It is easy to mistake the presenting symptoms of certain anxiety disorders with pathological narcissism. Both types of patients are worried about social approbation and seek it actively. Both present a haughty or impervious facade to the world.
The Stark Difference
They need someone to stroke their ego so that they are able to exert some sense of control once more. By contrast, the person with anxiety will also have a lower sense of self-worth, but they don't need anyone to stroke any egos.
Substance use disorders, trauma responses, and low self-worth may, at times, also mimic trait narcissism or even NPD.
In short, people with Social Anxiety Disorder attack themselves in response to social criticism. Narcissistic Personalities immediately attack the person making the criticism. They're both “hypersensitive” in social situations.
A person who is confident will often be more concerned with the needs of others than they are with him or herself. Narcissism, on the other hand, often involves the inability to see beyond oneself. However, this doesn't necessarily mean that a person with narcissism personality disorder always thinks highly of himself.
Researchers at Washington University in St. Louis found that most narcissists are actually aware that they are narcissists, but rather than see it as a problem, they embrace it and take pride in it. (Of course.) However, a self-aware narcissist can get help through psychotherapy, if they are willing to do it.
People with covert narcissism may be more likely to have anxiety or depression than people with other subtypes.
Both overt and covert narcissism can manifest depression symptoms and nuanced symptoms related to NPD such as rage, insomnia, hostile sentiments, and narcissistic injury. Covert narcissistic depression symptoms can also include depression due to unprocessed emotions.
Difficulty with depression and anxiety
Anxiety and depression are much more common with covert narcissism than overt narcissism, but it might also be much more obvious.
While some people may exhibit narcissistic traits occasionally and mildly, a pathological narcissist will routinely use destructive narcissistic tactics in order to gain false superiority and exploit relationships.
Mild: A mildly narcissistic person might be egotistical or boastful about their accomplishments but still function well in society.
While most people with NPD are not aware that they are narcissists, it's important to remember that no abuse is acceptable or excusable.
Narcissists have to be the best, the most right, and the most competent; do everything their way; own everything; and control everyone. Narcissists constantly need attention—even just by following you around the house, asking you to find things, or constantly saying something to grab your attention.
Use Self-Deprecating Tactics
Among many other things covert narcissists do, a hallmark of their eccentricity is using false humility or self-deprecating comments to garner people's attention and seek validation. They trivialize their skills and accomplishments, so people reassure them or shower them with praise.
A study from 2018 found a positive association between pathological narcissism and anhedonia, providing one more commonality between depression symptoms and symptoms of narcissism. In another study from 2020, researchers found a link between pathological narcissism and depression when it came to unprocessed emotions.
Rumour has it that SSRI's (such as Fluoxetine, known as Prozac) might have adverse effects if the primary disorder is NPD. They sometimes lead to the Serotonin syndrome, which includes agitation and exacerbates the rage attacks typical of a narcissist.
Rejection
Rejection causes major narcissistic injury and is one of the top 10 things narcissists fear the most. They can't handle it, even if it's a tiny slight. Remember, they have a sense of entitlement and pride themselves on being the ones who reject and discard their victims.
Overt vs. Covert Narcissists
So do covert narcissists know what they are doing? While they may be aware on some level that their behaviors have a negative impact on other people, narcissists also tend to lack self-awareness and insight.
Clinical Covert Narcissist husbands are often passive-aggressive. Like the overt narcissist, they may act attentive to what their wives want. However, they'll seldom spontaneously show interest in a sincere or sustained way. They'll "forget" their wife's work weekend trip (planned months in advance...).
“To what extent do you agree with this statement: 'I am a narcissist.'”
They physically abuse pets.
If a narcissist's dog has urinated on the carpet while the narcissist was out, the narcissist sees it as a personal affront—even though the narcissist left the dog alone for 12 hours. The narcissist then hits the dog and calls it names. The dog learns to fear the narcissist.