What's The Difference Between Self-Esteem & Narcissism?

produced by Anna Jay; photographed by Eylul Aslan; produced by Meg O'Donnell.
The word "narcissist" gets thrown around a lot. Certainly in the past year or so, we've seen it used to describe people like Donald Trump and Kanye West. But you've probably used it to describe your ex who still slides into your DMs every now and then.While the term can be used informally to describe someone who thinks the world revolves around them, narcissism is also a diagnosable personality disorder. So how do you tell the difference between the two?
Emily Grijalva, PhD, assistant professor at the University at Buffalo School of Management and faculty expert on narcissism, says that narcissistic personality disorder is "the very extreme form of a personality trait of narcissism."
In other words, some people might have narcissistic personality traits (being self-involved, needing attention or admiration), and that can be normal. After all, who among us hasn't felt a little self-important or highly confident now and again? But an actual personality disorder, where someone has an overly exaggerated sense of their own importance, is something that needs to be diagnosed by a clinician. And for people who have it, narcissistic personality disorder causes problems in a lot of areas of their lives.
"If it causes distress to the patient, interferes in their love life, work life, or some aspect of their life that’s problematic for them, that’s when it becomes a personality disorder," Dr. Grijalva says.
For example, she says, someone who has narcissistic personality disorder might have a hard time holding down a job because they have unrealistic ideas about their own self-worth that don't correspond to how other people see them.
Narcissistic personality disorder might also cause someone to think they're superior to everyone else and only associate with equally "special" people, insist on having the best of everything (like the corner office), or take advantage of people to get what they want.
And while, as Dr. Grijalva says, it's an extreme form of having narcissistic qualities, it's a complicated disorder that takes thorough psychological evaluation to diagnose.

Narcissistic personality disorder is the very extreme form of a personality trait of narcissism.

Emily Grijalva, PhD
However, Dr. Grijalva says that narcissism isn't frequently diagnosed, for a lot of reasons. For one thing, she says it often coexists with other disorders, such as bipolar disorder or borderline personality disorder, and doctors might diagnose another disorder before they would narcissism.
"It could also be that narcissists don’t consider themselves to have a problem that they need to have diagnosed," she says. "These are simply not people who are going to seek treatment, because they think they’re amazing and awesome. It’s just the people around them who think they have a problem. And they also probably wouldn’t be very amenable to making changes in the long run."
It makes sense, then, that a report in 2010 examining seven studies about the prevalence of narcissistic personality disorder found that roughly 1% of the adult population lives with it. According to MayoClinic, if people with narcissistic personality disorder do seek help, it's usually for mental health disorders, such as depression, or drug or alcohol use. And while causes for narcissism aren't known, it's usually treated with talk therapy to help those who have it to understand their emotions, and to have better relationships with the people around them.
So while we might throw around the term narcissism conversationally, it's important to remember that it's also a complicated condition, and there's a line between occasionally thinking you're hot shit and having a full-blown personality disorder.

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