By Anna McKenzie

These days, it may feel easy to call a self-absorbed person a narcissist. While many people may display narcissistic personality traits, narcissistic personality disorder (NPD) is difficult to diagnose and often occurs alongside other personality disorders, as well as substance abuse. Only clinicians can properly diagnose NPD after observing a person’s long-term patterns of functioning and their interactions with others.

However, it’s worthwhile to understand the signs and symptoms of NPD, especially if you suspect that someone close to you may be suffering from this disorder. Even if someone you’re connected to is only displaying narcissistic traits, it can be helpful to know how to best respond to that person and protect yourself if the relationship becomes abusive.

Signs of a Narcissist

How common is narcissistic personality disorder? We aren’t exactly sure. According to National Center for Biotechnology Information (NCBI), it’s estimated that up to 5% of the US population meet the criteria for NPD, but within clinical settings, that percentage can reach up to 15%. One reason why its prevalence is hard to estimate is because it regularly co-occurs with other personality disorders, especially histrionic personality disorder, borderline personality disorder, antisocial personality disorder, and schizotypal personality disorder. Substance use disorders are also common in people with NPD.

The Diagnostic and Statistical Manual of Mental Disorders (DSM) is a clinical guidebook that defines the criteria for mental health conditions. According to the DSM, a person must meet at least five of the following conditions to be diagnosed with NPD:

• Has a grandiose sense of self-importance (e.g., exaggerates achievements, expects to be recognized as superior without actually completing the achievements)
• Is preoccupied with fantasies of success, power, brilliance, beauty, or perfect love
• Believes that they are “special” and can only be understood by or should only associate with other special people (or institutions)
• Requires excessive admiration
• Has a sense of entitlement, such as an unreasonable expectation of favorable treatment or compliance with his or her expectations
• Is exploitative and takes advantage of others for personal gain
• Lacks empathy and is unwilling to identify with the needs of others
• Is often envious of others or believes that others are envious of them
• Shows arrogant, haughty behaviors and attitudes

These are the telltale signs of a narcissist, but again, only a clinician should be making a diagnosis of NPD.

Signs of a Narcissistic Relationship

If you suspect you’re in a relationship with someone who could be a narcissist, mindbodygreen’s Dr. Margalis Fjelstad suggests looking out for the following narcissistic personality traits:

• No boundaries and no understanding that his or her thoughts or feelings may be different from yours
• An inability to read body language and properly understand facial expressions
• Refusal to take responsibility for anything; constantly blaming other people for how they feel and what happens to them
• Deeply distrustful; they regularly “test” others by behaving badly
• Always seeking validation, but endless praise is never enough
• Makes promises easily in order to get what they want
• Suffers from extreme anxiety, insecurity, and shame
• Feels that they are inherently superior and should only associate with others of their caliber

Not sure how to deal with a narcissist? Not all relationships with those who display narcissistic personality traits are bad ones. If you can accept the person for who he or she is, maintain your boundaries, and have civil interactions and discussions, Healthline.com says you can care for your well-being while staying connected to that person. However, your relationship can grow toxic if these behaviors increase in intensity or frequency.

Abusive relationships may include name-calling, gaslighting, insulting, yelling, humiliating, isolating, and physical abuse. If you are constantly manipulated, criticized, attacked, or ignored when your loved one doesn’t get what they want, your relationship is unhealthy. You may need to separate yourself from that person, either temporarily or permanently, so you can get the help you need to restore your well-being. 

Have You Been Traumatized in a Relationship?

Being in a relationship with someone who is abusive can be a traumatic experience. If you experience the following within a relationship or after breaking up with someone, you may be dealing with symptoms of post-traumatic stress disorder (PTSD):

• Confusion or feeling a loss of purpose 
• Drawn to self-harming behaviors like cutting or disordered eating
• Extreme mood swings or emotional outbursts
• Physical pain (inexplicable nausea, migraines, digestive upset, chest pain)
• Depression and pervasive anxiety
• Racing thoughts, nightmares, or insomnia
• Reliving stressful events or dealing with intrusive negative thoughts
• Suicidal thinking or ideation
• Excessive use of substances in order to numb painful thoughts or feelings

If you are experiencing these symptoms, it’s time to reach out to a professional for assistance and support. When you say, “yes” to treatment, you can find healing from trauma and start feeling like yourself again.

Treatment for NPD and Other Conditions

Because people with NPD often suffer from other mental health conditions, they may improve with the help of antidepressants, antipsychotics, and mood stabilizers. Treatment for co-occurring substance use disorder can assist a person with NPD in learning how to deal with their impulses, regulate their emotions, and interact in healthy ways with others. 

To find out more about how we can help those with NPD, PTSD, and other conditions, contact us today. We would love to tell you more about our research-backed, evidence-based programs at The Meadows and help you take the next step toward healing.