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The megalomaniac differs from the narcissist by the fact that he wishes to be powerful rather than charming, and seeks to be feared rather than loved. To this type belong many lunatics and most of the great men of history.
Since narcissism is fueled by a greater need to be admired than to be liked, psychologists might use that fact as a therapeutic lever - stressing to patients that being known as a narcissist will actually cause them to lose the respect and social status they crave.
What is most difficult is when the large part of me that is a narcissist grows weary and is overtaken by the self-loathing part that always lurks in the shadows waiting for an opportunity to shine.
A narcissist is someone better looking than you are.
I like to think I'm not a narcissist, but truth be told, we all have those sides to our character.