Narcissistic Personality Disorder: Differentiating It From Self-Confidence - Promises Healthcare

Narcissism and high self-esteem – how can we tell them apart? It may be difficult to tell if someone is self-absorbed or rightfully self-assured as they may present in a similar manner. Confidence is extremely important in helping one set the foundation for a healthy way of living, promoting personal growth, success, and a sense of fulfilment. On the other hand, a narcissist’s self-absorption would hinder said personal growth, and such a way of thinking enables a toxic lifestyle.

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM V), Narcissistic Personality Disorder (NPD) is defined as comprising a pervasive pattern of grandiosity (in fantasy or behaviour), a constant need for admiration, and a lack of empathy, beginning by early adulthood and present in a variety of contexts. For one to be diagnosed with NPD, the individual must fulfil the following, as indicated by the presence of at least 5 of the following 9 criteria:

  1. A grandiose sense of self-importance
  2. A preoccupation with fantasies of unlimited success, power, brilliance, beauty, or ideal love
  3. A belief that he or she is special and unique and can only be understood by, or should associate with, other special or high-status people or institutions
  4. A need for excessive admiration
  5. A sense of entitlement
  6. Interpersonally exploitative behaviour
  7. A lack of empathy
  8. Envy of others or a belief that others are envious of him or her
  9. A demonstration of arrogant and haughty behaviours or attitudes

However, not everyone with NPD will get a clear diagnosis from a mental health professional. It is rare for someone with NPD to commit to seeking help, openly talk about their thoughts, or even attend a therapy session. Here are some points to consider when wondering if someone is confident or narcissistic.


Are they self-focused?

A narcissistic person may be obsessed with grandiosity, fantasising about achieving unlimited power, acceptance and resources, so much that they believe they deserve it more than others. As such, narcissism can be associated with the need to dominate others. However, a person with a healthy self-esteem will be inclined to establish deeper relationships with the people around them. Narcissism involves the inability to see beyond one’s self-interests, while self-confidence extends beyond self-focus, and to the needs of others.


Do they have a strong sense of entitlement and a tendency to exploit others?

As we have explored, people with NPD might feel they deserve more than others and have a strong sense of entitlement. This can manifest as the tendency to manipulate and exploit others to achieve their desires. Tactics such as spreading lies about others to get ahead are common, as they put personal gain above everything else.


Do they crave affirmation?

Praise, attention and affirmation are important to a narcissistic individual. With the need to fuel their sense of specialness, they may crave a constant expression of admiration and praise from others. Of course, we do not deny that everyone needs to be affirmed and encouraged to build self-confidence. However, unlike truly self-confident individuals, narcissists are hyper-sensitive to such attention and crave continual affirmations for emotional stability. Without them, they may feel disconnected, and even resent those who don’t think what they’re doing and saying is exceptional.


Do they have difficulty accepting constructive criticism? 

Despite the sense of specialness and outward sense of superiority, people with NPD may in fact struggle with pervasive feelings of insecurity. A subtype of NPD, covert narcissism,  can enable one to be defensive and over-sensitive to criticism. While the criticism may be a constructive one, they may treat it as a personal attack and react strongly against it. Their replies may be laced with contempt or passive-aggressiveness. This helps them seek relief and protect their self-esteem. 


How do they respond to success?

We are all prone to a little envy when we compare ourselves to people of higher social status or with greater achievements – but how we manage this sense of envy sets a confident person and a narcissist apart. In order to uphold their image and take the spotlight, a narcissist might put others down and attribute their successes to luck or financial background instead of acknowledging their skills or character. Moreover, these may be baseless comments. In contrast, while a self-confident person may also feel envious at times, they are less likely to dim someone else’s light in order to prove their worth. 

Hence, for persons with NPD, why is it important for them to seek therapy? Narcissism is found to be associated with externalising behaviour, including alcohol or substance abuse, antisocial behaviour, and aggression. These can lead to an unhealthy lifestyle and can be detrimental in the long run if no proper treatment is received. 

While the pointers in this article may act as a guideline to help you differentiate between a confident person and a narcissist, a diagnosis for NPD should be left to trained mental health professionals only. While it may be tempting to label someone with a personality disorder or to make judgements with such information, the presentation of mental health conditions goes far beyond a few attitudes or behaviours. If you believe a family member or a close friend is in need of an assessment and therapy for NPD, feel free to contact us for more information

You might also be interested in reading about what being in a relationship with a person with Narcissistic Personality Disorder is like, in our previous article: Healing from being with a persona with Narcissistic Personality Disorder.


  1. (Accessed 19/07/2022)
  2. (Accessed 19/07/2022)
  3. (Accessed 19/07/2022)
  4. (Accessed 19/07/2022)