Many scholars consider pathological narcissism to be a form of depressive illness, according to "Psychology Today". 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 (cyclothymic, dysthymic, or other). This picture is further obfuscated by the frequent presence of mood disorders, such as Bipolar I (co-morbidity).
While the distinction between reactive (exogenous) and endogenous depression is obsolete, it is still useful in the context of narcissism. Narcissists react with depression not only to life crises but to fluctuations in Narcissistic Supply.
The narcissist's personality is disorganized and precariously balanced. He regulates his sense of self-worth by consuming Narcissistic Supply from others. Any threat to the uninterrupted flow of said supply compromises his psychological integrity and his ability to function. It is perceived by the narcissist as life threatening.
I. Loss Induced Dysphoria
This is the narcissist's depressive reaction to the loss of one or more Sources of Narcissistic Supply or to the disintegration of a Pathological Narcissistic Space (PN Space, his stalking or hunting grounds, the social unit whose members lavish him with attention).
II. Deficiency Induced Dysphoria
Deep and acute depression which follows the aforementioned losses of Supply Sources or a PN Space. Having mourned these losses, the narcissist now grieves their inevitable outcome the absence or deficiency of Narcissistic Supply. Paradoxically, this dysphoria energizes the narcissist and moves him to find new Sources of Supply to replenish his dilapidated stock (thus initiating a Narcissistic Cycle).
III. Self-Worth Dysregulation Dysphoria
The narcissist reacts with depression to criticism or disagreement, especially 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 mutation of self-directed aggression.
IV. Grandiosity Gap Dysphoria
The narcissist's firmly, though counterfactually, perceives himself as omnipotent, omniscient, omnipresent, brilliant, accomplished, irresistible, immune, and invincible. Any data to the contrary is usually filtered, altered, or discarded altogether. Still, sometimes reality intrudes and creates a Grandiosity Gap. The narcissist is forced to face his mortality, limitations, ignorance, and relative inferiority. He sulks and sinks into an incapacitating but short-lived dysphoria.
V. Self-Punishing Dysphoria
Deep inside, the narcissist 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 had to resort to narcissism as a defense mechanism in the first place.
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 idealization 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 gnawing depression, they give up on life itself.