Can someone have NPD and bipolar

The relationship between narcissism and bipolar disorder

Someone who presents with a narcissistic personality it can be difficult to distinguish traits from someone who is mild to moderate in hypomania (bipolar mood elevation less acute than fully mania) with terrific self-esteem. And while the two may look the same, it's important to be able to make a clear distinction between the two. Let's examine these two phenomena in more detail.


The term narcissism has unfortunately evolved into a socially derogatory description of personality traits that match adjectives such as arrogant, selfish, insensitive, and selfish. The problem with this is that the actual clinical effects of narcissism have little to do with negative social characteristics. The narcissist is only showing a wide range of adjustments necessary at one time for his or her psychological survival.

Personality is something we all have. It is this unique organization of one's own strengths and abilities, the psychological defenses, developmental adaptations, coping styles and genetic predisposition. It is this group of qualities with which we meet the world. And it shows amazing endurance and relative stability over time. If someone had known you seven years ago and met you again today, he or she would notice some physical changes, but "how you are" probably wouldn't have changed much. Your "youth" tends to endure over time.

Some personality configurations come in forms that we identify with clinical terms that convey clusters of traits, attitudes, and behaviors. Their benefit is that they become a kind of clinical shortcut. Much can be conveyed in a word or two. Maladaptive personality traits accumulate in identifiable and recurring ways. The lexicon of personality includes familiar terms such as sociopathy, passive-aggressive, borderline, masochistic, and narcissistic, to name a few.

Think of the concept of personality as a specific color. Some people may be green; others blue, red, or yellow. Some days a person may be more intense blue or red, but they won't change from red to yellow, nor can they choose a day when they turn off their personality and go solid gray or white.

In its milder form, narcissism is simply a set of personality dynamics that affect an individual's organization. It is not a "diagnosis" of what is wrong. It is more of a description of how someone works. Given the narcissistic emphasis on strengths and social image, it is no surprise that many who display the narcissistic color are people who are very successful. They are executives, CEOs, academics, doctors, actors, lawyers. They lead with their strengths and do not cope well with aspects of weakness or vulnerability. Yet we wouldn't necessarily say that their narcissistic organization mirrors psychopathology. In essence, her life works despite her particular color. But when the coloring is strongly saturated; When their personality style really gets in their way, causing repetitive and ubiquitous interpersonal issues, their narcissistic organization can move into the realm of what is referred to as a narcissistic personality disorder. As with most psychopathologies, the behaviors, thoughts, feelings, and attitudes that reflect narcissism all exist on a broad continuum of experiences.

The real challenge in understanding how one's personality works is that, for most people, the synthesis of all the contributing parts is outside of conscious awareness. We do not choose to bring out all of the feelings, perceptions, attitudes, and behaviors that go with a particular personality style. The interplay of the many different aspects of our psyche has been precisely coordinated over many years. Much of what we are just happens automatically. We could say that the personality cluster has become functionally autonomous over time.

But how do we become blue, purple, yellow, or narcissistic?

The origins of development of a particular personality organization are not algorithmic. It is not that all people with strong narcissistic traits have been exposed to the same developmental influences. However, there is enough consistency in its pathogenesis to say that it often results in an individual's early needs being developmentally more advanced than his or her own age, a sense of inadequacy, a lack of adequate coordination by the primary parenting figures and a diffuse experience of developing self and not well formed. Despite the experience of a deficit, the narcissistically organized individual has learned to fall back on certain strengths and abilities in order to distance themselves from perceived weaknesses or weaknesses. If you think about it, it's actually a notable early developmental adjustment.

Narcissistic individuals have developed the ability to inflate, expand, and intensify their strengths. You learn to lead with them in such a way that their experience of feeling small or vulnerable is masked by depicting the opposite. The implication here is not that the narcissist's strengths are a delusion; but more so, that the narcissist is heavily invested in his strengths because they are used in the service of protecting or sustaining the self against the experience of inadequacy. Temporarily, everyone is fooled by this compensatory counterbalance, including the individual behind the narcissistic mask.

Another aspect of narcissistic self-awareness is the concept of grandiosity. According to Wikipedia, "grandiosity refers to an unrealistic feeling of superiority, a sustained view of oneself as being better than others." Miriam Webster defines grandiosity as "the quality or state of appearance or the attempt to appear more important or valuable than it is". These definitions are in line with what was previously said about narcissistic escape or avoiding shortcomings. Avoidance itself is achieved by investing in the grandiose image, which offers a reassuring distance from its opposing reality.

What's so wrong with this picture? Wouldn't we all feel big rather than small, powerful rather than vulnerable, masterful rather than incompetent? Yes of course. The dilemma, however, is that the narcissist must invest heavily in defense, as any rift in armor can lead to a sheer breakdown into unbearable areas of the self. The personality structure lacks sufficient flexibility, and the individual tends to feel the rapid onset of acute pain when their narcissistic style does not work well enough to gain the love, admiration, power, or control that the individual sought. This pain caused by the rapid breakdown of the immune system is known as narcissistic injury.

The unfortunate consequence of the narcissistic style is that people generally like and value people who can incorporate vulnerability into themselves. People who constantly need praise and recognition in order to strengthen their appreciation and thus avoid feelings of inadequacy can also become estranged between people, and this is where they lose. It's sad that the strategy of elevating others' opinions creates an inadvertent breakup rather than bringing others closer with interest and engagement. If only others could understand that narcissistic inflation really reflects the extent to which an individual is afraid of feeling small and inadequate, then we could all better gauge the plight the narcissist is facing.

Another point that will help us better distinguish narcissism from bipolar symptoms. The narcissistic personality does not usually go into remission. We can see different levels of intensity in the individual's personality style, but as mentioned earlier, narcissism is a persistent character style. With enough insight, motivation, and self-awareness, it can be modified, usually through psychotherapy, but it usually does not resolve, remains absent, and reappears at a later date. This is important when considering the differences between narcissism and narcissism in bipolar disorder.

Therapeutic work with a narcissistically organized individual involves helping him or her gradually become more open to the experience of inadequacy that has been historically distanced. This is not a small order. You see, the pathogenesis of pathological personality traits is about how individuals survived their own pain. For many, the potential to give up or easily change the way they are is really frightening due to the amount of emotional pain that needs to be kept in check. Once the individual learns to accept and experience denied and painful aspects of himself, he can gradually integrate into his experience. If this succeeds, the individual no longer has to maintain his compensatory behavior.

The good news here is that individual strengths and skills don't have to be given up. In fact, the opposite is true. When they no longer serve the defense function, strengths and capacities are released because they are no longer tied to a balancing agenda. The stiffness of the individual can decrease. One can begin to accept that he doesn't always succeed in being a Superman or a superwoman. Once this reality is no longer frightening, the individual can accept issues of vulnerability or weakness that are common to all of us.

Bipolar grandiosity

Bipolar grandiosity can sometimes disguise itself as a representation of narcissism. It can look the same on the outside and even feel the same on the inside. This can also lead to misdiagnosis. Even more confusing is the fact that bipolar grandiosity can coexist with narcissism, and when it does, the two sets of symptoms tend to potentiate synergistically. It is important to distinguish between the two to avoid misdiagnosis and to identify specific treatment approaches that are needed for each.

Let's start with clarifying the bipolar grandiosity. We typically see its presence during hypomania and / or mania, which is associated with a bipolar mood elevation. When individuals with bipolar disorder have an elevated mood, they may have experiences of well being that include euphoric mood, increased energy, and a high mood, upbeat outlook, accelerated thought processes, and increased creativity. In many ways, they feel a bit superhuman as the combination of symptoms during the mood elevation can allow bipolar individuals to function above their baseline in certain areas. When thoughts move faster, some cognitive connections are easier to make. When creativity is intensified through enhanced knowledge and a flurry of emotions that accompany hypomania, very unique creative processes can result. There is also the irony that sometimes the final product is not unique or special at all, but the experience of raising the mood can alter self-perception enough to make the individual believe they are producing something truly unique, specialized, and even superior. Taken to the extreme like in manic cases psychosis These grandiose self-perceptions can become delusional in nature. The individual truly believes he or she is the Messiah, the next contemporary Einstein, or perhaps a reborn Leonardo da Vinci.

The point is whether the elevation in mood leads to improved mental and creative processes or whether it simply creates the perception that this is happening. The bipolar individual in the midst of the mood elevation often perceives that he is capable of a unique greatness. This is the passing grandiosity we see in bipolar disorder.

Distinguishing bipolar grandiosity from narcissistic grandiosity

Bipolar grandiosity occurs in conjunction with several other symptoms associated with hypomania and / or mania. It is important that hypomanic and / or manic symptoms, including grandiosity, are all mood phase specific. As such, they do not hold out over time and are certainly not present during bipolarism. Depression where low self-esteem tends to be the dominant filter through which most self-assessment is passed.

Conversely, the narcissist's grandiose self-perception is more permanent. The experience of superiority is brought into play so often that it is an essential aspect of an individual's self-awareness. Consider interacting with two different people: one with bipolar hypomanic grandiosity and the other with narcissistic grandiosity. The interactions may actually feel similar to them. Perhaps the only noticeable difference is that the bipolar individual usually experiences greatly increased energy along with increased mood while the grandiose narcissist experiences his or her inflation on a psychological level, but he or she may not feel like he or she is triple his or her own normal physical amount has energy.

One final important distinction: unless there is comorbid psychosis or delusional disorder The narcissist's grandiosity does not usually reflect delusions. The messianic, Einsteinian, reincarnational manifestations of grandiosity mostly occur during manic psychosis and are not present in typical narcissism. And if the narcissist experiences delusional self-awareness under unusual circumstances, then he or she is living at the more extreme end of the narcissistic personality continuum.

Comorbidity of narcissism and bipolar disorder

It is estimated that approximately 5 percent of people with bipolar disorder (BD), including comorbid narcissists, have personality disorder (NPD). That's roughly one in 20 bipolar people who also have NPD.

In this case, the two disturbances can potentiate each other. Imagine the bipolar disorder narcissist starting to see an upswing in mood. Mental processes begin to move faster, the energy increases and the emotions develop into euphoria and strong optimism. The narcissistic aspects of the personality absolutely welcome this type of elevation as it provides the inflation and / or elevation that drives the core aspects of the narcissistic personality. Essentially narcissistic grandiosity is fed by bipolar exaltation and vice versa.

What's the problem with that? A person with bipolar disorder needs to learn to recognize the onset of hypomania. In this case, there is an opportunity for the individual to limit or offset the upward trend in mood and energy. Usually this is done through drug adjustments, regulating sleep, and failing to make decisions that further contribute to the mental and physical activation of the mood elevation.But This requires the bipolar individual to realize that the progression of the positive mood is not necessarily a positive thing. When we add narcissism to the mix, the individual's ability to discern what is adaptive or maladaptive becomes even more difficult, as the narcissistic defenses work closely with what occurs during the bipolar mood elevation, making introspection with accuracy nearly impossible .

The treatment of these problems in treatment is really the task of psychotherapy. Medication may be necessary to correct the situation, but it will not help you understand how mood and personality problems converge in your own psyche. Approaching narcissism in psychotherapy is a complex endeavor with a multitude of variables that make the process different for each individual.

If your own experiences match the previous content, I strongly recommend that you further investigate the problems with a psychologist who is familiar with the interface between mood disorders and personality.