It’s easy to see how narcissistic individuals might become depressed because of the root causes of narcissistic personality disorder. The deep-seated and constant fear of being exposed as a failure or bad person can take a toll over time. There is, in fact, a demonstrated link between narcissism and depression, particularly in vulnerable narcissists. But what about the other way around? Can depression actually cause narcissism? 

There are documented cases where individuals suffering from depression exhibited co-occurring symptoms of narcissism, but treatment with antidepressants resolved both problems. The episodic nature of the narcissism symptoms suggests that the real culprit in those cases is a mood disorder. 

Because of how devastating both conditions can be in someone’s life, it’s important to understand the nuances involved in determining a diagnosis for patients with co-occurring mental disorders as well as the root causes for narcissistic personality disorder. 

What Causes Narcissistic Personality Disorder?

Narcissistic personality disorder (NPD) is caused by childhood experiences that result in an undeveloped sense of self. This can happen because of narcissistic abuse and other kinds of abuse, but it can also happen when narcissistic parents overly pamper their children. 

They make them believe that they are part of a special family and that they are entitled to all the best things in life without having to earn them. Of course, there’s also likely some genetic involvement in the development of this and other types of personality disorders. 

What is the Link Between Depression and Narcissistic Personality Disorder?

As psychologist and narcissism expert, Jane Fjermestad-Noll points out, “There is a high co-occurrence of depression in patients with NPD.” In fact, 42 to 50 percent of patients with NPD also suffer from some kind of depressive disorder, and 9.6 percent of diagnosed narcissists suffer from a major depressive disorder. Another 28.6 percent of those with NPD suffer from mood disorders. 

These data demonstrate the strong link between these comorbidities, and this is particularly true of vulnerable narcissism and depression. Covert narcissists seem to have a higher risk of co-occurring depression. This may be because this type of narcissism usually arises from childhood adversity or trauma; something that makes a person more susceptible to depression as well. 

It appears, however, that narcissism increases the risk of depression rather than the other way around. There are a number of different possible reasons why that may be the case. It could be because narcissists are not capable of processing their feelings in an effective way. As those negative feelings are stuck inside them, it can result in depression whenever they are faced with challenges that threaten their narcissistic supply. 

It’s also true that because narcissists are constantly trying to maintain their carefully constructed false self, they often distance themselves from people with whom they might otherwise feel connected. That can easily result in a depressive state which then alters their behavior and threatens their sense of control over the situation. This causes them to further distance themselves and the cycle continues. 

What About Cases of Narcissistic Depression?

Narcissistic depression involves those relatively rare cases where depression seems to lead to narcissistic symptoms. The classic manifestation of this occurs more often in young people, and they are frequently diagnosed with NPD or some other developmental disorder. 

The narcissistic symptoms include an exaggerated opinion of themselves along with a strong sense of entitlement, interpersonal exploitation, a lack of empathy, and strong feelings of envy. There is also a tendency to become extremely punishing to those who don’t live up to the individual’s expectations. 

When these individuals are treated consistently and successfully for their depression, however, the narcissism also resolves. There is also often an element of bipolar mood disorder in these individuals, and in fact, because treating the depression also resolves the narcissism, it appears the mood disorder is the real culprit. 

Because of these nuances, it is important to really evaluate an individual’s personality structure and the dynamics of their interpersonal relationships. It can be challenging to tease apart the various comorbidities that are common in patients with these types of mental disorders, but taking the time to do so can ensure they are properly diagnosed and successfully treated. 

What Other Comorbidities are Common with Narcissism?

There are a number of common co-occurring disorders with NPD. Among the most common co-occurring mental problems are bipolar disorder, antisocial, histrionic, borderline, schizotypal, and passive-aggressive personality disorders, and substance abuse disorders. Among these possible comorbidities, antisocial personality disorder has the most profound and negative effect on the prognosis for a narcissist. 

There are also different patterns of comorbidities with respect to the different types of narcissism. There is a link between depression and both grandiose and vulnerable narcissism, but it is more common for vulnerable narcissists to suffer from depression. That’s also true of anxiety, and it may be that because vulnerable narcissists are more self-critical, they are more prone to these problems. 

Grandiose narcissists, on the other hand, don’t tend to subjectively judge themselves so harshly unless they are facing a professional or personal failure. They tend to have more problems, however, with substance abuse and antisocial and paranoid personality disorder. 

Final Thoughts

Many of the same causal elements of narcissism are also at the root of other personality disorders and mood disorders like depression. For that reason, it’s not uncommon for narcissists to have one or more co-occurring mental disorders. 

It’s important to tease apart the various underlying elements if you’re attempting to live with and understand the narcissist in your life. This is particularly important if they are seeking help for their condition. Unless they can get help for any other underlying conditions such as depression, it’s unlikely they will be able to completely resolve their narcissistic symptoms. 

With a better understanding of the various comorbidities that occur with narcissism, you’ll definitely want to read this blog post about the different kinds of personality disorders. It will give a much better understanding of these kinds of mental conditions.