Diagnosis of Narcissistic Personality Disorder

By virtue of its condition, people who are affected with narcissistic personality disorder rarely think that anything is wrong with them and that they should visit a doctor or get treated. This after all would go against their belief of self-perfection and power. However, as the condition worsens, it can cause severe problems in many areas of a person’s life – from work or school to personal relationships. Inspite of feelings of superiority and confidence there is an underlying current of low self-esteem and a fragile ego. Emotions tend to get very intense and the person is beset with contradictory feelings and confused thoughts. Depression is very common among such individuals. If you notice any of these problems, it is worthwhile to reach out for help and consult with your doctor or a mental health provider. A proper diagnosis of narcissistic personality disorder and its treatment can help make life more fulfilling and enjoyable.

A diagnosis of narcissistic personality disorder like most other mental conditions would require a thorough psychological evaluation. Your doctor would generally recommend you to a psychiatrist or similar type of mental health provider. Before your initial consultation it would be best to list out all the symptoms that you experience and make note of how severe they are and for how long they have been evident. Your psychiatrist will also enquire about your past with emphasis on the events in your childhood or any traumatic events that may have contributed towards the development of the condition. If possible, take a family member or a friend along so that your doctor receives an unbiased opinion about your condition as well.

In addition to the information received, the mental health care provider may ask a series of questions that will help determine the exact nature of the mental condition. These could include:

  • What are your symptoms? How often do they occur?
  • How do you feel when you are rejected or hurt by others?
  • How many close personal relationships do you have?
  • What are your plans for the future?
  • What accomplishments are you proud of?
  • How do you view others who share their problems and feelings with you?
  • How are your symptoms affecting your life?
  • Do you have a history of mental illness in your family?
  • Have you been treated for any other mental disorder?
  • Do you drink or use drugs?
  • Are you currently on any other medication?
Your answers to these questions in addition to an evaluatory questionnaire will give your doctor the information he needs to make a diagnosis. Many doctors also rely on the criteria mentioned in the Diagnostic and Statistical Manual of Mental Disorders (DSM) published by the American Psychiatric Association to diagnose the condition. There may even be a physical exam to rule out any medical problems that may be causing the symptoms. Apart from these exams, there are no specific tests for narcissistic personality disorder as it is possible to be diagnosed for more than one personality disorder at the same time. 
  1. Blais MA, Smallwood P, Groves JE, Rivas-Vazquez RA. Personality and personality disorders. In: Stern TA, Rosenbaum JF, Fava M, Biederman J, Rauch SL, eds. Massachusetts General Hospital Clinical Psychiatry. 1st ed. Philadellphia, Pa: Mosby Elsevier;2008:chap 39.
  2. L. Bobadilla, J. Taylor, Antisocial and Narcissistic Personality Disorder, In: Editor-in-Chief: V.S. Ramachandran, Editor(s)-in-Chief, Encyclopedia of Human Behavior (Second Edition), Academic Press, San Diego, 2012, Pages 154-160, ISBN 9780080961804, 10.1016/B978-0-12-375000-6.00026-4.