Narcissism: What Is It and What Makes It So Rare?

Narcissism: What Is It and What Makes It So Rare?

People with narcissistic personality disorder (NPD) are typically seen as self-centered, unempathetic, entitled, and attention-seeking. They’ll often use their achievements as a source of power, glorifying their image as “extremely successful” and attractive. As a result of this portrayal, a person with NPD may have high, unreasonable expectations for what other people should do for them.

But underneath their superiority is a fragile sense of self-worth and uncertainty.

As a Cluster B personality disorder, NPD causes vital impairments in functioning and negatively impacts various life areas, including social, family, and work relationships. They may also struggle with other disorders, such as substance abuse. Having another condition may be what prompts someone to seek help.

How common is an NPD diagnosis?

A mental health professional typically won’t diagnose someone with NPD until they’ve expressed struggling with their behavior and a desire to change it. But since they tend to believe there’s nothing wrong with them, they rarely enter treatment. 

Research suggests that about 0.5% of the U.S. population has NPD, and is more commonly found in men than in women. But because the diagnosis depends on various factors and the willingness of a person to seek treatment, the number of people with NPD is more of an estimate.

How is NPD diagnosed?

A person with NPD often comes to therapy to either get support for their perspective or because a family member is insisting they attend treatment. Usually, it takes a severe loss or facing a potential failure for someone with NPD to get help, although it’s common for them to seek treatment for another mental health problem, such as depression or substance abuse.

There’s been some controversy on how NPD is diagnosed, mainly because many mental health professionals focus on visible behaviors rather than inner struggles due to their difficulty expressing themselves and perceived self-esteem. This makes it nearly impossible for someone not formally trained and educated to make a proper diagnosis.

Although it’s tempting to assess people you suspect of having NPD based on the following information, narcissism is far more complex than certain behaviors and attitudes. Signs and symptoms of narcissistic personality disorder vary from person to person but may include:


  • An exaggerated sense of self-importance and uniqueness
  • Feeling superior, or more important than others
  • Feels deserving of special treatment
  • Fantasies of unlimited potential for success

Excessive need for admiration:

  • A sense of entitlement or have an unreasonable need to be the center of attention
  • Often monopolizes conversations
  • When ignored, they feel mistreated or neglected

Superficial and exploitative relationships:

  • Relationships are surface level rather than the unique qualities of other people
  • Other people are valued as long as they’re viewed as beneficial

Lack of empathy:

  • Limited or unaware of caring for the emotional needs or experiences of others

Identity disturbance:

  • Grandiose sense of self is easily threatened and extremely rigid
  • Self-stability is dependent on others viewing them as exceptional
  • Denies any reality that challenges their grandiosity

Difficulty with attachment and dependency:

  • Relies on feedback from their environment
  • Superficial interactions
  • Avoidant of intimacy

Chronic feelings of emptiness:

  • May grow restless, depressed, or bored when attention and special treatment are unavailable.
  • Secretly feel insecure, ashamed, vulnerable, or humiliated

Vulnerable to change:

  • Have difficulty coping with stress and adapting to life changes
  • Have trouble managing emotions and behavior
  • Feel depressed or moody due to falling short of perfection

Treatment for NPD

If any of these aspects sound familiar, consider reaching out to a mental health professional. Treatment can ultimately help you learn how to regulate your emotions, change harmful behaviors, and improve your relationships’ quality.