Uncovering the Complexity of Narcissistic Personality Disorder in Women

NPD in females can be a complicated mental health issue, having potentially serious consequences. It often manifests through grandiosity, entitlement, and manipulation patterns that can be difficult to recognize without proper knowledge or experience.

While NPD affects both men and women, the symptoms may present differently for each gender due to societal expectations and norms surrounding femininity. For this reason, it is essential to understand how it is presented in women so that effective treatment plans can be created accordingly.

We will explore the diagnosis process and available treatment options tailored explicitly toward female individuals with NPD while providing helpful coping strategies for those affected by the disorder.

What is Narcissistic Personality Disorder (NPD)?

Young Woman With Narcissistic Personality Disorder

NPD is a psychiatric condition marked by an outsized self-view, grandiosity, and entitlement; individuals with it often lack compassion and struggle to form strong bonds. As a result, people with NPD often lack empathy and have difficulty developing meaningful relationships.

It is believed that the prevalence of NPD may be higher in women than men, with an estimated 1-6% of the population being affected.

NPD is characterized by grandiose behaviour, a craving for admiration and an inability to empathize with others, which can cause significant distress or impair functioning in adulthood.

People with NPD often display a shallow emotional range, exhibiting indifference or contempt towards those who do not meet their standards. Individuals with NPD often can be fixated on fantasies of triumph, and anticipate being treated as exclusive or unique by others.

Female narcissists tend to they may exploit others for personal gain, be arrogant and envious of others’ successes, and feel entitled to superiority. Furthermore, they are hypersensitive to criticism or rejection.

Studies suggest that certain genetic predispositions may increase susceptibility to the condition, while environmental elements such as parenting techniques could also influence its formation. Some studies suggest that alterations in brain chemistry may contribute to narcissistic tendencies; however, more research is necessary to make definitive conclusions.

NPD is an intricate and severe psychological affliction that can have significant repercussions on the lives of those impacted by it. Therefore, diagnosing NPD to provide effective treatment accurately is crucial, so let’s explore what diagnosing this disorder looks like for women specifically.

Key Takeaway: People with Narcissistic Personality Disorder exhibit an inflated sense of self-worth and entitlement, though its exact causes are yet to be determined. It’s caused by genetic predisposition and environmental factors such as parenting styles.

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Diagnosing NPD in Women

It can be tricky to recognize NPD due to the many different signs and actions that come with it. To accurately diagnose NPD in women, clinicians need to understand the diagnostic criteria and consider any potential differential diagnoses. In addition, co-occurring disorders are common among individuals with NPD, so these should also be assessed during diagnosis.

For a diagnosis in women to be made, the DSM-5 criteria must be met. Grandiosity, an inflated ego; obsession with power or triumph; craving admiration from others; incapacity to empathize with other people’s feelings and emotions, such as anger or envy; and a sense of entitlement – these must all be present for NPD diagnosis in women.

These traits must lead to significant distress or impairment before being diagnosed.

Differential diagnosis considerations when diagnosing NPD in women include other personality disorders, such as histrionic or BPD, which share similar characteristics but differ from NPD. Additionally, substance use disorders may mimic specific symptoms associated with narcissism, so they should also be considered when diagnosing.

Many individuals will experience co-occurring issues such as depression or anxiety, which can further complicate diagnosis and treatment planning for this population group.

Consequently, healthcare providers must assess for any other potential issues when diagnosing a person with NPD to guarantee they receive complete care during their treatment.

Key Takeaway: DSM-5 criteria must be met when evaluating female patients, and any other potential coexisting diagnoses should be considered. It is essential to assess for additional issues as these can further complicate diagnosis and treatment planning for this population group.

Treatment Options

Psychotherapy is the primary form of treatment for NPD in women. CBT has been proven advantageous in moderating symptoms of NPD, such as arrogance, prerogative, jealousy and insensitivity. In CBT sessions, individuals learn to recognize their distorted thinking patterns and replace them with more realistic beliefs about themselves and others.

Other psychotherapies modalities, such as Dialectical Behavior Therapy (DBT), Interpersonal Psychotherapy (IPT), Schema-Focused Therapy (SFT), Acceptance & Commitment Therapy (ACT) and Eye Movement Desensitization & Reprocessing (EMDR), can be beneficial in aiding women with NPD to gain insight into their behaviour patterns while developing healthier ways of coping.

All these approaches help individuals gain insight into their behaviour patterns while developing healthier ways to cope with stressors or difficult emotions.

Medication management may also be necessary for some cases of NPD in women. For example, selective serotonin reuptake inhibitors (SSRIs) or lithium, used as antidepressants and mood stabilizers, respectively, can assist in alleviating the psychological distress that often accompanies narcissistic tendencies.

It’s important to note that medication alone will not treat the underlying causes of narcissism, but it can provide relief from related psychological distress, so other therapies are more effective.

Finally, self-care strategies are essential for managing symptoms of NPD in women. For example, self-compassion exercises like mindful meditation can help reduce shame or insecurity by reminding us that we all make mistakes from time to time and deserve love despite our imperfections.

Regular physical activity has also improved self-esteem while providing a healthy outlet for stress relief when needed most – something especially valuable when narcissistic behaviours become overwhelming or destructive towards oneself or others around them. Regularly engaging in creative activities like writing poetry or painting helps cultivate a connection between mind and body, further supporting emotional well-being over time.

Treatment options are available so that an individualized approach can be tailored to each person’s unique needs. Realizing the potential effect of gender on NPD, it is feasible to identify beneficial assistance and craft successful tactics for managing it.

Key Takeaway: CBT is the go-to approach for treating female NPD, with potential adjuncts such as medication and self-care strategies. Through these therapies, individuals can gain insight into their behaviour patterns while developing healthier coping mechanisms to manage stressors or difficult emotions.

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Women coping with Narcissistic Personality Disorder may face difficulties which are exceptionally particular to them. Therefore, it is important to understand the impact of gender on experiencing and treating NPD to manage symptoms and find supportive resources effectively.

Women may experience heightened guilt, shame, insecurity and self-doubt compared to men. They may also be less likely to seek professional help due to fear of judgment or stigma.

They may struggle more than men when understanding how their behaviour affects others, making them less likely to recognize that they need help managing their disorder. Therefore, we must identify the disparities between genders to acquire suitable therapy and aid.

Navigating NPD can be challenging. By comprehending the effect of gender on managing and encountering this disorder and searching for encouraging resources to help regulate symptoms, women may take constructive steps toward dealing with their condition.

With early intervention strategies such as identifying risk factors and warning signs of developing NPD, it is possible to prevent or reduce the severity of this disorder in women.

Key Takeaway: Women with NPD may be more prone to shame, guilt and insecurity than men due to gender differences. Women with NPD must comprehend the ramifications of their condition on themselves and others to access appropriate care and aid – they necessitate assistance navigating this intricate landscape.

Prevention and Early Intervention Strategies

Identifying and recognizing the associated risk factors and early warning signs can be essential to successful treatment outcomes. Recognizing possible danger signs and indicators of the development of NPD in women is crucial to preventing or reducing its effects. In addition, identifying the need for expert assistance early on is essential to achieving successful treatment results.

Risk elements connected to the emergence of NPD may include parental narcissism, childhood adversity, being nurtured in a milieu that encourages such behaviour and past substance abuse or other mental health problems.

Warning signs to look out for when it comes to possible struggles with narcissism include boastful behaviours like bragging about achievements, overstating accomplishments, expecting special treatment from others; lack of empathy towards the feelings and needs of others; hypersensitivity to criticism or rejection; self-absorption; shirking responsibility for their own mistakes or those made by people they are responsible for managing/supervising etc.


Narcissism is characterized by grandiosity, entitlement, and an excessive need for admiration. Signs of narcissism in females may include arrogance and a sense of superiority; being overly focused on physical looks; an incapacity to be sympathetic or considerate towards others; having trouble with criticism or failure; and being unable to create deep relationships. Narcissistic behaviour can also manifest in manipulation tactics such as gaslighting or guilt-tripping. If you are concerned that someone close to you has narcissistic traits, it's important to seek professional help from a qualified mental health practitioner.

A narcissist woman may exhibit an overinflated sense of self-worth, demand excessive adulation and focus on their own needs while disregarding those of others, have difficulty controlling emotions such as jealousy or rage, and be obsessed with ideas of grandeur. Additionally, they often exploit people to get what they want and cannot recognize boundaries.

According to a National Institutes of Health study, approximately 6.2% of women have been diagnosed with a narcissistic personality disorder.

Although these figures may not accurately reflect all cases due to a lack of awareness or access to mental health services, many individuals likely remain undiagnosed.

No significant distinction has been revealed between genders in the rate of narcissistic personality disorder. Although research has not demonstrated a significant difference in prevalence between genders, some studies indicate that women may have a higher rate of narcissism than men.

A female narcissist may be more prevalent among women than men; however, further research is needed to confirm this hypothesis.


Those suffering from NPD should seek assistance from specialists familiar with treating this condition, as it can be managed through appropriate treatment and support. Recovery is achievable with patience, understanding, and compassion towards oneself or loved ones suffering from NPD.

Take the first step towards a healthier you and book an appointment with Well Beings Counselling today. Our experienced team can help you identify, manage, and overcome Narcissistic Personality Disorder in Women through our comprehensive range of counselling services.

Pareen Sehat MC, RCC

Pareen Sehat MC, RCC

Pareen’s career began in Behaviour Therapy, this is where she developed a passion for Cognitive Behavioural Therapy approaches. Following a Bachelor of Arts with a major in Psychology she pursued a Master of Counselling. Pareen is a Registered Clinical Counsellor (RCC) with the BC Association of Clinical Counsellors. She specializes in CBT and Lifespan Integrations approaches to anxiety and trauma. She has been published on major online publications such as - Yahoo, MSN, AskMen, PsychCentral, Best Life Online, and more.

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