My name is Sam Vaknin. I am the author of Malignant Self-Love, Narcissism Revisited.

Many scholars consider pathological narcissism to be a form of depressive illness. This is the position of the authoritative magazine Psychology Today, for instance.

The life of the typical narcissist is indeed punctuated with recurrent bouts of dysphoria, ubiquitous sadness and hopelessness, anhedonia, loss of the ability to feel pleasure, and clinical forms of depression, cyclophagic, dycemic, or some other episode.

This picture is further obfuscated by the frequent presence of mood disorders, such as the bipolar I disorder.

While the distinction between reactive exogenous and endogenous depression is now obsolete, it is still useful in the context of narcissism.

Narcissists react with depression not only to life crisis, but to fluctuations in narcissistic supply and to the internal dynamics that these fluctuations generate.

The narcissist’s personality is disorganized. It is precariously balanced. The narcissist regulates his sense of self-worth by consuming narcissistic supply from others, from his human environment.

Narcissistic supply is attention, adulation, admiration. The narcissist uses this feedback, uses these human inputs to regulate his self-confidence, self-esteem, and his sense of self-worth.

Any threat to the uninterrupted flow of narcissistic supply compromises the psychological integrity and the ability to function of the narcissist. It is perceived by the narcissist consequently as life-threatening.

So we have several types of dysphoria and depression in pathological narcissism.

First, there is the loss-induced dysphoria. This is a narcissist’s depressive reaction to the loss of one or more sources of narcissistic supply or to the disintegration of a pathological narcissistic space, the geographical area within which the narcissist hunts for sources of supply.

The pathological narcissistic space is the stocking or hunting grounds of the narcissist. It is the geographical social unit whose members leverage the narcissist with attention, admiration, adulation. When these people disperse or refuse to continue to provide the narcissist with his supply, the narcissist goes into deep funk, deep depression.

Then we have the deficiency-induced dysphoria. This is a deep and acute depression which follows the aforementioned losses of supply sources and space.

Having warned these losses, the narcissist now grieves their inevitable outcome in absence or deficiency of narcissistic supply.

So when the narcissist loses a source of supply, there is one type of depression when he digests the meaning of the loss, outcomes, the inevitable outcomes of the loss, when he realizes that he no longer is going to have narcissistic supply, he has deficiency-induced dysphoria which is much more acute and much deeper.

Paradoxically, this second type of dysphoria energizes the narcissist and moves him to find new sources of narcissistic supply and to replenish his dilapidated stock.

Then we have the self-worth dysregulation dysphoria.

The narcissist reacts with depression to any criticism or disagreement, especially when they come from a trusted and long-term source of narcissistic supply.

He fears the imminent loss of the source and the damage to his own fragile mental balance.

The narcissist also resents his vulnerability and his extreme dependence on feedback from others.

This type of depressive reaction is therefore a kind of mutation of self-directed aggression.

The narcissist hates his dependence, resents himself and directs aggression at himself in the form of depression.

Then we have the grandiosity gap dysphoria.

The narcissist firmly, though counterfactually, perceives himself as omnipotent, omniscient, omnipresent, brilliant, accomplished, irresistible, perfect, immune, invincible, etc.

In other words, the narcissist entertains grandiose fantasies and an inflated self-image. Any data to the contrary is usually filtered, altered or discarded altogether.

Still, sometimes reality is so strong, so overwhelming and so pervasive that it intrudes and this creates a grandiosity gap.

The abyss between the narcissist’s self-perception, his inflated self-image, his false self and the drab, dreary and shabby reality in which he finds himself.

The narcissist is then forced to face his mortality, his limitations, his ignorance and his relative inferiority. He sucks, he sinks into an incapacitating, albeit short-lived dysphoria.

Finally, we have the self-punishing dysphoria.

Deep inside, the narcissist, as we said, hates himself and doubts his own worth. He deplores his desperate addiction to narcissistic supply. He judges his actions and intentions harshly and sadistically. He may be unaware of these dynamics, but they are at the heart of the narcissistic disorder.

And the reason the narcissist has to resort to narcissism as a defense mechanism in the first place is this self-hatred.

Narcissism as a defense mechanism is compensatory. It compensates for deep-seated self-hatred, self-defeat and self-destruction.

This inexhaustible well of ill-will, self-chastisement, self-doubt and self-directed aggression yields numerous self-defeating and self-destructive behaviors from reckless driving and substance abuse to suicidal ideation and constant depression.

It is the narcissist’s ability to confabulate that saves him from himself.

His grandiose fantasies remove him from reality and prevent recurrent narcissistic injuries.

Many narcissists end up delusional, schizoid or paranoid.

To avoid agonizing and knowing depression, they give up on reality itself. It’s the only way to survive.