What Are 12 Signs of a Narcissist?

1. Grandiose sense of self

• Feels superior to others and believes they deserve special treatment
• Often accompanied by fantasies of unlimited success, brilliance, power, beauty, or love

2. Excessive need for admiration

• Must be the center of attention
• Feels slighted, mistreated, depleted, and enraged when ignored
• Often monopolizes conversations

3. Superficial and exploitative relationships

• Bases relationships on surface attributes and not unique qualities of others
• Values people only to the extent they are beneficial to themselves

4. Need for control

• Perfectionistic
• Becomes upset when things don’t go their way 

5. Lack of empathy

• Severely limited or totally lacking the ability to care about the emotional needs or experiences of others, even loved ones

6. Identity disturbance

• Sense of self is highly superficial, extremely rigid, often fragile, and easily threatened
• Self-stability depends on maintaining the view that one is exceptional
• Retreats from or denies realities that challenge this view of self

7. Difficulty with attachment and dependency

• Relies on feedback from the environment
• Relationships exist only to shore up a positive self-image
• Tends to avoid intimacy; interpersonal interactions are superficial

8. Chronic feelings of emptiness and boredom

• Feels empty, bored, depressed, or restless when attention and praise are not available

9. Vulnerability to life transitions

• Difficulty maintaining reality-based personal and professional goals over time
• Feels overwhelmed by compromises required by school, jobs, and relationships
• May have “failure to launch” syndrome when young

10. Lack of responsibility

• Blames others for their faults
• Deflects responsibility onto others, often with those close to them

11. Lack of boundaries

• Beliefs others think the same as they do
• Feels shocked and insulted when told no

12. Fear of rejection

• Afraid of being wrong or seen as bad or inadequate
• Does not develop trust in the love of others

No specific laboratory tests are needed to diagnose NPD. The diagnosis of NPD is made by a mental health professional, such as a psychiatrist with the help of various guidelines available under the aegis of the American Psychiatric Association. The psychiatrist takes the person’s family history, personal history of any other psychiatric illness and asks questions to determine if the person has alcohol or drug addiction. They might give a questionnaire to the person who needs to answer honestly. A family member or some other close one is typically involved in the whole process.

While the traits above are examples of how people with NPD behave, a clinical diagnosis of NPD is based on the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria. Someone is diagnosed with NPD if they meet at least 5 of the 9 traits below:

1. Grandiose sense of self-importance
2. Sense of entitlement
3. Preoccupation with fantasies of unlimited success, power, brilliance, beauty, or ideal love
4. The belief that they are “special” and unique and can only be understood by, or should associate with, other special or high-status people or institutions
5. Require excessive admiration
6. Interpersonally exploitative and take advantage of others
7. Lack empathy
8. Envy others or believe others are envious of them
9. Show arrogant, haughty behaviors and attitudes

People need five out of nine traits to be diagnosed with narcissistic personality disorder.

The traits of a narcissist have been defined by the American Psychiatric Association. They have been described under the section of narcissistic personality disorder (NPD). NPD falls under the umbrella of personality disorders described in psychiatry.

Doctors diagnose NPD by looking for the presence of at least five of the following nine criteria (traits)

1. A grandiose sense of self-importance (the person keeps on exaggerating their achievements and talents).
2. Preoccupation with fantasies of unlimited success, power, brilliance, beauty or ideal love.
3. A belief that they are special and unique and can only be understood by, or should associate with, other special or high-status people or institutions.
4. A need for excessive admiration (the person wants to be at the center of attention).
5. A sense of entitlement (the person has unreasonable expectations of favorable treatment).
6. Interpersonally exploitive behavior (the person always tries to take advantage of people around them, such as family members, friends and colleagues).
7. A lack of empathy (the person is inconsiderate of the feelings, emotions and opinions of others, even their loved ones).
8. Envy of others or thinks that others are envious of them.
9. Exhibits arrogant and haughty behaviors or attitudes.

What exactly causes a person to become a narcissist is not known. Like other mental disorders, the causes seem to be complex. The causes may be linked to the person’s upbringing, substance abuse, genetics or some specific connections between their brain and thinking.

A person with narcissistic personality disorder needs long-term therapy that requires consistent follow-ups with the mental health care professional. The treatment involves a combination of psychotherapy and medication management.

Options for psychotherapy include the following

• Individual psychotherapy
• Group therapy
• Family therapy
• Couples therapy
• Cognitive-behavioral therapy (CBT)

Violent behavior of the person may necessitate hospital admission to avoid dangerous situations.

There are no psychiatric medications that are specially dedicated to treating NPD. The medications used for treating other psychiatric illnesses are usually helpful in dealing with the traits of NPD. These drugs include

• Antidepressants
• Antipsychotics
• Mood stabilizers

Dealing with a narcissist who may be a loved one, a friend or a boss, is very challenging, but not impossible. Here are some ways that you can deal with them when they are around you

• Do not try hard to change them to avoid disappointment.
• Confront the narcissist in person and not in front of other people.
• Create a good support system for yourself to let go of the negativity created by the narcissist.