Based on some overlapping symptoms, borderline personality disorder (BPD) and narcissistic personality disorder (NPD) are two mental health disorders that are often mistaken for one another. Both disorders are cluster B personality disorders, which are characterized by overly emotional or unpredictable thinking or behavior. The BPD and NPD relationship is interesting as the disorders have a co-occurrence rate of approximately 25%, according to the National Alliance on Mental Illness (NAMI).
When examining borderline personality disorder vs. narcissism, it’s important to note that although these disorders share some common symptoms, they’re each distinct with their own set of diagnostic criteria. For example, both disorders deal with conflict in a way that’s unhealthy to themselves and those around them. However, it’s the expression of the anger that results from the conflict that’s 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.”
What is Narcissistic Personality Disorder?
So, what is narcissistic personality disorder (NPD)? Like borderline personality disorder, the Diagnostic and Statistical Manual of Mental Disorders (DSM) lists nine common symptoms of narcissistic personality disorder. If an individual exhibits five of these nine symptoms consistently, they meet the criteria for an NPD diagnosis.
- 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
The BPD and NPD Relationship
Narcissistic personality disorder can exist on its own but can also co-occur with borderline personality disorder. It’s vital to understand the BPD and NPD relationship because some of the symptoms of both disorders overlap. If you mix and match the symptoms of NPD with the symptoms of BPD, you’ll get someone who’s struggling in their everyday life.
When comparing borderline personality disorder vs. narcissism, another similarity is that both people with NPD and people with BPD struggle 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. “Intense and stormy relationships” is, in fact, one of the characterizing symptoms of borderline personality disorder.
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 can’t step outside of themselves to consider the opinions of others. This affects someone with NPD socially and emotionally, including 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 each individual’s 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.
Treatment for Personality Disorders
At Clearview Treatment Programs, we provide treatment for various mental health disorders, including cluster B personality disorders. Our clinicians create customized treatment plans based on each client’s needs. These treatment plans can include various therapies like acceptance and commitment therapy (ACT), cognitive behavior therapy (CBT), dialectical behavior therapy (DBT), and mindfulness.
If you’re struggling and need help, we’re here for you. At Clearview, we offer several treatment programs and have experience with and expertise in treating both disorders. Our treatment programs include our Dual Diagnosis Treatment Center, our Women’s Treatment Center, and our outpatient treatment centers.