There’s plenty of narcissists that know they’re narcissists, and there’s therapy tools to help them participate in the world in a more healthy manner, but as you sorta indicated, it’s very rare any want to, and even more rare than any actively go down that path, so seeing someone speaking as if they’re struggling with it internally without seeing any sign of having already developed those tools makes it highly unlikely they’re legit. Probably just regular old mental illness of some sort, maybe attention seeking coupled with drug use and emotional instability. Wonder if they’re single, that’s right up my alley.

Weird how often I see this take. Narcissism is really Narcissistic Personality Disorder, and it is possible for someone with NPD to recognize they have it and want to change. Not super common, but it is possible.