Checked for clinical accuracy on 25 July 2026. Next review due July 2027. This article is general information and is not a substitute for advice about your own situation.
ADHD and narcissistic personality disorder can both strain relationships, but for different reasons. ADHD is a neurodevelopmental condition, so distraction, restlessness and impulsivity come from neurobiology and can feel disrespectful to others even when they are unintentional. NPD involves an exaggerated sense of self-importance, a need to be admired, and a lack of empathy that comes from being focused on oneself. Both conditions can be treated, and both respond to therapy.
A note before you read on
This article is general information, not medical advice about your own situation. If you are worried about your own or someone else's substance use, speak to your GP. In an emergency call 999 in the UK, or 112 anywhere in Europe.
Relationships are about compromise. Whether romantic, platonic, familial, or professional, there is generally a give-and-take in them. However, those who have personality disorders may have difficulty functioning and interacting as other people may expect. Some may lack empathy or impulsivity that they cannot control.
What is ADHD?
ADHD, or attention deficit hyperactivity disorder, is a neurodevelopmental disorder in which a person will struggle with their ability to control their impulses. People with ADHD may also have difficulty paying attention and can be easily distracted. Another hallmark of ADHD is restlessness, and people with ADHD may often have a hard time sitting still. People who don't have the condition may often exhibit ADHD symptoms. The difference is that these behaviours are constant and uncontrollable for people with the condition.
What Is Narcissistic Personality Disorder (NPD)?
It is normal for most of us to experience the occasional bout of narcissism. Maybe we even accomplish something that causes us to exhibit narcissistic traits, but these traits are often temporary. Narcissistic personality disorder (NPD) is an entirely different thing. People with NPD may have an exaggerated sense of self-importance, often with no discernible cause. They often believe they are special and are entitled to things others aren't. Those who have NPD need to be loved and admired by the people around them. They want attention, and they may exhibit superficial confidence. Individuals with NPD will also have a sense of entitlement, and they may become frustrated when they don't get the attention and admiration from others they feel they deserve.
How do ADHD and Narcissism Affect Relationships?
ADHD and narcissistic personality disorder can both be incredibly detrimental to an individual's interpersonal interpersonal relationships. One of the hallmark symptoms of NPD is an inability to understand the feelings of other people and a lack of empathy. This can affect relationships because people who have NPD may expect praise and validation from others and become disappointed when they don't get it. Because they have an inflated sense of self, people with NPD often lack empathy, and this can cause strife in relationships. People who have NPD may also exploit or manipulate the people around them for their gain or amusement. This can lead to them having troubled and unfulfilling relationships. The symptoms of ADHD, on the other hand, can be difficult for other people to deal with. Friends and significant others may feel frustrated when a person is easily distracted, especially during a conversation. This inattention can feel disrespectful and insensitive while most of the time unintentional. Being easily distracted can also lead to disorganisation and flights of fancy, and people who have ADHD may change plans on a whim. The impulsivity that is associated with ADHD can also lead to a person being seen as unreliable. This can be an undesirable trait in a partner, friend, or co-worker.
Can ADHD and NPD Co-Occur?
Some research suggests that ADHD and NPD can co-occur. Some research would indicate that ADHD is a risk factor for developing NPD. It's also suggested that the parenting styles used as a response to raising someone with ADHD can cause that person to develop narcissistic traits later on in life.
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The Similarities and Differences between ADHD and Narcissism
ADHD and NPD may share various similarities. However, there are also several differences. When it comes to similarities, people living with ADHD and NPD can both exhibit impulsive behaviour. They may have difficulty controlling their thoughts and actions. This can also lead to poor time management skills. Emotional dysregulation is also common with both mental health conditions. People who have either mental health condition may struggle with regulating their emotions. Both conditions can also cause a person to seek attention from other people. However, the motivation behind that behaviour is different. People who have ADHD behave in the way that they do because of their neurobiology. Someone with NPD engages in attention-seeking and impulsive behaviour because they want to feel admired by or superior to the people around them. Both conditions can cause people to appear to lack empathy for different reasons. Individuals with ADHD may show a lack of empathy because they have difficulty understanding social cues. Individuals with narcissistic personality disorder may display a lack of empathy because they are too focused on themselves. There's also a person's self-image. For individuals with ADHD, their self-image can be affected by external factors. However, for those with NPD, their self-image is resistant to external factors such as criticism.
Treatments
Mental health professionals have a variety of treatment options for both conditions. For ADHD, medication and interventions such as cognitive behavioural therapy or CBT have proven to be effective at helping people manage their symptoms. Developing structure and routine can help a person minimise their hyperactivity and impulsivity. For NPD, there are treatments available. Therapy and medication can help a person. Psychotherapy can be especially useful for helping people with NPD learn how to relate to others. Group therapy can allow a person to develop healthy social skills and build empathy. People who have NPD are also encouraged to reflect on their actions so they can recognise and address their maladaptive behaviour patterns.
Can People With NPD and ADHD Have Healthy Relationships?
Yes, given treatment, people who have ADHD or NPD can develop healthy relationships. However, it is important to note that people with personality disorders may struggle to maintain meaningful long-term relationships. Treatment can help them manage their symptoms and minimise their unhealthy behaviours. It'd also be ideal for the people around them to understand their conditions and adjust their expectations accordingly.
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Get Control and Build Healthy Relationships
Relationships are a major part of the human experience. Everyone has them. Those relationships can be with family members, friends, or romantic partners. Regardless, they're often a huge part of a person's life. For many people, they're the most important part of life. However, relationships are breakable, and some people have conditions that can cause them to act in ways that harm them. These conditions and resulting behaviours can be managed, and a person can maintain their healthy behaviours by managing them. If you're struggling with a behavioural condition and can't maintain healthy relationships because of it, understand that help is available. You can manage your condition and have a fulfilling social life. Start building healthy relationships today
Last reviewed 2026-07-25. Next review 2027-07-25.
Questions people actually ask
Can someone have both ADHD and narcissistic personality disorder?
Some research suggests the two can co-occur, and some research indicates that ADHD may be a risk factor for developing NPD. It has also been suggested that the parenting styles used in response to raising someone with ADHD can contribute to narcissistic traits later in life. A qualified professional is the right person to assess which condition, or both, is present.
How can you tell ADHD apart from narcissism?
Look at the motivation rather than the behaviour. Both can involve impulsivity, emotional dysregulation and attention seeking. With ADHD the behaviour comes from neurobiology. With NPD the person seeks attention because they want to feel admired by or superior to those around them. Self-image differs too. In ADHD it is affected by external factors, whereas in NPD it resists criticism.
Why do both conditions look like a lack of empathy?
The appearance is similar but the reason differs. Someone with ADHD may seem to lack empathy because they find social cues difficult to read. Someone with NPD may appear to lack empathy because their attention is fixed on themselves. Understanding which is happening changes how you respond and what kind of support is likely to help.
What treatments are available for ADHD and NPD?
For ADHD, medication and interventions such as cognitive behavioural therapy have proven effective at helping people manage symptoms, and building structure and routine can reduce hyperactivity and impulsivity. For NPD, therapy and medication can help. Psychotherapy supports learning how to relate to others, and group therapy can build social skills and empathy. Reflecting on your own actions also helps.
Can people with ADHD or NPD have healthy relationships?
Yes. Given treatment, people with either condition can develop healthy relationships. People with personality disorders may still find long-term relationships harder to maintain, so it helps when those around them understand the condition and adjust their expectations. Treatment helps manage symptoms and reduce the behaviours that damage relationships.
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