What can be confused with narcissism?

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Based on overlapping symptoms, Borderline Personality Disorder (BPD) and Narcissistic Personality Disorder (NPD) are often mistaken for one another. The two personality disorders even have a rate of co-occurrence of about 25 percent, according to the National Alliance on Mental Illness (NAMI). Though the two personality disorders share some common symptoms, they are distinct disorders with their own set of diagnostic criteria. For example, both BPD and NPD deal with conflict in a way that is unhealthy to themselves and those around them. It’s the expression of the anger that results from the conflict that is different. In her article “Blame-Storms and Rage Attacks,” Randi Kreger, co-author of Walking on Eggshells, points out the difference in how those with BPD and NPD express anger. While those with Borderline Personality Disorder may fly into a rage and push people away, they will often calm down, feel shame for their reaction, and promise never to do it again. “Unless they’re in treatment, the underlying issues don’t go away. Some conventional [borderlines] do not get angry at all, but hold it in or express it inwardly through self-harm,” says Kreger. “The anger of narcissists, on the other hand, can be more demeaning,” she continues. “Their criticism evolves from their conviction that others don’t meet their lofty standards — or worse, aren’t letting them get their own way.”

Symptoms of Narcissistic Personality Disorder

Just like Borderline Personality Disorder, the Diagnostic and Statistical Manual of Mental Disorders (DSM) lists nine symptoms of Narcissistic Personality Disorder. If you exhibit five of these nine symptoms in a persistent manner, you meet the criteria for diagnosis of NPD:

An exaggerated sense of one’s own abilities and achievements

A constant need for attention, affirmation, and praise

A belief that you are unique or “special,” and should only associate with other people of the same status

Persistent fantasies about attaining success and power

Exploiting other people for personal gain

A sense of entitlement and expectation of special treatment

A preoccupation with power or success

Feeling envious of others, or believing that others are envious of you

A lack of empathy for others

NPD and BPD: Similarities and Differences

Narcissistic Personality Disorder can exist on its own, but can also be found co-occurring with Borderline Personality Disorder. Mix and match five out of nine symptoms of NPD with five out of the nine symptoms of BPD, and you get someone who will likely be described at least as “difficult” or “high maintenance,” and who certainly is having a tough time in day-to-day life.

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Both people with BPD and with NPD deal with an intense fear of abandonment. Enhancing that fear of abandonment is the fact that sustaining relationships with others in the face of these symptoms is a challenge to say the least. “Intense and stormy relationships” is, in fact, one of the characterizing symptoms of BPD. In an article for Psychology Today, Susan Heitler, PhD, author and Harvard graduate, describes emotionally healthy functioning in the absence of BPD or NPD: “Emotionally healthy functioning is characterized by ability to hear your own concerns, thoughts, and feelings and also to be responsive to others’ concerns.” In the world of the narcissist, that second part just isn’t present. Narcissists are unable to step outside of themselves to imagine any weight behind someone else’s opinion. This renders someone with NPD socially and emotionally ineffective, and affects their ability to maintain relationships. On the other hand, those with BPD are often over-responsive to other’s concerns, especially when they are in the “idealization” phase of a relationship. But anger and resentment from putting the other’s concerns first inevitably cycles around, causing resentment, at which point the relationship will enter the “devaluation” phase. The key to a healthy relationship, says Heitler, is finding the point where both parties’ concerns are taken into consideration. “When differences arise, socially effective folks are pros at finding win-win solutions because they routinely hear and take into consideration both their own and other people’s concerns,” she said.

Personality Disorder Treatment

A personality disorder treatment center can help you with an accurate diagnosis so that you can design an effective treatment plan to overcome the symptoms of both Borderline Personality Disorder and Narcissistic Personality Disorder and have healthier and more fulfilling relationships.

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