

Posted June 2020 by John Sherk, B.S.W., B.S. Bible; MDiv.; 4 updates since. Reading time: 5 min. Reading level: Grade 10+. Questions on narcissistic personality disorder? Email Toni at:

According to the Mayo Clinic, narcissistic personality disorder (NPD) is a “mental health disorder in which a person has an inflated sense of self-importance.” Although fewer than 200,000 cases occur in the US per year, that doesn’t lessen its importance. It’s vital to know some basic information about narcissistic personality disorder for various reasons. Having an introductory knowledge gives you tools so that you can consult your doctor. Additionally, it’s also commonly mixed up with other conditions such as borderline personality disorder (BPD).

Signs and Symptoms

A popular phrase amongst mental health workers is that people with mental health disorders are just like everyone else, only more so. The same holds true for those who suffer from narcissistic personality disorder. Some symptoms include:

  • Grandiosity
  • Constantly seeking attention and commendation
  • Disregard for others’ feelings
  • Excessive need for admiration
  • Social isolation
  • A lack of empathy
  • Emotional callousness
  • Monopolize conversations and belittle or look down on people they perceive as inferior
  • Extreme sensitivity to criticism
  • They believe they should only associate with high-status people
  • Envy toward others, and the belief that others are envious of them
  • Obsessive thoughts about power, success, intelligence, physical attractiveness, and romantic relationships
  • Demanding perfection from others
  • A deep-rooted inferiority complex

Along with these signs and symptoms of narcissistic personality disorder, people who suffer from it often have a short-temper and struggles to form and maintain boundaries. Normally, signs and symptoms of NPD begin to manifest between 18 and 25 years old. The presence of these signs during adolescence does not necessarily mean they’ll continue into adulthood. Although not a symptom of NPD, people with NPD also often struggle with substance abuse, impulsivity, and shame. Behind the mask of supreme confidence lies a great deal of fragility and vulnerability.

Causes of Narcissistic Personality Disorder

With so many diverse and multiplicitous symptoms, there need to be known causes and a known cure. Unfortunately, causes of narcissistic personality disorder are not well known or thoroughly understood. However, as with most mental health conditions, a combination of genetic, biological, and environmental play significant roles. Just like victims of abuse often become abusers, so those with NPD often had parents who exposed them to narcissistic behaviors. Some traits include:

  • Neglect of children
  • Parents with low self-esteem
  • Self-absorbed parents
  • Parents who overpraise their child
  • Parents who suffer from depression, angst, and anxiety
  • Parents with an inferiority complex
  • Verbal and physical abuse
  • Not being able to love your parents enough

Even with all of this in mind, predicting when a child who will grow up to suffer from NPD is impossible. So even if the genetic and biological factors are observed, the aspects from environment and upbringing remain influential. Vice versa also applies.

Rather than discussing causes, most experts focus on risk factors instead. Men suffer from NPD more than women. Also, children with overprotective or neglectful parents and children from at-risk communities like poor urban areas – all these present as risk factors.

Narcissistic Personality Disorder in a Relationship

As you can imagine with all of the information above, it must be very challenging to be in a relationship with someone who suffers from narcissistic personality disorder. Tragically, it often leads to abuse. For example, the person with NPD will often put down their partner to elevate themselves. Yet, at the same time, they’ll constantly demand the attention and praise of their partner. Perhaps not overtly, but they might fish for compliments. At some point they may recognize that their behavior negatively impacts the relationship, so they’ll apologize and demonstrate humility and contrition. Unfortunately, this can also be used as a means for more attention.

Often, people with NPD aren’t aware that they have it; they have minimal self-awareness and perceive their actions, perceptions, and reactions as normal. To illustrate, children of someone with NPD may withdraw love, affection, and attention from their parents in order to protect themselves. In turn, the parent with NPD will wonder why their children don’t love them. But rather than trying to cling to their children, they may instead deem their children as inferior. In a romantic relationship, the person with NPD will think about every problem as revolving around them. If their partner struggles with body image issues, the person with NPD will make their partner’s problem about them instead.

Furthermore, people in a relationship with sufferers of NPD will often become codependent. For example, the person with NPD makes their partner, friend, or family member feel needed by constantly seeking their commendation and regard. If that partner, friend, or family member in a relationship with the person with NPD has the feeling of being needed themselves, they’ll pursue that relationship. In fact, both will pursue the relationship even if both acknowledge the harm that it does to both.


Finally, it’s important to distinguish between narcissistic personality disorder and borderline personality disorder. Although the two conditions often overlap in signs and symptoms, they’re still very different. In fact, narcissism can be a symptom of borderline personality disorder, but they’re not types of one another. They’re distinct. A few differences include:

Aloof and distantClingy, desperate to avoid abandonment
Appears confident, self-assuredAppears unstable, low self-image
Puts down othersCycles between idealizing and putting down
Sensitivity to criticismDissociative symptoms like paranoia
Pushes people awaySucks people in

Even with these in mind, it may not be clear cut. It can be challenging to distinguish between narcissistic personality disorder, borderline personality disorder, sociopathy, psychopathy, and bipolar disorder. Each of these disorders share common symptoms of at least one of the others. In the best situation, a professional will wait until they’ve worked with someone for a year or two before they formally diagnose them with NPD or BPD to ensure they’re not misdiagnosed.

If you’d like more information on narcissistic personality disorder, and possible treatments, click here.

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