Narcissism: Symptoms and Signs

Medically Reviewed by Melinda Ratini, MS, DO on March 18, 2025
Written by Martha Anne Tudor
7 min read

Narcissism is extreme self-involvement to the point where a person ignores the needs of those around them. While anyone may have narcissistic behavior once in a while, true narcissists often disregard others or their feelings. They don’t understand the effect their behavior has on other people.

It’s important to note that narcissism can be 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. You can have narcissistic tendencies, such as bragging, that are OK sometimes. But NPD is different, as your behaviors and symptoms are more severe, and they happen in all kinds of situations. NPD isn't a character flaw or defect, it's a mental health disorder. With NPD, your symptoms make it hard or impossible to have satisfying relationships. 

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

The causes of narcissism aren't fully understood or known. But like other mental illnesses, it can be linked to your environment. Children who are encouraged to believe they’re extraordinary and always deserve the best, even at the expense of others, may develop NPD. Traits such as confidence are rewarded as they grow up, but qualities such as empathy aren’t. Childhood trauma or neglect can also lead to narcissism.

There’s no gene for NPD. You aren’t born with it. 

There are two types of narcissism. These types have common traits but come from different childhood experiences. The two types also influence different ways narcissists 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 magnify their importance. They are very self-confident and aren’t sensitive.

Vulnerable narcissism

This type of narcissism is usually the result of childhood neglect or abuse. People with this behavior often fear being abandoned, feel insecure but act overly confident, and need others' approval. Their narcissistic behavior protects them from feeling not good enough. Even though they go between feeling inferior and superior to others, they may get upset or anxious when others don’t treat them as if they’re special.

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

Most common signs of narcissism 

Sense of entitlement. A common sign of people with narcissism is the belief they’re superior to others and deserve special treatment. They believe others should obey their wishes and that 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 finally their own needs come first. They may try to keep people at a distance in order to keep control. They often 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 validation from others. They often brag or exaggerate their accomplishments for recognition. They like to feel appreciated to boost their ego.

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

Arrogance. People with narcissistic behavior see themselves as superior to others. They may become rude or abusive when they don’t receive the treatment they think they deserve. They may speak or act rudely toward those they consider inferior.

Other signs include:

  • A sense of self-importance and 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 

Signs of vulnerable (covert) narcissism

In this type of narcissism, people feel that the world and other people owe them. They believe they deserve payback and are often gloomy or resentful. They believe others have a better life than they do. Some signs include a weak sense of self, hypersensitivity to criticism, need for validation, and acting like victims.

Signs of NPD

Common signs of NPD are often called by the acronym SPECIAL ME: 

Sense of self-importance

Preoccupation with power, beauty, or success 

Entitled

Can only be around people who are important or special

Interpersonally exploitive for their own gain

Arrogant

Lack empathy

Must be admired

Envious of others or believe that others are envious of them

With the right treatment, some narcissists can learn to spot 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. 

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 spot narcissism in yourself, you might work to develop 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 NPD. It can help you understand the narcissist’s strengths and weaknesses. Knowing who they are may help you accept the situation, if you so choose, 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. It’s not your job to control their 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 may help. A counselor can show you ways to approach problem-solving with the narcissist.

Certain things may lead to problems with a narcissist. It’s best not to:

Argue or confront. Try not to 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 little to no empathy. So, honest, heartfelt communication often doesn’t get through and can 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.

Is narcissism curable?

No, but it's treatable. Treatment takes a lot of time and effort. People with NPD rarely seek help on their own. But they might seek help for a related issue, such as anxiety. Treatment requires an individualized approach. That’s because there’s no proven medication or therapy to treat NPD.  If you have NPD, you can learn how to strengthen your connections to others in healthy ways.

Can you survive marriage to a narcissist?

Possibly. If your partner has NPD, it can be tough. They put themselves first, and your mental health could suffer. Focus on your well-being, use coping ways, and set boundaries. Only you can decide what you’re willing to tolerate.

Do narcissists fall in love?

People with narcissistic tendencies, but not NPD, likely experience love in the same ways as people without narcissism. But people with NPD have traits that are the opposite of the ability to love someone. Those traits include a lack of empathy and tendency to exploit others for personal gain.

Do narcissists lie a lot?

Yes. They lie to retain control, boost their self-image, and manipulate situations for their benefit. Lying can be a way for narcissists to keep their grand self-view, even if it means making up achievements, relationships, or experiences. For narcissists, lying is often habitual behavior, not just a response to specific situations. 

What are 5 main signs of a narcissist?

Five main signs of narcissism are a huge sense of self-importance, constant need for admiration, lack of empathy, sense of entitlement, and manipulative or exploitive behavior.