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At times, a 22-year-old from Los Angeles is convinced he is “unmatched in his abilities”. Living with narcissistic personality disorder, his grandiose moments often turn “detached from reality”, he explains. “You are on cloud nine and you think, ‘People will see that I stand above others … I will achieve remarkable feats for the world’.”

In his case, these phases of exaggerated self-worth are often succeeded by a “sudden low”, a period when he feels overwhelmed and self-conscious about his behavior, leaving him particularly vulnerable to disapproval from those around him. He first suspected he might have narcissistic personality disorder (NPD) after looking up his traits on the internet – and was later evaluated by a clinician. But, he is skeptical he would have agreed with the assessment if he hadn’t previously arrived at that realization personally. “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 – especially if they experience a sense of being better. “They’re in a delusional world that they’ve constructed. And that world is like, No one compares to me and {nobody can question me|no one should doubt me|my authority is absolute.”

Defining Narcissistic Personality Disorder

Although people have been called narcissists for over 100 years, it’s not always clear what is meant by the label. It’s common to label everybody a narcissist,” explains a psychology professor, who believes the word is “overused” – but when it comes to a formal diagnosis, he notes many people conceal it, due to widespread prejudice associated with the illness. An individual diagnosed will tend to have “an exaggerated self-image”, “impaired compassion”, and “a strategy of using people to bolster one’s self-esteem through actions such as seeking admiration,” the expert says. Those with NPD may be “deeply egotistical”, 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 emphasizes.

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

Variations by Gender in NPD Presentation

Although up to 75% of people found to have NPD are males, studies indicates this statistic does not mean there are fewer narcissistic women, but that women with NPD is frequently manifests in the less obvious variety, which is under-identified. Male narcissism tends to be a bit more accepted, similar to everything in society,” says an individual who discusses her NPD and borderline personality disorder (BPD) on online channels. It is not uncommon, the two disorders appear together.

Individual Challenges

I find it difficult with dealing with feedback and rejection,” she explains, “because if I hear that the issue lies with me, I tend to switch to self-protection or I completely shut down.” Despite having this response – which is often called “narcissistic injury”, she has been attempting to address it and take advice from her support system, as she doesn’t want to slip into the negative conduct of her earlier years. I used to be manipulative to my partners during adolescence,” she admits. Via therapeutic interventions, she has been able to mitigate her NPD symptoms, and she says she and her current boyfriend “have a dynamic where I told him, ‘Should I make a harmful comment, if my words are controlling, call it out {right then and there|immediately|in the moment’.”

Her childhood primarily in the care of her father and says she lacked healthy examples in her youth. I’ve had to teach myself continuously the difference between acceptable versus unacceptable to say when arguing because it wasn’t modeled for me as a kid,” she shares. “Nothing was off-limits when my family members were insulting me when I was growing up.”

Origins of Narcissistic Traits

Personality disorders tend to be linked to difficulties as a child. “There is a genetic component,” notes a consultant psychiatrist. But, when someone exhibits NPD characteristics, it is often “connected with that person’s unique upbringing”. Those traits were “a coping mechanism in some ways to manage during childhood”, he continues, when they may have been neglected, or only shown love that was dependent on meeting particular demands. They then “continue to use those identical strategies as adults”.

Similar to other of the individuals with NPD, John (a pseudonym) thinks his parents “might exhibit similar traits. The 38-year-old shares when he was a child, “their needs came first 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 “intense expectations to achieve good grades and professional advancement, he recalls, which made him feel that if he didn’t achieve their goals, he wasn’t “acceptable.

In adulthood, none of his relationships ever worked out. “I’ve never cared about anyone really,” he says. As a result, relationships weren’t relationships seriously.” He believed he wasn’t experiencing genuine affection, until he met his current partner of three years, who is facing similar challenges, so, similar to his experience, struggles with mood stability. She is “highly empathetic of the internal struggles in my head”, he explains – it was surprisingly, she who first suspected he might have NPD.

Pursuing Treatment

Following an appointment to his doctor, John was referred to a clinical psychologist for an diagnosis and was told his diagnosis. He has been recommended for therapeutic sessions through national services (ongoing counseling is the primary approach that has been proven effective NPD patients, experts say), but has been on the patient queue for an extended period: “They said it is likely to occur in a few months.”

John has only told a small circle about his NPD diagnosis, because “negative perceptions are widespread that all narcissists are abusers”, but, privately, he has accepted it. The awareness assists me to understand myself better, which is always a good thing,” he says. Those interviewed have come to terms with NPD and are looking for support for it – hence being willing to talk about it – which is possibly not the norm of all people with the condition. But the growth of NPD content creators and the development of virtual networks point to {more narcissists|a growing number