Narcissistic personality disorder (NPD) is a mental health condition that’s estimated to affect between one and five percent of the UK population. It impacts how a person thinks, feels, and behaves, and makes it difficult for them to maintain healthy relationships. Without boundaries in place, the behaviours of people with NPD can negatively affect the mental health of those who interact with them too.

With that said, we’ll cover exactly what NPD is, its symptoms, and tips for coping with narcissistic people.

What is narcissistic personality disorder (NPD)?

What is narcissistic personality disorder?

Narcissistic personality disorder (NPD) is a mental health condition and recognised by the World Health Organization as a personality disorder. Generally speaking, NPD affects how a person thinks, feels, and behaves – often causing them to lack empathy, have an intense need for praise and admiration, and to experience an inflated sense of self-importance.

It’s important to note that not everyone with NPD behaves in the same way, and having narcissistic traits doesn’t necessarily mean a person has NPD. For this reason, research draws a line between two main types of narcissism: adaptive and maladaptive narcissism. These two categories are intended to highlight a difference between the productive and unproductive aspects of narcissism.

Adaptive narcissism refers to aspects of narcissism that, in some cases, can be helpful – for example, self-confidence and an ability to celebrate yourself and your achievements.

Meanwhile, maladaptive narcissism is linked to personality traits that can negatively impact both a person and the people they interact with – for example, aggression, entitlement, and a desire to take advantage of others for their own benefit. Maladaptive narcissism traits are those most commonly associated with NPD.

This distinction means that NPD doesn’t refer to traits like high self-esteem, being confident and assertive, taking pride in your accomplishments, being competitive, or disliking someone.

What are the symptoms of narcissistic personality disorder?

What are the symptoms of narcissistic personality disorder

It’s not unusual for people with narcissistic traits to initially come across as very charming. This can be particularly true in romantic relationships, which can make it difficult for people to spot the signs early on.

The type and severity of NPD symptoms can vary from person to person. However, some of the most common include…

  • Having a strong sense of importance and entitlement – for example, wanting constant or excessive admiration from others
  • Manipulative and/or controlling behaviour
  • Expecting to be treated as superior to others
  • Being consumed by fantasies of power and success
  • Finding it difficult to build and maintain relationships
  • Expecting people to unquestionably carry out requests
  • Believing other people are unimportant or inferior
  • Belittling others to feel superior
  • Inability to recognise the needs and feelings of others
  • Experiencing low self-esteem and feelings of shame and worthlessness, and concealing this

Because reality often doesn’t fit with a narcissistic person’s view of themselves, NPD can sometimes cause people to live in a fantasy. Having fantastical views of the world and themselves can serve as an escape from any inner feelings of worthlessness or shame.

As a result, it’s not unusual for people with NPD to react to anything that interferes with this fantasy with extreme defensiveness, or even anger. This can cause those around them to feel as though they’re walking on eggshells trying not to upset them.

What can cause narcissistic personality disorder?

There’s no single cause of NPD. Instead, experts believe that the condition could be linked to multiple factors, including…


The environment a child grows up in, including culture and parenting style, may impact their risk of developing NPD.

For example, studies have found that experiencing mistreatment during childhood may increase the risk of NPD. Bullying and excessive criticism has also been found to have a similar effect.


Research has found that some common personality traits linked with NPD, like grandiosity and entitlement, can be inherited.


There’s evidence to suggest that certain biological factors may impact the development of NPD. For example, brain scans have suggested that people with NPD have less grey matter in areas of the brain associated with empathy.

What are the different types of narcissistic personality disorder?

What are the different types of narcissistic personality disorder

While many types of NPD share common ground, each has varying traits and symptoms. We’ll cover these below…

Overt narcissism

People with overt narcissism (also known as grandiose narcissism) are typically charming, well-liked by others, extroverted, overbearing, and may appear dominant and aggressive. Overt narcissists have a tendency to believe that they’re more important than others.

Research suggests that overt narcissists are less likely than other narcissistic personalities to experience negative emotions such as loneliness, sadness, and worry. This tends to be because they have a genuinely high opinion of themselves and believe they’re entitled to take advantage of others for their own gain.

Though not always the case, a common cause of overt narcissism is being treated as superior to others during childhood, and carrying the same expectations into adulthood.

Covert narcissism

Covert, or vulnerable, narcissism is the opposite of overt narcissism and can be more difficult to spot.

Unlike overt narcissism, covert narcissists tend to be more withdrawn and have a lower sense of self-worth. This means that they often need praise and admiration from others to feel good about themselves. They might go back and forth between feeling inferior and superior, have intense fantasies about being successful, and become easily offended when people don’t give them special treatment.

As a result, covert narcissists tend to be more sensitive and at greater risk of experiencing depression and paranoia. Their narcissistic behaviour serves to protect them against feelings of inadequacy.

This type of narcissism is most common in people who were neglected or abused as children. It’s also possible for people to fluctuate between overt and covert narcissism.

Antagonistic narcissism

Many narcissistic personalities are competitive in nature, but this can be particularly noticeable in antagonistic narcissists.

This type of NPD can cause people to have difficulty trusting others; instead seeing everyone around them as a rival and all social interactions as a competition.

As a result, antagonistic narcissists can come across as hostile, aggressive, and unwilling to forgive.

Communal narcissism

Communal narcissists perceive themselves as caring, generous, and altruistic, but act in the entirely opposite way. With communal narcissists, there’s a gap between their actions and beliefs.

People with communal NPD may appear outraged when someone is mistreated, but fail to view their own behaviour in the same way when they mistreat people themselves.

Malignant narcissism

Malignant narcissism is considered to be the most severe type of narcissism. People with this form of NPD may display severely hostile and vindictive behaviour towards other people, get enjoyment from the suffering of others, and become paranoid about perceived threats.

Malignant narcissism can significantly impact a person’s quality of life, and the lives of the people they interact with.

What impact can narcissistic personality disorder have?

What impact can narcissistic personality disorder have

Narcissistic personality disorder can impact both those with the condition and the people they interact with.

Unlike other mental health conditions like anxiety and depression, NPD holds a certain stigma – and it’s not unusual for people with the condition to feel shunned by society as abusers or manipulators. This can make it difficult to reach out for help and support.

However, NPD can be difficult to live with. Many people with the condition experience low self-esteem, are easily hurt by others, and struggle to form and maintain relationships. These factors can increase the risk of loneliness and impact a person’s quality of life.

On the other hand, people who interact with or have relationships with people who have NPD can be affected too. For example, research has linked narcissistic abuse with an increased risk of anxiety, depression, low self-worth, and post traumatic stress disorder (PTSD).

However, this will depend on the severity of narcissistic behaviour and the nature of a relationship.

6 ways to cope if someone close to you has narcissistic personality disorder

Whether in the workplace or personal relationships, it can be difficult to cope with people who have NPD.

Below, we’ll cover some tips and ideas that can help. It’s important to remember that you’re not alone, and that help is available if you’re struggling.

1. Remember that you’re not to blame for their actions

The first thing to remember when coping with a person who has NPD is that you’re not to blame for their actions. While it might feel like they take everything out on you, NPD is a mental health condition and not a reflection of you.

Equally, you’re not responsible for supporting or fixing them.

2. Set boundaries

One of the most important things you can do when you’re dealing with a narcissist is to set boundaries and stick to them. Doing so allows you to establish what you are and aren’t prepared to accept.

For example, you could set boundaries around how often you see or talk to them. Without boundaries, people with NPD may try to push you around.

If setting boundaries is something you struggle with, you might find our article on the power of saying ‘no’ helpful.

3. Acknowledge when they’re being manipulative

People with NPD can sometimes be manipulative. Gaslighting is a common form of manipulation that can make you doubt yourself and your experiences. It’s most frequently seen in romantic relationships but can also occur in friendships, families, and the workplace.

For example, someone might deny that they’ve said something or accuse you of being too sensitive, which can cause you to start doubting your own thoughts and feelings.

Becoming aware of this behaviour can be a useful way to protect your mental health because it allows you to acknowledge what’s really going on.

For help with this, you might like to read our article; What is gaslighting and how can you handle it?

4. Take steps to boost your confidence and self-esteem

As we’ve mentioned, having narcissistic people in your life can sometimes affect your mental health and how you view yourself. For this reason, it can be beneficial to take steps to boost your own confidence and self-esteem.

If you’d like help with this, check out our article; 16 ways to improve your confidence and self-esteem.

5. Surround yourself with positive people

If you’re unable to remove or distance yourself from a narcissistic person – for example, if they’re a family member or you work with them – one of the best things you can do is to surround yourself with positive people who lift you up.

If you’d like to make some more meaningful connections, our articles, 9 different ways to meet new people and 12 ways to make new friends, are worth a read.

6. Seek support if necessary

If the behaviours of someone with NPD are impacting your life, it’s important to remember that there’s help and support available.

Some useful resources include…

  • The Echo Society UK – offers the opportunity to connect with others going through similar experiences, and provides online counselling and workshops.

  • Narcissistic and Emotional Abuse – created by Anne McCrea who walked away from a narcissistic relationship. Here, you can ask questions, read real life stories, and discuss your experiences with others. There’s also a Facebook group.

  • The Nurturing Coach – comprehensive guide to narcissistic abuse and offers counselling.

  • Narcissistic Abuse Survivors UK – a members only Facebook group for survivors of narcissistic abuse and those in a relationship with a narcissist.

  • Kim Saeed – American blog with a newsletter and Youtube channel. Kim Saeed has experienced abuse, but now helps people who are being abused or have been abused.

What to do if you think you’re displaying narcissistic traits

If you think you’re displaying narcissistic traits, it’s important to speak to your GP.

According to the NHS, treatment for personality disorders like NPD usually centres around talking therapy. This involves talking to a therapist about your symptoms to get a better understanding of your thoughts, feelings, and behaviours. As well as listening, a therapist may work alongside you to develop coping strategies for any unhelpful behaviours and attitudes you may have.

You can either ask your GP to refer you to a talking therapy service, or refer yourself directly to NHS talking therapies.

Alongside treatment, some people also find it useful to journal, take steps to break unhelpful habits, and educate themselves about what NPD can look like.

Final thoughts...

Having NPD or interacting with someone who does can be difficult. Without a lack of healthy boundaries and understanding of how the condition can manifest itself, NPD can have a negative impact on your mental health.

For this reason, it’s important to take steps to take care of yourself and reach out for help and support if you need it. If you’re currently being mistreated by someone with NPD, the key thing to remember is that you’re not alone and that you deserve to be treated with respect.

For further reading, head over to the healthy mind section of our website, which has information on everything from finding meaning, purpose, and belonging to counselling and therapy.

Do you have any suggestions on the best ways to handle people with NPD? If you’re comfortable doing so, we’d be interested to hear from you in the comments below.