The word “narcissist” gets thrown around constantly these days. 

While social media and other cultural trends certainly fuel more narcissistic behavior, does that mean more people are narcissists? How do you identify a narcissist, and what does it actually mean to experience this mental disorder?

From a therapeutic perspective, there are distinct differences between engaging in narcissistic behavior and being clinically diagnosed with Narcissistic Personality Disorder (NPD). In therapy, the difference will dictate the types of interventions a therapist will use.

What Is Narcissistic Behavior?

Chances are, we’ve all engaged in narcissistic behavior at some point — though some more than others! More than just focusing on yourself in a self-affirming way, narcissistic behavior is a level of self-absorption that negatively impacts others. 

Some examples of narcissistic behavior include:

• Self-centeredness: Being overly preoccupied with one’s own needs, desires, and achievements, at the expense of others.

• Excessive focus on image and status: Focusing external validation that bolster one’s appearance or image of success.

• Need for external validation: Pursuing praise and admiration from others to validate one’s own sense of self-worth.

Narcissistic behavior varies in intensity, from mild to severe. On the mild end of the spectrum, someone might show situational selfishness, with a few negative impacts on others. When more severe, someone might display deep self-focus with no regard for how it impacts those around them.

What is Narcissistic Personality Disorder?

Narcissistic Personality Disorder (NPD) is a mental health condition with specific diagnostic criteria and impacts only 6% of adults in the U.S. It’s one of 10 types of personality disorders, a family of mental health conditions defined by long-term patterns of behavior and inner experiences that differ significantly from what is expected.

The key difference between NPD and narcissistic behavior is that NPD involves a pattern of pervasive self-importance. While there is some overlap, there are two ways they are different.

It has specific clinical diagnostic criteria.  

NPD is a formally recognized mental health condition based on specific diagnostic criteria in the Diagnostic and Statistical Manual of Mental Disorders, the reference book clinicians use to diagnose mental health and brain-related conditions. These are the guidelines for making an NPD diagnosis: 

• Fantasies of success and power over others

• Need for admiration, attention, and validation

• Lack of empathy towards others

• Exploitation of others

• Being envious of others and/or believing others are envious of them

• Arrogance or disdain for others

• Struggles forming and maintaining relationships

• Defensiveness to criticism

While all people with NPD will engage in narcissistic behavior, not all people who engage in narcissistic behavior have NPD. A licensed mental health professional – like a psychologist or a psychiatrist – can diagnose NPD when five of the above diagnostic criteria have been met.

It’s more impactful on daily life.

While someone just exhibiting narcissistic behavior may snap in and out of it depending on the situation, people living with NPD tend to fully internalize thoughts and behaviors that don’t allow them to see outside of themselves.

NPD creates significant challenges in a person’s life. Research has shown that people with NPD are more likely to have anxiety, depression, substance use disorders, suicidality, relational issues, and in general, a lower quality of life.

Despite outwardly appearing confident and self-assured, people with NPD experience deep-seated insecurities and fragile self-esteem. Because of this, it can be hard for people with NPD to form genuine connections and maintain stable relationships.

While narcissistic behavior can still create issues with relationships and beyond, they’re less likely to reach the same level of dysfunction experienced by those with NPD.

How to Help Someone Who May Have NPD 

While there is no cure for NPD, there are various methods that have been found effective in managing symptoms.

Opening Up the Conversation About Support 

Someone with NPD is likely resistant to any type of treatment given their inability to see outside of themselves, which can make engaging in support tricky. Instead of suggesting therapy for the suspected personality disorder or narcissistic behavior, suggest they try therapy for other issues they might be experiencing like stress, burnout, or anxiety. 

Sharing personal experiences about how therapy has helped loved ones in the past could also be a useful tactic in showing how beneficial therapy can be.

Treating NPD requires specialized therapy, like Cognitive Behavioral Therapy, and long-term support to address maladaptive thinking patterns and problematic coping mechanisms. Octave has hundreds of therapists that are trained to address personality disorders.

While there are no specific medications for NPD, psychiatrists will often prescribe medication for personality disorders including mood stabilizers and antipsychotic medications. If symptoms of anxiety or depression are present in either NPD or narcissistic behavior, antidepressants and anti-anxiety medications may even be effective.

Suggest and Mirror Lifestyle Changes

Because someone with NPD is likely to have a higher likelihood of developing depression and anxiety, lifestyle interventions can be particularly helpful in managing the intensity of symptoms. Avoiding substances and taking care of oneself with proper sleep, nutrition and movement, can go a long way especially if someone is hesitant to engage in therapy. 

If there’s resistance, you can suggest being accountability partners for each other where you both engage in healthier lifestyle choices together.

Every person is unique and what works for one person may not work for another. The best thing you can do as a loved one is remain patient and supportive as they navigate their mental health condition.