5 Mental Health Disorders People Mistake for Narcissism5 Mental Health Disorders People Mistake for Narcissism
A Little Help For Our Friends
Dr. Kibby McMahon explains five mental health conditions that are often mistaken for narcissism and compares how their behaviours overlap and differ. The conversation focuses on what truly defines narcissistic personality disorder and how a clearer understanding can change how someone responds in difficult relationships.
1:07:52•10 Jun 2026
5 Conditions That Look Like Narcissism but Aren’t What You Think
Episode Overview
- Narcissistic personality disorder is about a rigid need to feel superior and special, not just being rude, selfish, or emotionally messy.
- Borderline personality disorder and narcissism can both swing between idealising and devaluing others, but one is driven more by fear of abandonment, the other by fear of losing status and specialness.
- ADHD, autism, and complex PTSD can all lead to behaviour that feels self-centred or uncaring, even when the person does care deeply.
- Obsessive-compulsive personality disorder may look like narcissistic control, but is often rooted in perfectionism and rule-following rather than a need to be above others.
- Understanding the fear or belief underneath someone’s behaviour can guide whether you validate, set firmer boundaries, or decide the relationship is too damaging.
“Narcissist has become shorthand for ‘this person is evil,’ and I really want to understand what is narcissistic personality disorder and what is not.”
Curious why everyone online seems to be a “narcissist” these days? This episode of A Little Help For Our Friends takes that trend apart and asks a tougher question: could something else be going on beneath the behaviour that feels so selfish and hurtful? Clinical psychologist Dr. Kibby McMahon walks through five conditions that can easily be mistaken for narcissistic personality disorder: borderline personality disorder, ADHD, autism spectrum disorder, complex PTSD, and obsessive-compulsive personality disorder.
She explains that many partners and family members turn to the internet saying, “my husband only thinks about himself” or “my mum always makes things about her,” and are quickly told, *they’re a narcissist*. Kibby argues that, “narcissist has become shorthand for ‘this person’s evil,’” and instead breaks down what genuine narcissistic personality disorder is: a rigid, fragile need to feel superior and “on top” in order to feel worthy.
From there, she compares how each of the five disorders can look similar on the surface—forgetfulness, emotional chaos, blunt comments, controlling rules, or intense self-protection—yet be driven by very different fears. Is someone panicking about being abandoned, desperate for order, overwhelmed by trauma, or clinging to feeling special? The answer matters, because it changes what actually triggers them and what kind of responses might help.
Kibby keeps things grounded with real-life examples from her own relationships and family, showing how even clinically trained people can struggle to tell narcissism from ADHD or trauma in everyday life.
The episode is especially helpful for anyone stuck in a painful relationship and wrestling with that uncomfortable question: “Are they a narcissist, or is something else going on?” It leaves you with more nuance, less black‑and‑white thinking, and a better sense of what you might want to tolerate, address, or walk away from. If someone in your life feels selfish or uncaring, could a different explanation open up new options for you?
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