Narcissistic personality disorder (NPD) is a mental health condition that influences a person’s thoughts, emotions, and actions. People with NPD have an exaggerated sense of self-importance, a strong need for admiration, and a lack of empathy for others. They may also have difficulty with relationships, emotions, and stress.
NPD is not very common in teens, but it can cause significant problems for them and their families. According to the DSM-5, NPD affects about 0.5% of the general population, and it is more prevalent in men than in women. NPD usually begins in teens or early adulthood, and it may be influenced by social and cultural factors, such as media exposure, parenting styles, and economic conditions. However, more research is needed to understand how these factors affect the development and expression of narcissism in teens.
It is normal for teens to have some degree of self-importance, as they are developing their identity and autonomy. However, there is a difference between healthy self-esteem and pathological narcissism. Healthy self-esteem is based on realistic self-evaluation and balanced by prosocial behaviors, such as empathy, cooperation, and altruism. Pathological narcissism is based on an inflated self-image and distorted by antisocial behaviors, such as arrogance, manipulation, and exploitation.
Blume Behavioral Health is a quality mental health center for teens. We offer residential treatment facilities based in Redondo Beach, California that provide tailored services for teens who are struggling.
Narcissism and NPD are both related to self-centeredness, but they are not the same thing. Narcissism is a personality trait that can vary in degree and context, while NPD is a mental health disorder that affects multiple areas of a person’s life and causes significant distress.
Some signs that can help you tell the difference between simple narcissism and NPD are:
People with simple narcissism may have some inflated self-esteem, but they can also acknowledge their flaws and limitations. People with NPD have a pervasive and extreme sense of self-importance, and they often deny or rationalize their faults.
People with simple narcissism may be self-absorbed or attention-seeking, but they can also form meaningful and reciprocal bonds with others. People with NPD have difficulty with empathy and intimacy, and they often exploit or manipulate others for their own gain.
People with simple narcissism may be sensitive or defensive to criticism, but they can also learn from it and improve themselves. People with NPD react to criticism with anger, contempt, or retaliation, and they rarely change their behavior.
People with simple narcissism may recognize their narcissistic tendencies and seek help if they cause problems. People with NPD usually lack the insight to see that they have a disorder and they do not seek help unless they face a crisis.
Although NPD is the sole recognized diagnosis concerning narcissistic characteristics, researchers have pinpointed various subtypes within NPD, such as:
This is the most classic type of narcissism, characterized by a sense of grandiosity, a continuous desire for admiration, arrogance, and fantasies of unlimited power and success.
This is a more hidden type of narcissism, characterized by a sense of inferiority, a constant need for validation, self-pity, and resentment of others.
This is a type of narcissism that involves hostility, aggression, manipulation, and exploitation of others. People with this subtype may also have antisocial personality disorder or psychopathic traits.
This is a type of narcissism that involves a sense of entitlement and superiority based on one’s involvement in altruistic or prosocial activities. People with this subtype may also have a hidden agenda or expect recognition for their good deeds.
This is a type of narcissism that involves a combination of narcissistic, antisocial, paranoid, and sadistic traits. People with this subtype may also have a disregard for morality, empathy, and human rights.
Each subtype of NPD may have different symptoms, causes, and treatments. Therefore, it is important to seek professional help if you suspect that your teen has NPD or any of its subtypes. A therapist can help your teen understand their behavior, develop healthier self-esteem, and learn coping skills. Therapy can also help you and your family deal with the challenges of living with a teen with NPD.
You can help your teen by noticing if they act in ways that show they have NPD. This is a mental problem that makes them think too highly of themselves and not care about others. Here are some behaviors they might express:
People with NPD often have an inflated sense of self and may believe they are superior to others.
Teens with NPD may seek constant admiration and validation from others to boost their fragile self-esteem.
They may struggle to understand or empathize with the feelings and experiences of others, prioritizing their own needs above all else.
Due to their self-centered nature and lack of empathy, they may have trouble forming and maintaining healthy relationships.
They may believe they are entitled to special treatment or privileges without putting in the necessary effort or consideration for others.
Teens with NPD may use manipulation or coercion to control others and get what they want, often disregarding the feelings or boundaries of those around them.
They may react strongly to criticism or perceived slights, becoming defensive or hostile when their abilities or actions are questioned.
Teens with NPD may have grandiose fantasies of unlimited success, power, brilliance, or beauty, often exaggerating their achievements or talents.
Due to their belief in their own superiority, they may have difficulty respecting authority figures or following rules and boundaries set by others.
People with NPD might have difficulty understanding or relating to the emotions and experiences of others, leading to a lack of genuine empathy in their interactions.
They may expect special treatment or attention from romantic partners, friends, or family members, often feeling outraged if their needs are not immediately met.
Teens with NPD may manipulate others’ emotions for personal gain, using guilt-tripping, emotional blackmail, or other tactics to control or influence them.
While they may have many acquaintances, their relationships tend to be shallow and transactional, lacking depth or genuine emotional connection.
They may struggle to take responsibility for their actions, often blaming others or external circumstances for their mistakes or shortcomings.
If you have a teenager who is self-centered, demanding, and insensitive, you may wonder if they have narcissistic personality disorder. Having a narcissistic teenager can be very challenging and stressful. You may feel frustrated, hurt, or angry by their behavior. You may also worry about their future and their relationships. However, there are some strategies that can help you handle the situation effectively and support your teen’s emotional health. Here are some tips:
Your teen’s narcissism is not your fault, and it is not a reflection of your parenting. It is a result of their personality and their developmental stage. Try not to let their words or actions get to you, and don’t blame yourself for their problems.
Your teen needs to know that there are rules and consequences for their behavior. Be firm and consistent, and don’t let them manipulate you or get away with things. Explain what you expect from them, and what will happen if they don’t follow through. For example, you can say, “You need to do your homework before you go out with your friends. If you don’t, you will lose your phone privileges for a week.”
Your teen may crave admiration and validation, but you don’t want to feed their ego or make them feel superior. Instead of praising their intelligence, beauty, or talent, praise their hard work, kindness, or generosity. As an example, you could say, “I’m proud of how you studied for your test. You really put in a lot of effort.” or, “That was very nice of you to help your brother with his homework. You are a good sister.”
Your teen may have trouble understanding or caring about other people’s feelings or needs. You can help them develop empathy and compassion by asking them questions, sharing stories, or volunteering together. As an example, you can ask, “How do you think your friend might have felt when you canceled your plans at the last minute?” or, “How would you feel if someone did that to you?” You can also share stories of people who are less fortunate or who have overcome challenges, and ask your teen how they feel about them. You can also volunteer together at a local charity or community service, and show your teen how rewarding it can be to help others.
If your teen’s narcissism is causing serious problems in their life or yours, you may want to consult a mental health professional. A therapist can help your teen understand their behavior, develop healthier self-esteem, and learn coping skills. Therapy can also help you and your family deal with the stress and challenges of living with a narcissistic teen.
If your teen has NPD, you may feel overwhelmed and helpless. Your teen may need professional help to overcome their NPD and improve their mental health and well-being. That’s where Blume Behavioral Health can help. We are a quality mental health center for teens. Our residential treatment facilities provide tailored services for teens who are struggling with mental health challenges.
At Blume Behavioral Health, your teen will benefit from a comprehensive approach that includes:
Don’t let NPD ruin your teen’s life and your family’s happiness. Contact us today and get the help you need.
Daniel Duel MD is a board-certified psychiatrist specializing in General Adult Psychiatry with a focus on Addiction/Substance Use Disorders. As the Medical Director of an outpatient addiction clinic, he oversees a multidisciplinary team providing comprehensive care. He has extensive experience treating complex mood, psychosis, OCD, anxiety, and geriatric disorders. Dr. Duel is a UCLA graduate, trained in TMS and Cognitive Behavioral Therapy.
©2025 Blume Behavioral Health. All rights reserved.
