How can one man be so tone-deaf and completely oblivious when it comes to nearly any human interaction? Narcissism. People throw out a lot of insults when it comes to Trump, and they are warranted. But the guy absolutely has Narcissistic Personality Disorder, for real. And no, I’m not his doctor, and thus I cannot actually diagnose him. But NPD is one of those disorders that are so blatant. That you can see it a Colorful Trump To All My Hater Vintage Shirt. And I will keep repeating: I have never had this much biographical information on any patient I have ever diagnosed. And I’ve had a few famous patients…
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Another ‘behind the scenes’ opinion is that since there is no clear, effective medication for NPD, it doesn’t exist for MDs. They prefer to diagnose comorbidities, like Bipolar and Depression. To be fair I’d say the issue is that to diagnose NPD, you need to have a good Colorful Trump To All My Hater Vintage Shirt. And as you note, most people who present for services with NPD are not presenting. Because they have self-diagnosed accurately and want help. They will instead report comorbidities, like depression, anxiety, insomnia, be taken at face value. And get meds for it. Then they will end up with diagnoses of Bipolar Disorder nearly every time.
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