There are both obvious, surface symptoms of narcissism and less-evident, underlying personality traits of people with narcissism, or narcissistic tendencies. For example, a narcissistic friend might publicly exaggerate his achievements to others, but deal with a low self-esteem in private. He may expect praise from everyone, but secretly feel he doesn’t deserve it. Note that not everyone who exhibits narcissistic tendencies has narcissistic personality disorder or even diagnosable narcissism. Only a health professional trained in mental disorders and personality disorders can diagnosis a person with narcissistic personality disorder.
A narcissistic friend might see himself as superior to others, or in some way more special or better than others, and strive to make others recognize this and feel inferior to him. He may strive to be the center of attention and believe other people, whether family, friends, or co-workers, should follow his lead or plans. Sometimes, a narcissistic friend may exhibit extreme jealousy of others or believe others are jealous of him.
At the same time, a narcissistic friend might have a low or fragile self-esteem. He could have trouble accepting criticism, or he might feel embarrassed or ashamed of some aspect of himself or his life he doesn’t share. Usually, people with narcissism are easily hurt and feel rejection strongly. A narcissistic friend who doesn’t outwardly exhibit these symptoms might seem unemotional or somewhat detached. Yet, typically these are symptoms he keeps hidden from others, so his friends and even his family members might not be aware of them.
It is possible to show narcissistic personality traits without having diagnosable narcissistic personality disorder. From time to time, perfectly healthy people fantasize about having more power than they actually have, become jealous of others, or set unrealistic goals. Such behaviors don’t mean the people have a personality disorder.
Generally, people who do have diagnosable narcissism or narcissistic personality disorder showcase these attitudes or behaviors on a regular basis. They have symptoms of narcissism that impair their lives in some way. Their relationships or jobs suffer, they begin to abuse drugs or alcohol, or they entertain thoughts of suicide. So, a narcissistic friend may be one who sometimes takes advantage of others or doesn’t pick up on the feelings and emotions of others, but that doesn’t necessarily mean he has a full-blown diagnosable personality disorder. He simply could have narcissistic traits or a type of subclinical narcissism.
Treatment for narcissistic personality disorder is usually a blend of psychotherapy and medication. Yet, suggesting a narcissistic friend see a doctor isn’t like suggesting a friend who’s just broken his hand visit the emergency room. Unfortunately, mental health stigma and other social nuances still prevent many people from seeking treatment. Still, if certain symptoms or side effects of the narcissistic traits arise, such as depression, substance abuse, or suicidal thoughts, it’s crucial for the friend to seek help. In situations with such extreme symptoms, family members and other friends might consider an intervention.