Narcissism: Symptoms and Signs

Medically Reviewed by Jabeen Begum, MD on March 30, 2023
6 min read

Narcissism is extreme self-involvement to the degree that it makes a person ignore the needs of those around them. While everyone may show occasional narcissistic behavior, true narcissists frequently disregard others or their feelings. They also do not understand the effect that their behavior has on other people.

It’s important to note that narcissism is a trait, but it can also be a part of a larger personality disorder. Not every narcissist has narcissistic personality disorder (NPD), as narcissism is a spectrum. People who are at the highest end of the spectrum are those that are classified as NPD, but others, still with narcissistic traits, may fall on the lower end of the narcissistic spectrum.

The cause of narcissism isn't known. But it can be linked to your:

  • Environment. Your parents may have given you either too much adoration or too much criticism that didn't match your actual experiences and achievements.
  • Genetics. Narcissism may be linked to your inherited characteristics, including certain personality traits.
  • Neurobiology. This is the connection between your brain, behavior, and thinking.

People who show signs of narcissism can often be very charming and charismatic. They often don’t show negative behavior right away, especially in relationships. People who show narcissism often like to surround themselves with people who feed into their ego. They build relationships to reinforce their ideas about themselves, even if these relationships are superficial.

There are two types of narcissism that narcissistic behavior can fall under. The two types can have common traits but come from different childhood experiences. The two types also dictate the different ways people will behave in relationships.

Grandiose Narcissism

People with this behavior were most likely treated as if they were superior or above others during childhood. These expectations can follow them as they become adults. They tend to brag and be elitist.

Those with grandiose narcissism are aggressive, dominant, and exaggerate their importance. They are very self-confident and aren’t sensitive.

Vulnerable Narcissism

This behavior is usually the result of childhood neglect or abuse. People with this behavior are much more sensitive. Narcissistic behavior helps to protect them against feeling inadequate. Even though they go between feeling inferior and superior to others, they feel offended or anxious when others don’t treat them as if they’re special.

Narcissism is still being studied and explored, since many narcissists and people with narcissistic personality disorder don’t seek treatment. But there are some common traits of people with narcissistic behavior that you may be able to spot.

Sense of Entitlement

A common sign of people with narcissism is the belief that they are superior to others and deserve special treatment. They believe that others should be obedient to their wishes and that the rules don’t apply to them.

Manipulative Behavior

Another common trait of narcissism is manipulative or controlling behavior. A narcissist will at first try to please you and impress you, but eventually, their own needs will always come first.

When relating to other people, narcissists will try to keep people at a certain distance in order to maintain control. They may even exploit others to gain something for themselves.

Need for Admiration

One of the most common signs of a narcissist is a constant need for praise or admiration. People with this behavior need to feel validation from others and often brag or exaggerate their accomplishments for recognition. They also like to feel appreciated to boost their ego.

Lack of Empathy

Lack of empathy is another sign of narcissism. This means that the narcissist is unwilling or unable to empathize with the needs, wants, or feelings of other people. This also makes it difficult for them to take responsibility for their own behavior.


People with narcissistic behavior already see themselves as superior to others, so they may become rude or abusive when they don’t receive the treatment they think they deserve. While they hold themselves superior, they may speak or act rudely toward those that they deem are inferior.

Other signs include:

  • A sense of self-importance, exaggerating their achievements and talents
  • A preoccupation with fantasies of success, power, or brilliance
  • A belief that they're more special or unique than others and should only associate with other high-status people
  • Envy of others or the belief that others are envious of them
  • Insisting they have the best of everything 
  • Feeling they deserve privileges and special treatment

With the right treatment, some  narcissists can learn how to recognize their behavior. This can improve their lives and the lives of those around them. But narcissists often don't seek help because it doesn’t fit the image they have of themselves. They may need encouragement to get professional help.

If you’re in a relationship with a narcissist, you may be able to change your dynamic in the relationship. It may be possible to change the way your partner looks at you to help lessen the effects of their narcissistic behavior.

If you recognize narcissism in yourself, you can learn to have more self-compassion. This means treating yourself with kindness instead of comparing yourself to others. This can lower your need for praise and recognition.

If you're in a relationship with a narcissist, try these steps:

Educate yourself. Find out more about the disorder. It can help you understand the narcissist’s strengths and weaknesses and learn how to handle them better. Knowing who they are may also allow you to accept the situation for what it is and have realistic expectations.

Create boundaries. Be clear about your boundaries. It may upset or disappoint the narcissist, but that’s OK. Remember, it’s not your job to control that person’s emotions, says Kimberly Perlin, a licensed clinical social worker in Townson, MD.

Speak up for yourself. When you need something, be clear and concise. 

Watch your wording. Narcissists don’t take constructive criticism well. Try to make comments in careful, positive ways.

Stay calm. Try not to react if they try to pick a fight or gaslight you (making you doubt your own reality). If they lash out, think of them as a 3-year-old who feels rejected because their parent sets a bedtime.

Create a support system. Living with a narcissist can lead to feelings of insecurity, confusion, and self-doubt. Make sure you have a core group of people in your life to support you,.

Bring in a counselor. Therapy won’t cure your partner’s narcissism, but it may help you work certain things out. A counselor can show you ways to approach problem-solving with the narcissist.

Certain things may trigger problems with a narcissist. It's best to not to:

Argue or confront. Try to not confront a narcissist directly. As difficult as it may be to constantly tiptoe around them, it can be better to manage their need to feel in charge.

Direct them. Narcissists like to have control and often fear losing it. Efforts to lead or instruct them will often fail.

Expect them to see your point of view. Narcissists don’t like to admit when they’re wrong or that they’re unlovable, so trying to make them see things your way could backfire.

Expect deep, meaningful communication. Narcissists have very little empathy, so honest, heartfelt communication often doesn’t get through and can even create an angry outburst or shutdown response,.

Go over past issues. Don’t try to make them see a long line of behavior dating back years – or how they’re just like their father, for example, Perlin says. Instead, stay in the present when you express requests or hurt feelings.

People with narcissistic personality disorder usually don’t change, so keep that in mind. Even if you learn to manage your relationship better, it probably won’t ever be a healthy relationship.