Yeah. Low self-esteem is an underlying problem for many people with NPD . They seek constant praise to value themselves, after all. [edit: whoops, you asked "while having SA". Well, I still think so]
On that topic...
Most narcs don't talk about themselves as being narcissistic, in my experience. My dad, for example, is a full blown narc and it's just completely natural to him that he is the center of the world. It's not something he thinks or talks about - because... he's a narc.
Self-proclaimed narcissists tend to just be insecure and self-absorbed people who're trying to be edgy and special. It often seems to be some sort of projection thing. People don't care about me -> I don't care about them!-> I only care about myself! Yes, that's it! They just don't understand me. Those sheeple.
that's what she said