The term narcissist gets thrown around quite often, especially when talking about an arrogant coworker, or an especially entitled family member. When we hear the word narcissist, we can usually picture someone we have all encountered in our lives, someone who believes they are a blessing to those around them.

But what does being diagnosed as a narcissist really mean?

The Diagnostic and Statistics Manual (or DSM for short) is the handbook for diagnoses of mental and psychiatric disorders for professional clinicians. This book allows for diagnoses to be standardized and reduces the likelihood of people being falsely diagnosed. It is updated every few decades or so to reflect the new research in the field.

In it, they refer to Narcissistic Personality Disorder. And it has had the same 9 criteria for diagnosis of narcissistic personality disorder for over 20 years, although because of challenges in diagnosing it they actually considered removing it from the DSM altogether. It can be hard to diagnose because narcissists don’t just fit one profile; they can be socially-extroverted CEOs or introverted hermits, and narcissists frequently also have other mental disorders making diagnosis no simple matter.

If you would like more information on why it can be so hard to diagnose, see the article “Narcissistic Personality Disorder: Diagnostic and Clinical Challenges” published in The American Journal of Psychiatry.

While all of these criteria are signs of narcissism, they only need to fulfill 5 of the criteria for a diagnosis of narcissistic personality disorder.

The 9 criteria of a narcissist are the following:

  1. Has a grandiose sense of self-importance.
  2. Has frequent fantasies of unlimited success, power, brilliance, beauty, or ideal love.
  3. Believes that he or she is “special” and unique and can only be understood by, or should associate with, other special or high-status people.
  4. Requires excessive admiration, is easily swayed by compliments.
  5. Has an intense sense of entitlement.
  6. Is interpersonally exploitative (takes advantage of their friends).
  7. Lacks empathy, is either unwilling or unable to consider others and their feelings.
  8. Is often envious of others or believes that others are envious of him or her.
  9. Shows arrogant, haughty behaviors or attitudes.

The thing you may notice about a lot of these criteria are that most people have a few of them to a degree.

However, before you go around diagnosing those people around you, it is important to consider the purpose of the DSM. The DSM is intended to be used by professional psychologists and clinicians, with most people being diagnosed because the issue is causing massive issues in their lives or the lives of those around them.

So before you start diagnosing Denise in accounting or your Aunt Carol, consider if it is really that you just find them unpleasant, annoying, and/or arrogant.