Personality disorders are diagnosed on a different ‘axis’ than mood disorders such as depression and bipolar. So it appears obvious that he has narcissistic PD, but he could also have major depression or a lesser form of depression suc as such as dysthymic disorder.
But in addition to narcisstic PD, he may also have borderline PD which is characterized by manipulative behavior patterns. Borderline has no treatment and when identified, most practioners are urged to simply avoid treating these people because they constantly try to cause trouble.
Individuals with NPD do not tolerate discomfort well and most commonly enter therapy for depression.
http://www.depression-guide.com/disorder-narcissistic-personality.htm
Seems quite likely that he could be depressed. (I’m certainly no expert in this. jmo)
Has anybody considered that maybe Ubama misses his boyfriends on the down low?