Narcissist or ADHD?The Surprising Truth No One Is Talking About
Artwork: Jake Baddeley
Narcissism. The trendy hot topic of the day.
But just how accurate is what your hearing?
Toxic relationship?
What’s the solution?
Breakup and go ‘no contact.’
That’s it in a nutshell.
In this essay, I will explore the facts compared to some of the fluff floating around about narcissism. I will dive deep into why ADHD is often misdiagnosed as NPD and explore the challenges and consequences of this phenomenon.
By the end of this article, you will gain a more equanimous and compassionate understanding of a loved one (past or present), free from sensationalized judgments and damaging stigmas.
The research is clear but not as sensational or exciting as the last emotionally charged REEL spinning anecdotal opinions confabulated with facts.
The story about narcissism vs. pathological narcissism by the psychotherapists and psychiatrists pioneering treatment for Narcissistic Personality disorder tells a very different story than what’s trending.
I am not a therapist, coach, or guru. Although, I am challenging the mainstream narrative because I know I am not alone in these observations.
I will explore the nuance and complexity of Narcissism. Requiring more than a dilettantes effort simply scrolling for validations served up by an algorithm and a self-styled expert who deleteriously slaps a one size fits all “Narcissist” label on any boyfriend/ girlfriend acting imperfectly.
Please remember as you read that this article is not intended to invalidate abuse or be dismissive toward trauma.
On the contrary, I hope to contribute my thoughts based on my hard-won experience and the deep dives into the literature I have taken along my journey.
As someone who understands firsthand the devastating long-term impact chronic physical and verbal abuse can have and how tempting it has been to fall prey to victim identity and project blame.
I had to see the abuser in me and the victim in me to heal and integrate the two in order to see the whole picture. To start ‘Becoming a Person’ as Dr. Carl Rogers titled one of his books.
To integrate the parts into a contiguous whole filled with pleasure and pain is the essential process of integration.
Layers, textures, and angles to see yourself inside the kaleidoscope of your life.
We go in and out of focus. We find wonder in the turning dial. The novelty of sequences fluidly shifting pixel-painted dots coloring our lives right before our eyes.
In doing so, I increase my capacity for compassion for myself and others.
By remembering there is a human behind every dysfunction, and if there is dysfunction, then there is someone suffering.
Many Branches, Same Root.
By truncating very complex topics into the following over-simplified summary, we can build a new empathetic map of those we hurt and those who hurt us.
When this happens, we can take the essential step toward empowerment and eliminating the crippling effects of victim identity.
This moves the mind-body into a more resilient or even an Anit-Fragile mode where you expand, enlarge, and increase through adversity. (Taleb 2012).
From this reframe or state of mind, we can become more adept at successfully working with each other’s strengths and weaknesses.
A paradigm shift might occur where committed relationships become an almost transcendental path or spiritual crucible in our quest for growth, freedom, expansion, and personal sovereignty.
Most negative acting out or reactive abuse in its various forms presenting as triggers, mood, or personality disorders is a response to eliminate present-moment felt anxiety rooted in an outdated survival system formed from childhood trauma. (Mate, Johnson, Brown, Smailes, Bernstein et al).
In other words, many expressions have the same root cause.
Today, we are failing at relationships. That’s no secret.
As much as we are evolving in one direction, we are devolving in the area of long-term relationships.
We are getting better at breaking up and not staying together.
57% of single adults are not looking for a relationship or dating. — Pew Research
Some of this pair bonding disruption is good. Breaks apart the calcified parts, squeaky parts, abusive parts, unconscious parts, and the stereotyped roles past and present.
Instead, we should focus on the ‘ how to’ relationship.
Novel idea, no?
Was for me.
It’s a good ‘ole fashioned skill, not a mystery sent by a new self-care cupid.
By making the disciplined effort to learn new relationship skills such as non-violent communication, emotionally focused communication, trigger control, assertiveness techniques, and active listening, you can empower yourself to get what you emotionally need by meeting your partner’s emotional needs and inviting them to join you.
Emotional needs get met by all, anxiety drops, calm minds, centered hearts, and dysfunction recedes into the sunset.
And maybe you’ll consider learning new relationship skills to bring value to your partner, build better and be a better person.
Labeling someone as a ‘Narcissist’ in our current climate who is not NPD is a death sentence for the relationship and traumatizing to the labeled.
It Was For Me.
But just how accurate is diagnosing someone by proxy?
Not as good as your spinning head and hurting hearts are hoping, I’m afraid.
If we all step off the grandiose ledge of pointing fingers at “Narcissists” with vitriol and resentment for a moment and consider the following true statement:
Neurotypical people (without a disorder) have affairs, lie, act out, get angry, overreact, act grandiose, gaslight, and manipulate at times.
So do people who have mood disorders and personality disorders.
How do you know if they are true “Narcissists.”
YOU DON’T.
You may think you do because you are keying in on narcissistic traits from memes or REELS, but that does not make someone a “Narcissist.”
And there is no online coach teaching you about narcissism and no contact capable of diagnosing someone by proxy.
Blanket labels cast by third parties without a clinical diagnosis are highly unethical and rampant across social media.
I don’t care how well matched you think you are at connecting the dots between your partner and the memes and REELS.
This is not how it works Diagnosis is done by licensed doctors, period.
To think you can diagnose someone by proxy is like believing you can perform open heart surgery after watching “A Heart Coach” dancing with a scalpel to some funny background tune on social media. Whoever resonates with your desire to be a heart surgeon and scrolling REELS does not mean you are remotely qualified to slice your boyfriend’s chest open and rip out his heart. This is delusional, narcissistic and would land you in jail.
But that is exactly what coaches are doing and the people who follow them are attempting.
Unethical and highly grandiose to say the least.
But you say, “but they did narcissistic things.”
Sure.
That does not make someone a pathological narcissist or NPD.
And anyone not diagnosed with NPD can readily change and learn skills when motivated.
Even more promising is that people diagnosed with NPD are showing remission and recovery through Transference Therapy.
Led by a team of psychoanalysts, psychiatrists, and psychologists such as Frank Yeoman, Dianne Diamond, and Otto Kernberg — the man who coined the term Narcissist Personality Disorder.
I went through a devastating breakup with a girl (almost fiancé) about a year and a half ago.
I was crazy about her. We were compatible on many levels. The kind of compatibility that made being together easy and fun. Except for the parts when it wasn’t. Sound familiar?
She and I were both triggered by things we were doing that hurt each other. Did we know how to work with each other’s triggers or our own?
No.
Were there disordered behaviors marked by Red Flags?
Yes.
I was emotionally reactive when triggered.
And I have learned that most of my overreactions were reactive abuse I did not intend.
What I intended was to work things out but acted out at times in ways that was confusing and highly dysregulating for her.
Real and Reactive forms of abuse can feel the same to the recipient’s nervous system.
I was feeling judged, labeled, and emotionally distanced.
Stonewalling is one of the four deadly horsemen that kill relationships, according to leading relationship psychologist John Gottman.
Thus, it increased my anxiety which increased my mansplaining and elevated tone at times. Unhealthy bids for connection. But bids for connection nonetheless.
My reactions confirmed her fears which — I could feel.
In turn, this caused her more dysregulation and emotional stonewalling, which turned to ‘grey rocking’ that made me even more anxious, and so on.
Triggers and Power Struggle
I wanted us to work.
We had the values and compatibilities.
We also had things to forgive and dysfunction to work through.
In other words, things were getting real.
We were teetering on the edge of the power struggle stage and the acceptance stage.
Preventing us from entering the commitment and bliss stages as described by Dr. Susan Campbell in her book, The Couples Journey, Intimacy as a Path to Wholeness.
Her back story wasn’t perfect, and mine wasn’t either.
Who’s is?
I wanted to learn, work, and grow together.
Instead, I attacked her beliefs that seemed incompatible with creating a healthy long-term relationship.
Maybe they do, maybe they don’t. Black and white is not the point — at all.
We both were triggered keeping us stuck in our Fight or Flight sympathetic nervous system.
You can not see or hear the other person’s emotional needs when you’re in survival mode.
Instead, you see someone like your ex who abandoned you over and over or you see a threat… a narcissist.
Who Am I?
You edit my life, and according to her friends and people who have never met me, had all the information needed to “diagnose” me.
Listen, I do not fault them. Everybody is doing the best they can with what they have.
Nonetheless, I was Scarlet Lettered.
I was labeled.
Then discarded.
No Contact.
Ghosted.
Why?
I’m a “Narcissist.”
Doesn’t matter the opinion of my therapist I have seen for over a year or all the assessments I have taken.
I was going through a stressful transition, and I know I put too much (toxic) pressure on her emotionally. Admittedly, I was emotionally immature but I have the capacity to see my wrongs, drop my defenses, die from remorse, and learn new skills.
I am determined to see my failures and read every book, live my purpose and be an amazing husband and father one day.
I didn’t know how to validate her and how essentially important that is to support your partner’s autonomy from a place of grounded gentle compassion.
By the time I was learning this, it was too late.
I wanted her to soothe my anxiety, and her surrendering to my controlling efforts would be evidence of her love for me, calming my nervous system.
I wasn’t changing to meet her needs.
She wasn’t changing to meet mine, either.
I didn’t know how.
She didn’t know how either.
If we both became vulnerable and honest, we would be letting down our defenses and retiring long-established protector parts (IFS) that don’t want to go quietly into the night.
You got to be in a relationship to get good at relationship.
It’s complex, but not all that complicated.
First, I needed to do deep emotional work.
Not spiritual bypassing or biohacking, or plant medicine.
I’m talking about digging in and confronting the agony of seeing your great parents as not so great.
Sort it out in yourself, process the roller coaster of emotions, and integrate the wounded boy with the present man.
Then press on into the intensity of feeling big remorse, making room for even bigger empathy.
And not stop until you learn new skills and get the tools to build better.
It’s sweaty, grueling, laborious, heart-wrenching, ugly, sobering, exciting, hard, and enormously rewarding.
I don’t want to get better at breaking up; I want to get better at staying together — with one person, every day, good and bad, for all my days.
That is a message I think many people are hungry to hear.
My Triggers blinded me.
Maybe yours are too?
Neither of us knew the skills to repair the ruptures effectively.
In turn, creating more anxiety around her feeling emotionally dysregulated, which triggered me more which triggered her more.
As a result, the toxic cycle spools up.
Spiraling down we went.
Antithetical to the hyper-sensational propaganda being proffered today.
Some believe Triggers are a reenactment of childhood trauma and are a natural process of unhealed wounds surfacing. (Masters 2018)
The triggers bring the Parts of ourselves Richard Schwartz, creator of Internal Family Systems, would call the ‘protector parts’ and ‘firefighter parts’ to the surface.
Some “Parts” people will not see in our non-intimate lives.
Only intimate partners get to see the deepest, most closely guarded protector and firefighters’ parts.
Since the ego tangles all the parts together, we perceive our partner as the ‘part,’ To make matters worse; we project the parts we can’t see in ourselves onto them as partners.
This is why intimacy is such a unique place.
It forces us to face our fears and deepest childhood wounds and grow or lose the person we’ve bonded with.
And with every breakup, those protector parts that sabotage our deepest desires to protect a traumatized inner child get better at their job, making their abode a little deeper in our minds until we no longer see them.
We only see the person in the mirror.
Hook-Up Culture and Break-up Culture See It Differently.
The common belief is today is, “my partner is an object whose purpose is to make my feelings feel better.”
You must break toxic bonds if they no longer feel good.
Hogwash.
The pain to grow or the pain to leave?
The pain was good for me. I sought growth and healing harder than ever before.
It was a catalyst for one of if not the most important pivotal points in my life.
Rather, heartbreak can be used to break free of the fear all these coping mechanisms are hiding behind.
Why?
Because I loved her.
The gravity of a love bond (toxic or not) is the glue that helps us stick through to help heal each other on a mutual journey of attuning to the other while repairing rupture and earning secure attachment.
Over time our nervous system and neural pathways become connected to an alarm from those childhood traumas.
But if we work together by earinging secure we re-pattern our nervous system to feel safe and our partner feels like healthy and the relationship is no longer toxic.
Our mind-body connection will relearn to know and see our partner as safe.
Together (not alone) as a team, you have helped heal each other.
By earning secure attachment.
The felt experience is a changed reality.
You see, you have power.
Your partner has power.
The power to grow together.
What To Believe?
‘Earning secure’ as it is called, is hard to achieve when any combination of behaviors, including past traumas, attachment styles, mood, or personality disorders, is at play.
Especially in our Narc blaming culture today, interpreting every infraction as the death diagnosis of a relationship — narcissist and victim.
Two roles, Two actors playing parts.
Two ego identities.
Not two complex humans full of nuance and novelty.
The false info spewed by many of these poorly informed coaches emphasizes that narcissism is fatalistically evil and untreatable.
This is patently false and a gross confabulation.
Fact. People with narcissistic presentations range from healthy narcissism to unhealthy (pathological) narcissism or Narcissistic Personality disorder.
Deflate The Balloon.
The devil, I mean, data is in the details.
According to Pew Research, there are approximately 12MM males between 30 and 50 years old who are single in the USA.
According to the DSM IV-TR, Narcissistic Personality Disorder (NPD) is diagnosed in between .05% — 1% of the general United States population. The DSM-IV-TR tells us that most people diagnosed with NPD (50–75% of all patients) are men. 3.
Let’s use the higher probability and say 1% of 12MM 30–50 single and dating men may have NPD.
That’s only 120,000 eligible men who might be diagnosably NPD.
According to Pew Research, there are approximately 8MM females single between 30–50 years of age.
In other words you may date one guy with NPD out of every 66 guys you date.
Now if you only are dating guys who make at least $100,000 per year your probability of dating a guy with NPD goes to approximately 1 out of every 666 guys you date.
You only date guys who earn $100k per year, and are 6' feet tall or taller your chances of dating someone with NPD is approximately 1 in 6,666 guys.
According to the litany of self-styled coaches and sometimes misinformed therapists, the picture painted across their grid obfuscates the facts.
What I have seen across “Narc Coaches” is masked outward-facing resentments now being used to sell their online courses.
In other words, they’re capitalizing on followers’ vulnerability and need for validation.
Shame-blaming humans by ubiquitous labeling of behavior is a form of socially sanctioned passive-aggressive behavior.
This shotgunning mass pejoratives online obliterates the truth by misjudging, mislabeling, and objectifying humans — ultimately creating paranoia.
Distorting perceptions of a complex human who may need skills just like you.
Pause.
Yes, think about it.
Many of the “coaches” are spewing passive-aggressive soundbites.
They’re still full of resentment and want to enlist you into their program while giving them adulation in the form of follows, comments, likes, and buying their online course.
Shame-blaming humans by ubiquitous labeling of behavior is a form of socially sanctioned passive-aggressive behavior.
This shotgunning labels with mass pejoratives online obliterates the truth by misjudging, mislabeling, and objectifying humans — ultimately creating paranoia.
The coach as the savior, the follower as the victim, and the ex is the persecutor. In other words the manipulative Karpman Drama Triangle (Triangulation) is at play.
Watch this video by Prof. Sam Vanknin discussing ‘predatory triangulation’ as it relates to his first-hand experience with self-styled expert Richard Grannon.
When I read or listen to the clinical experts on narcissism, they don’t sound or talk anything like these people.
People such as Frank Yeoman, Joan Lachkar, Dainne Daimond, Otto Kernberg, Elsa Ronningstam, Ross Rosenburg, Neville Symington, Stephen Aeternburn, and Praticia Kuhlman, to name a few.
Common Ground
A child experiences trauma in the formative years from 0–6. Mom is not a secure base (Bowlby & Mahler); divorce, abuse, you name it.
The child adapts in one of two ways to overcome the obstacle.
One solution:
A child may take a narcissistic path and goes up and over the obstacle.
If the child’s environment doesn’t allow their trajectory to level out in the healthy range, his flight pattern will continue too far and become pathological.
Second solution:
A child may take a passive, compliant, submissive path.
According to some psychologists, if a child attempts narcissism as a solution and fails, that child may find a Borderline Personality strategy as a solution.
Explaining the high right of co-morbid behavior between NPD and BPD. Up to 40% of untreated people with BPD meet the criteria for NPD.
Two different adaptive solutions children form to survive in their environment.
Both stem from the same root cause.
But what it takes to understand a pathological untreatable person vs. someone like me, who learned bad habits from a narcissistic father growing up competing in sports, an entrepreneur at 23 and battling to make it in a selfish narcissistic world, is very different from what the trend leads people to believe.
I had a secure attachment via an emotionally attuned stay-at-home mother who mirrored me and was a constant safe base.
Critical features to forming a core self, empathetic capacity, and ability to change.
I feel the full range of emotions, empathize deeply and can be introspective enough to see myself through my girlfriend’s eyes.
I came out of the fog alone and with help from my wonderful therapist, Chris.
Pot Calling the Kettle Black.
And that is precisely what is going on.
There are enough emotionally charged memes and people preaching from their social media pulpit, casting a net so wide that any fish who has suffered ruff waters could potentially be with a “Narcissist.”
Some are just updating the words to be more PC and sellable.
Ghosting has become ‘no contact.’
and…
Asshole has become a ‘Narcissist.’
This isn’t working.
And our current break-up culture supports a narrative supported by a subconscious belief — mom and dad didn’t stay together, so we won’t either, and here is the explanation to why, I’m out.
Self-Care, dating apps, who’s next?
Rinse and repeat.
Am I a Narcissist?
When a partner doesn’t have the skills to manage triggers, this increases emotional reactivity, further destabilizing the relationship.
When you are dysregulated and looking for answers, it’s easy to project and blame the person you are with as the reason.
Am I a pathological narcissist, no?
Was I narcissistic at times? Yes.
I tested high in Self-awareness and self-confidence on the last inventory assessment. As I went over the results with my therapist he confirmed that was NOT NPD nor did I score in the range for any other cluster b personality disorder.
I tested high on the healthy side of narcissism and helps explain why I am a gregarious, self-starting, taking action, competent human who loves life assisted and challenged by a high-functioning ADHD brain.
ADHD or Pathological Narcissist?
My investigation below looks at the discrepancy in misdiagnoses between NPD and ADHD. The critical thing to keep in mind is these mistakes are being made by clinicians interviewing real people. And…
If professionals are misdiagnosing, then consider the gross mislabeling hurt exes, and online coaches may be fostered by cognitive bias. In other words, we see what we want to see.
How can a hurt, biased partner looking for an explanation for the pain they have or are experiencing accurately diagnose a person based on a meme or REEL?
Attention Deficit Hyperactivity Disorder (ADHD) and Narcissistic Personality Disorder (NPD) may seem like two completely different mental health conditions. Still, they have much in common, so much so that ADHD is often misdiagnosed as NPD.
This is a significant concern in the mental health community, as misdiagnosing someone can lead to incorrect treatments and delayed interventions, potentially harming a person’s well-being.
ADHD is a neurodevelopmental disorder that affects about 5–10% of children and 2–5% of adults worldwide (Polanczyk et al., 2007).
It is characterized by hyperactivity, impulsivity, and inattention, which can negatively impact academic, occupational, and social functioning.
On the other hand, NPD is a personality disorder characterized by a pervasive pattern of grandiosity, a lack of empathy, and a need for admiration.
While these two conditions appear to be vastly different, they do share some similarities, which can and do lead to misdiagnoses.
One reason ADHD can be misdiagnosed as NPD is the overlap in symptoms. People with ADHD may come across as self-centered and attention-seeking because they can be very impulsive and have difficulty regulating their behavior.
As Dr. John M. Grohol, founder of Psych Central, puts it, “They don’t intend to be [narcissistic], but their impulsivity can lead them to interrupt others and not be aware of how their behavior is affecting those around them” (Grohol, 2016).
This behavior can be mistaken for grandiosity and self-importance, which are hallmark traits of NPD.
Additionally, people with ADHD may struggle with low self-esteem and feelings of inadequacy, which can lead to compensating by inflating one’s sense of self-importance. This can also be perceived as grandiosity and narcissism, further contributing to the misdiagnosis.
Another factor that contributes to the misdiagnosis of ADHD as NPD is maladaptive coping mechanisms that resemble narcissistic behavior.
People with ADHD may use aggression, manipulation, and exploitation to meet their needs, leading to a perception of a lack of empathy or a tendency to exploit others.
While these behaviors do not necessarily indicate NPD, they can resemble the disorder’s characteristics, further complicating the diagnostic process.
As a clinical psychologist, Dr. George Sachs reminds us, “Many people with ADHD have had to compensate for their weaknesses in social skills or executive functioning, so they may use maladaptive coping mechanisms to manage their symptoms” (Sachs, 2018).
Environmental factors such as stress or trauma can exacerbate the symptoms of ADHD and NPD, making it difficult to distinguish between the two.
For example, someone with ADHD may experience chronic stress due to difficulties with time management, organization, and completing tasks on time, which can worsen symptoms such as impulsivity and hyperactivity.
Similarly, someone with NPD may experience stress due to difficulties with relationships and a need for constant admiration, which can exacerbate their grandiosity and lack of empathy.
These environmental factors can further complicate the diagnostic process and lead to misdiagnoses.
Misdiagnosing ADHD as NPD can have significant consequences for the individual. For example, someone with ADHD may be prescribed medications or therapy designed for NPD, which may not treat their symptoms effectively.
Additionally, the stigma surrounding NPD may lead to negative perceptions of the individual, impacting their relationships and social functioning.
As a clinical psychiatrist, Dr. Dale Archer explains, “Once labeled with NPD, it’s difficult to shake off the stigma, and individuals may be written off as being unchangeable or untreatable” (Archer, 2018).
Like me, this can lead to a sense of hopelessness and exacerbate feelings of low self-esteem and inadequacy, worsening my ADHD symptoms.
To avoid misdiagnoses, it is essential to take a thorough approach to assessment.
Clinicians must consider the possibility of comorbidities and environmental factors that can impact the presentation of symptoms.
Additionally, clinicians must know the similarities and differences between ADHD and NPD to make informed diagnostic decisions.
In conclusion, while ADHD and NPD may seem like vastly different disorders, they share similarities that can lead to misdiagnoses.
Overlap in symptoms, maladaptive coping mechanisms, and environmental factors can contribute to the confusion between the two disorders.
For me, I chose to stop blaming her and to become curious about her world.
I sought only to understand her.
To be big enough to see me through her eyes.
I saw the narcissist, the man, and the human she loved.
A man capable of change, healing, and love.
References:
Masters, R. A. (1994). Transformation through intimacy: The journey toward mature monogamy. Penguin.
Karpman, S. (1968). Fairy tales and script drama analysis. Transactional Analysis Bulletin, 7(26), 39–43.
Forty percent of BPD patients share the dual diagnosis with NPD. https://www.psychologytoday.com/us/blog/5-types-people-who-can-ruin-your-life/202102/borderline-and-narcissistic-personality
Archer, D. (2018, September 21). Is it ADHD or Narcissism? Psychology Today. https://www.psychologytoday.com/us/blog/reading-between-the-headlines/201809/is-it-adhd-or-narcissism
Grohol, J. M. (2016, January 27). Is It ADHD or Something Else? Psych Central. https://psychcentral.com/blog/is-it-adhd-or-something-else/
Polanczyk, G. V., de Lima, M. S., Horta, B. L., Biederman, J., & Rohde, L. A. (2007). The worldwide prevalence of ADHD: a systematic review and meta-regression analysis. American Journal of Psychiatry, 164(6), 942–948.
Sachs, G. (2018, January 22). ADHD vs. Narcissism: How to Tell the Difference. Psychology Today. https://www.psychologytoday.com/us/blog/the-adhd-advantage/201801/adhd-vs-narcissism-how-tell-the-difference
