Attention deficit hyperactivity disorder (ADHD) and narcissism are two completely separate conditions, but both can affect an individual’s relationships, work or school life, and ability to function in society.

People with ADHD tend to be impulsive and may have difficulties with organization and paying attention. They may also act impulsively without fully thinking about the consequences of their actions.

Conversely, individuals with narcissistic personality disorder (NPD) tend to overly focus on themselves and may also lack empathy for others. They can also have an inflated sense of self-worth and an entitled attitude.

That said, older research suggests that having ADHD symptoms as a child increases the likelihood of developing personality disorders, including NPD, as an adult.

This article looks at ADHD and narcissism and the relationship between these two conditions.

Person reads about the comparison between ADHD an narcissismShare on Pinterest
Lucas Ottone/Stocksy

ADHD is a common neurodevelopmental disorder. Doctors typically diagnose it in childhood, and it may persist into adulthood.

Children with ADHD may:

  • have difficulties paying attention
  • act without thinking about what the result will be
  • have difficulty with hyperactivity

Adults with the condition will also encounter similar symptoms and issues with organization, time management, and impulsiveness.

There are three types of ADHD, depending on symptoms:

  • Predominantly inattentive presentation: This type of ADHD typically involves problems with focus and concentration. People with this type often have difficulty sticking to tasks and may have trouble completing school or work assignments.
  • Predominantly hyperactive-impulsive presentation: A person with this type of ADHD has trouble sitting still and often fidgets or squirms. They may also talk excessively and have trouble waiting their turn or taking turns in games.
  • Combined presentation: Someone with this type of ADHD can experience both inattentive and hyperactive-impulsive symptoms.

ADHD is a spectrum disorder, which means its symptoms can range from mild to severe.

However, while ADHD presents some challenges, it is important to note that there may also be numerous benefits to having the condition. Learn more about them.

An inflated sense of self-importance and a preoccupation with one’s own needs characterize narcissism or NPD.

People with narcissistic tendencies may have issues empathizing with others and have an unrealistic sense of entitlement. They may also be excessively achievement-oriented and need constant validation from others.

Narcissism is also a spectrum disorder, so while some individuals have mild symptoms, others may exhibit more extreme behaviors.

Learn more about NPD.

There are some similarities and differences between ADHD and NPD. For example, someone with ADHD may appear self-focused during the conversation. However, the reasons for this apparent self-focus are very different from those of someone with NPD. For example, a person with ADHD may be overwhelmed and have trouble focusing. They also may not be intentionally not listening or paying attention.

In contrast, an individual with NPD may intentionally not listen because they are shutting the other person out in a behavior called stonewalling. People with NPD have ego-syntonic personalities. They tend to think other people are the problem and they are not the issue. Also, they are unlikely to apologize for the behavior, which is not the case for those with ADHD.

At the beginning of new relationships, someone with NPD may “love bomb,” meaning they take extreme measures to impress the other person and engage in grand gestures. While someone with ADHD may be extremely enthusiastic in the early days of a relationship, they may not pursue the individual to the same extent as someone with NPD.

Another difference is that although people with either condition may be habitually late to appointments, the underlying reasons once again differ. For example, someone with ADHD may be unable to organize themselves to arrive on time. However, when they do, they may apologize profusely. In comparison, someone with NPD may be late because the appointment is not important to them, and they typically will not apologize for their lateness. In fact, they may be annoyed that meetings start without them or that people are bothered by their lateness.

Both ADHD and NPD diagnoses involve comprehensive psychiatric interviews and assessments.

In ADHD, the protocol typically includes:

  • A diagnostic interview: A doctor uses a standardized set of questions to determine how many ADHD diagnostic criteria apply to the individual. It also allows them to understand if the person has any other psychiatric disorders that may resemble ADHD.
  • A family interview: The individual’s family or significant others can provide the doctor with additional information about the person’s symptoms.
  • Checklists using the Diagnostic and Statistical Manual of Mental Disorders, 5th edition: These checklists are standardized behavior rating scales that allow the doctor to compare the individual with those without ADHD. They are not diagnostic by themselves but can help with the overall evaluation.
  • Physical examination: A thorough medical exam can help the doctor rule out other specific causes for symptoms such as seizure disorders.

Doctors also diagnose NPD using a psychiatric interview. However, there are challenges, as someone with NPD may not recognize their own behaviors and be extremely sensitive to any perceived criticisms. Therefore, doctors may find it difficult to speak with them and discuss their symptoms.

If an individual displays five or more of the following criteria, healthcare professionals may diagnose NPD:

  • an inflated sense of self-importance
  • a need for excessive praise or admiration
  • a sense of unreasonable entitlement
  • a tendency to take advantage of people to achieve their goals
  • a preoccupation with fantasies of success, power, or perfect love
  • a lack of empathy
  • a belief that they are special and unique and should only associate with similar individuals
  • a belief that others are jealous of them
  • feelings of envy toward others
  • arrogant behavior and attitudes

Some older research suggests that children with ADHD may be more likely to develop NPD in adulthood.

In an older study from 2006, researchers noted that adults with childhood ADHD had an increased risk of receiving certain personality disorders in later life. These include antisocial personality disorder and narcissistic personality disorder.

A similar 2009 study looked at 96 adults with ADHD and compared them with a control group of 85 individuals. In the ADHD group, 9.4% had NPD, compared with 1.2% of the control group.

As many as 9 in 10 adults with personality disorders had significant ADHD symptoms as children. However, doctors do not yet fully understand the reasons for this finding.

NPD is a diagnosis that includes symptoms such as an exaggerated sense of self-importance and lack of empathy.

In contrast, ADHD is a neurodevelopmental disorder that affects attention, impulsivity, and hyperactivity.

Some older evidence suggests children with ADHD may be more likely to develop NPD in adulthood. However, doctors do not yet fully understand the underlying reasons. Therefore, more studies are necessary to better understand this link.