Is it ADHD, narcissism, or both?

Research shows people who are diagnosed with attention-deficit hyperactivity disorder (ADHD) as children are at greater risk of developing narcissistic personality disorder (NPD) and other personality disorders later in life. But it’s important to acknowledge that while they often go hand in hand, ADHD and NPD are two very different conditions. 

ADHD can cause problems with focus and impulse control, which can sometimes impact relationships and social skills. NPD, however, involves an intense sense of grandiosity and superiority over other people. People with NPD often lack empathy and may appear rude, condescending, or manipulative. These beliefs and behaviors can also impact relationships.

Both ADHD and NPD can cause a person to behave in what appears to be self-serving ways, negatively affecting relationships and interrupting their ability to function in daily life. However, while these conditions can co-occur, they may require different forms of support. Understanding the similarities and differences between ADHD and NPD can help you better understand yourself and your symptoms.

What’s the connection between narcissism and ADHD?

We don’t yet have a full understanding of why ADHD and NPD co-occur so frequently. However, research suggests the overlap might be due to a combination of the following risk factors:

• Neurobiology: People with ADHD may have differences in the parts of the brain that regulate the ability to see things from another person’s point of view. This is called perspective taking, and it can affect a person’s capacity to demonstrate empathy. Similarly, an inability to empathize is a core feature of NPD. There’s evidence to suggest this could be due to disruptions in various brain systems.
• Genetics: Both ADHD and NPD are believed to run in families. This means that if you have a close relative, like a parent or sibling with ADHD or NPD, you might be more likely to develop one of these conditions. 
• Environment: Experiencing childhood trauma such as abuse or neglect may play a role in the onset of both NPD and ADHD. Children with ADHD who remain in traumatic environments may be more likely to develop a personality disorder. 

Recognizing narcissism vs. ADHD

Receiving an accurate diagnosis is one of the first and most important steps you can take toward managing your health. However, this can be more challenging when you have symptoms that could be the result of multiple conditions. 

So, if you think you might have NPD, ADHD, or both, understanding what these disorders have in common and what sets them apart can help you get the care for your needs.

ADHD symptoms can include: 

• Difficulty staying on task
• Trouble paying attention
• Disorganization
• Restlessness
• Frequent or excessive movement in inappropriate settings
• Interruptions or excessive talking based on setting
• Difficulty with delayed gratification

On the other hand, NPD symptoms can include: 

• Grandiose sense of self-importance
• Fantasizing about amassing success, power, beauty, brilliance, or idealized romantic love 
• A belief they’re superior to others and they can only be understood by other “superior” people
• Chronic envy or a belief that others are envious of them
• The exploitation of others for personal gain
• A desire for constant affirmation and admiration
• A deep sense of entitlement  
• Rude, arrogant, or haughty attitudes or behaviors 

Some symptoms of ADHD and NPD can overlap. These include: 

• Difficulty demonstrating empathy: Imagine you’re sharing something personal with a friend, and they get up and wander around the room while you’re talking. This could be due to restlessness brought on by ADHD. Or, if they have NPD, it could be due to their belief that your emotional experiences aren’t important.
• Problems in interpersonal relationships: Imagine your partner frequently forgets about important details from previous conversations. This could be due to problems with focus brought on by ADHD. Or, if they have NPD, it could be due to their belief that your needs aren’t worthy of their attention. 
• Impulsivity: Imagine a colleague interrupts you during a meeting. This could be due to difficulty with self-regulation and impulse control brought on by ADHD. Or, if they have NPD, it could be due to their grandiose belief that what they have to say is more brilliant than anything you have to share.

Can you have narcissistic personality disorder and ADHD?

You can have NPD and ADHD at the same time. However, the relationship between these two conditions is complex and not yet fully understood. While having ADHD doesn’t automatically mean you’ll develop NPD, the vast majority (90%) of people with personality disorders exhibited signs of ADHD as children. But, like other co-occurring conditions, we don’t know whether this link is causal or correlational. 

How are ADHD and narcissism treated?

If you think you might have ADHD, NPD, or both, working with a mental health professional can help. A therapist can provide an assessment and an accurate diagnosis to ensure you get the right support for your needs. 

If they discover you’re living with co-occurring conditions, your therapist will likely suggest an integrated approach to your care. This means you’ll work together to create a treatment plan that reflects each of your mental health concerns.

Treatment for ADHD and NPD may involve a combination of therapy and medication. However, there’s limited evidence that therapy is effective for treating NPD. It’s also worth mentioning that many people with NPD don’t recognize their symptoms as problematic. So they may be more likely to enter therapy at the request of someone else or if they’re having problems due to another issue, like ADHD. 

In this case, the goal of treatment may be to reduce interpersonal conflict, improve functioning, and manage ADHD symptoms like inattentiveness or hyperactivity. To support these goals, your therapist may use a modality like cognitive behavioral therapy (CBT). Medication is also frequently used to treat ADHD. You can talk to your provider about whether medication is right for you.

Find care with Rula

ADHD and NPD are different mental health conditions that share some key symptoms. Sometimes co-occurring, they can both cause a lack of empathy, impulsivity, and relationship problems. 

If you’re experiencing any of these challenges, know that you don’t need to know your diagnosis to ask for help. With Rula, you can access our extensive network of mental health professionals and choose a provider to work with in just a few clicks. To get started today, check out our therapist-matching program. You can sort through your options, choose a therapist who takes your insurance, and make your first appointment for as soon as tomorrow.

Find a therapist with Rula