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.
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). Both disorders are cluster B personality disorders, which are characterized by overly emotional or unpredictable thinking or behavior.
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.
In this blog post, we’ll explore both the similarities and differences between borderline personality disorder and narcissism, as well as what it looks like when an individual has both.
What is Borderline Personality Disorder?
Before we dive deeper into the differences and challenges of BPD and NPD, it helps to understand what borderline personality disorder looks like on its own. The Diagnostic and Statistical Manual of Mental Disorders (DSM) outlines nine common symptoms that define BPD.
If an individual consistently shows five or more of these nine symptoms, they meet the criteria for a BPD diagnosis.
- Intense fear of abandonment, whether real or imagined
- Unstable or shifting sense of self-identity
- Rapid mood swings or emotional instability
- A pattern of intense and unstable relationships
- Impulsive behaviors that may be self-damaging (such as reckless spending, unsafe sex, or substance use)
- Repeated suicidal thoughts, threats, or self-harming behavior
- Chronic feelings of emptiness
- Inappropriate, intense anger or difficulty controlling anger
- Stress-related paranoia or feeling disconnected from reality
What is Narcissistic Personality Disorder?
So, what is 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 consistently exhibits five or more of these nine symptoms, 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
Can Someone Have Both Borderline + Narcissistic Personality Disorder?
It is possible for an individual to have both borderline personality disorder and narcissistic personality disorder. When an individual meets the criteria for both conditions simultaneously, it’s known as comorbidity or dual diagnosis.
Can a Person Have BPD With Narcissistic Features or Vice Versa?
A person with BPD can exhibit narcissistic traits (and vice versa) without meeting the full diagnostic criteria for both disorders. In these cases, the secondary characteristics don’t define the diagnosis but can influence how symptoms show up in daily life.
For example, someone with BPD might display moments of entitlement or superiority during relationship conflict, while someone with NPD might show intense emotional reactivity that resembles BPD.
Why Symptoms Overlap
The overlap happens because each disorder affects how an individual relates to themselves and others. BPD is marked by a deep fear of abandonment and a fragile sense of identity, while NPD centers more on fragile self-esteem and a need for admiration.
Together, these patterns can fuel cycles of unstable relationships, where someone may crave closeness but also push people away in an attempt to protect themselves from being hurt.
How It Shows Up in Daily Life
In real life, this might manifest as oscillating between intense fear of rejection and an outward display of superiority. An individual may become emotionally overwhelmed if they feel abandoned while also reacting with anger or defensiveness when their self-image is challenged.
The push and pull between wanting connection and needing control can make daily life and relationships especially difficult.
The BPD + NPD Relationship: Overlapping Symptoms
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.
Fear of Abandonment + Relationship Struggles
When comparing borderline personality disorder vs. narcissism, another similarity is that both individuals with NPD and those with BPD struggle with an intense fear of abandonment. That fear of abandonment gets even stronger because the symptoms make it hard to keep stable relationships.
Identity + Self-Esteem Issues
Both BPD and NPD involve problems with self-image. Someone with BPD may feel like they don’t have a stable sense of who they are, while someone with NPD may base their self-worth on admiration from others. In both cases, self-esteem is fragile and can swing quickly.
Emotional Instability
Mood swings are common in both disorders. A person with BPD might go from feeling elated to devastated in minutes, while a person with NPD might react with intense anger or sadness when their self-image is threatened.
Impulsivity
Impulsive behaviors such as reckless spending, substance use, or risky relationships can appear in both conditions. For BPD, it often stems from emotional overwhelm, while for NPD, it may come from entitlement or a drive to maintain control.
Difficulty with Empathy
While often more central to NPD, both disorders can make it hard to see another person’s perspective fully. In BPD, strong emotions can block awareness of how someone else feels. In NPD, empathy may be overshadowed by self-focus.
Anger + Irritability
Both BPD and NPD can involve frequent anger outbursts. For individuals with BPD, anger is often tied to fear of abandonment. For those with NPD, it’s usually connected to perceived criticism or rejection.
Differences Between BPD + Narcissism
Even though borderline personality disorder and narcissistic personality disorder share some overlapping traits, they are distinct in the way they affect emotions, relationships, and self-image. Examining these differences helps clarify why individuals with each condition may struggle in different ways.
Emotional Patterns
While both disorders involve unstable emotions, the way they appear is different. People with borderline personality disorder often experience rapid mood swings, intense sadness, and overwhelming fear of being abandoned.
Narcissistic personality disorder, on the other hand, revolves more around protecting fragile self-esteem, often through anger, defensiveness, or an outward sense of superiority.
Relationship Dynamics
In relationships, BPD tends to show up as clinging or desperation for closeness, even when that closeness feels unstable. Someone with NPD usually struggles with emotional distance, putting their own needs or image first, and having a harder time truly considering others’ perspectives.
Sense of Self
Borderline personality disorder is marked by a fragile or shifting sense of identity, where an individual may feel unsure of who they are. Narcissistic personality disorder is instead driven by a rigid, inflated self-image that needs constant validation from others to stay intact.
Find the Right Personality Disorder Treatment for You
Clearview Treatment Programs in California provides treatment for various mental health disorders, including cluster B personality disorders. Our clinicians create customized treatment plans tailored to each individual’s specific needs.
These treatment plans can include various therapies, such as acceptance and commitment therapy (ACT), cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT), and mindfulness-based therapy.
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. Contact us today to learn more about our programs.
