Narcissism Vs. Bipolar

Narcissistic personality disorder
#1

I was told by a Psychologist that Narcissism can be misdiagnosed as Bipolar disorder and vice versa because both disorders exhibit similar traits:

What Are the Symptoms of Bipolar Disorder?

  • Increased energy, activity, and restlessness
  • Excessively “high" overly good, euphoric mood
  • Extreme irritability
  • Racing thoughts and talking very fast, jumping from one idea to another
  • Distractibility, can’t concentrate well
  • Little sleep needed
  • Unrealistic beliefs in one’s abilities and powers
  • Poor judgment
  • Spending sprees
  • A lasting period of behavior that is different from usual
  • Increased sexual drive
  • Abuse of drugs, particularly cocaine, alcohol, and sleeping medications
  • Provocative, intrusive, or aggressive behavior
  • Denial that anything is wrong

What are the symptoms of Narcissistic Personality Disorder?

  • A grandiose sense of self-importance (e.g., exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements)
  • Is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love
  • Believes that he or she is “special” and unique and can only be understood by, or should associate with, other special or high-status people (or institutions)
  • Requires excessive admiration
  • Has a sense of entitlement, i.e., unreasonable expectations of especially favorable treatment or automatic compliance with his or her expectations
  • Is interpersonally exploitative, i.e., takes advantage of others to achieve his or her own ends
  • Iacks empathy: is unwilling to recognize or identify with the feelings and needs of others
  • Is often envious of others or believes that others are envious of him or her
  • shows arrogant, haughty behaviors or attitudes

Can a person with NPD also be Bipolar?

#2

Regarding mis or multiple diagnosis, the following is clipped from a website - it is all interesting reading. Author is a professor of psychiatry at Harvard.

http://www.addresources.org/article_shadow_syndromes_ratey.php

"The problem is, every patient is different—including every patient with the same diagnosis. Asa result, the number of syndromes recognized by practicing psychiatrists has leapt in the 40 years since the first edition of the DSM appeared in 1952. That volume described 8O categories of abnormal behavior. DSM II, published in 1968, more than doubled this number to 145 syndromes, and DSM II raised the total to 230. DSM IV, which appeared in 1994, lists 410 in all. What the ever increasing number of possible diagnoses means is that a person who comes into a psychiatrist’s office complaining of being “depressed,” for example, could be categorized as belonging to one of four major categories —bipolar disorder, major depression, “other specific affective disorders,” or "atypical affective disorder"—with several subcategories included within each of these main categories. A patient diagnosed as bipolar could then be further characterized as mixed, manic, or depressed, for instance.) It is a complex business.

As time goes by, we find that the art of diagnosis grows ever more fragmented; seemingly sound diagnostic categories keep breaking down. Emotional problems do not fit the “concrete blocks” of the DSM I, II, or III; real people come into the office with bits of this and pieces of that. A patient might show signs of panic disorder, signs of major depressive disorder, and signs of a narcissistic personality disorder all in the same package. He or she may have parts of a whole array of syndromes, and yet not suffer from all of the symptoms of any one syndrome. Or he may fit every aspect of a syndrome down to the smallest detail and yet be so mildly affected compared to either people suffering from that problem that even a good therapist might miss the diagnosis. Finally, a patient may exhibit only one or two symptoms from a particular syndrome, a condition long known as a forme fruste in conventional medicine. "

#3

Blitzen, very good point, I need to think more about that one. However the more I roll it around in my head It’s more likely that someone could be BPD with N traits. You’re right, I don’t believe it can be the other way around.

#4

DD,

I don’t know that much about bipolar (except that it seems to be biochemical, treatable to near non-existance, and yes, I would let my daughter marry one), but I do know that I have come across a lot of diagnosed bipolars with marked Narcissistic tendencies.

(No NPDs that seem bipolar though…hmmmm…maybe just the crowd I associate with? Yes? No? Offers?)

The question is, are the bipolar misdiagnosed as NPD…OR…did the fact of growing up with bipolar (and all the fun that must entail) precipitate an Narcissistic focus?

GD

#5

I had posted this reply on another CarePlace forum (A New Path) but perhaps it will help anyone who is still reading this board. ;-(

I hope there are members who can offer concrete information, DD. What I've learned comes via my experience with a NPD spouse and several family members diagnosed with bipolar-1 and bipolar-2.  

It is my understanding that 'yes', NPD is common-enough for people who have bipolar disorder. As difficult as it might be to distinguish the difference between a personality disorder and a bipolar mania, the main distinction seems to be Consistency.

Grandiosity is a long-term trait for someone diagnosed with NPD. The bipolar person also exhibits grandiosity though it's relative to biological moods and not external circumstances.

Same thing with 'revenge' or 'envy' or other pathological traits/patterns observed in the Narcissist over their lifetime. Perhaps ego defenses increase during a 'corrosive life event' in the N's life, but the defenses were ALWAYS there though not as magnified perhaps.

Bipolar people might also be distinguised by their capacity for empathy and their TRUE remorse once a mania has run its course. This is when their depression might lead to suicidal obsessions because they DO feel terrible about the harm they caused other people or themselves.

In my experience, the X never could feel deeply remorseful for his behavior because of course, he unconsciously projected blame (justification) onto others. Not so with bipolar people. They suffer tragically for moods over which they have no control.

A few people I've encountered online had made the assumption their partner was NPD when in fact, they were eventually diagnosed with bipolar. And yes, bipolar can manifest as late as Midlife when symptoms had been more manageable at a younger age. We might consider bipolar as a potential cause of the Midlife Crisis and at this point, it appears many therapists are seeking familial history to rule out bipolar as the problem.

This is merely my perception but it might have some validity in other people's experience with bipolar and NPD: Holding the self responsible.

The more narcissistic a bipolar person may be, the less likely they will be responsible about taking medication to sooth destructive moods. In other words, the bipolar person must CARE (empathize and remorse) about the people they impact when they are unable to regulate emotions. The Narcissist uses ego defenses to deflect personal responsibility (we've all experienced this!). So the more responsible someone is about their mental illness and it's impact on others, the less likely they are to be NPD.

I could be all washed up on that point but it's something I've thought about.

My sis is not NPD but the thought sure crossed my mind prior to her diagnosis. She always takes her meds and she also sees a psychiatrist for cognitive behavioral therapy. My nephew (he's still a teen) resists medications and that's why we've tried to counteract his narcissism with activities urging him away from isolation.

The X never considered his thinking might be nutz even when he was destroying himself and others. His arrogance remained consistent over his lifetime (we met at 19 and divorced in our 50's) though it was never pathological until several uncontrollable events threatened his illusions of grandiosity at Midlife.

Did he seek help? HELK NO

Did he sympathize with his family's pain? HELK NO

Did he trust anyone to be telling him the truth? HELK NO

Not so with my sis. As soon as people started talking to her about her behavior, she sat her little be-hind in a psychiatrist's office and asked for help.

"NPD is one of the most commonly occurring personality disorders among bipolar patients (Brieger, Ehrt, & Marneros, 2003); and bipolar disorder is the third most common Axis 1 disorders found in narcissistic patients (5-11%; Ronningstam, 1996)." ~Excerpted from page 121, Elsa Ronningstam, Understanding and Identifying the Narcissistic Personality.

"Notable is the bipolar NPD patients' appreciation for mood elevation and capability to integrate high energy and activity level into periods of successful personality functioning, and even highly valuable professional or creative achievements.

"...Identifying the presence of genetic or biological communalities awaits further research." (page 124)

hugs all, 

CZBZ

#6

Misdiagnosing Narcissism - The Bipolar I Disorder

http://samvak.tripod.com/journal71.html

Misdiagnosing Personality Disorders as Bipolar I Disorder

http://samvak.tripod.com/personalitydisorders61.html

Sam

#7

I AM THRILLED TO DISCOVER “REAL PROOF” IN THAT MY FATHER’S FATHER WHO
HAD COME BACK
FROM WORLD WAR II DID SUFFER FROM PTSD. HE ALSO ABUSED HIS KIDS/
NEGLECT/ INDIFFERENCE/ THAN ANGER. IT IS A PROVEN FACT THE PTSD IS
PASSED ON THROUGH THE GENERATIONS. NPD IS OFTEN THE REACTION FROM
THIS PTSD. BOTH MY DAD AND HIS BROTHER
HAVE NPD. AND ALSO DOES MY BROTHER.

NONE OF THIS IS MY FAULT. NONE OF THIS IS MY FAULT. NONE OF THIS
IS MY FAULT.
On Nov 8, 2007, at 6:53 AM, samvaknin wrote:

#9

Here is another interesting discussion of actual NPD

GD

#10

I found this to be a very interesting thread…being that I am Bipolar…

TJ

#11

can i add this?..my brother was misdiagnosed as bi-polar…but the episodes were short-lived not in definate cycles as with BPD.he had breif psychotic episodes which were short-lived…suicidal one day fine the next…my last ex N was convinced he was hyper/bi-polar too…and was up and down like a yo-yo for NO apparent reason and could be"triggered’by a tiny slight for example.
i have heard that TRUE bPD has 6mth cycles…is this true?(rather than rapid cycling?

#12

do these people perhaps have a form of unresolved PTSD from childhood abuse perhaps?be that abuse physical emotional or even from being"loved too much"engulfed by a dominating parent(mostly mother)or converseley,form being’smothered"and overptotected?/whatever…they traumatize those that care about them…and perhaps therefore many are suffering from stress/trauma now or are going through a form of "post -traumatic grief?loss as well as recovering from varoius"traumas"inflicted on them by their N partners?

#13

My cycles are long cycles of depression with short manic cycles thrown in… In regards to whether this is brought on by overcrontrolling parents, etc., I don’t know. I can surely tell you that my mother is very controlling, and was abusive… I first became depressed when my father died at age 12, my parents has been separated since I was about 3 years old but I secretly thought that they would get back together since we saw him from time to time… I was not diagnosed bipolar until 38 years old…first it was diagnosed as major depression, however.

For one thiing, I think that bipolar disorder tends to create a narcisstic or self centered personality disorder because one is constantly concerned about their illness and it becomes the center of their life. It is difficult to fight that. Of course for most bipolars, there are other diagnoses…for me it is social anxiety disorder and PTSD…

I’m always anxious and since being diagnosed with bipolar tend to fly off the handle easily…something I didn’t do prior to… But as I said I have dealt with depression on and off for years, never ever figuring out why or what primiarily it was… Once I found it, then it all made sense, but I still haven’t found anything long term that treats it…which is difficult in itself…

TJ

#14

My ex had a whole lot of borderline going on. I don’t know that she ever had cycles, but she did seem different depending on whether or not she was single, in a relationship, or trying to keep one from falling apart. Borderline is thought to center around a fear of abandonment, real or perceived, that determines their behavior. My exes father left her life quite abruptly at a very young age and she was relocated several times after that.

I can see similarities between PTSD and personality disorders, but the disorders are much, much worse.

#15

yes loads of similarities…its like they are living out their past almost and working thriough stuff sometimes…my last one used to "swing"between being needy/independant…fearing abandonment and wanting it…no wonder are heads were"all over the place"really…they didnt seem to know what they wanted…so how could we?
It does seem to be a kind of PTSD type thing though…but they end up giving us PTSD and a LOAD of grief…pure projection really.?

#16

First: Interesting that Susiejo writes, D.D. calls her blitzen, and she responds to it, signing G.D., also then Sam Vaknin appears—where’s he been? Very interesting!!!

But what I really want to say is that I work with several students who are diagnosed as bipolar, and while yes, there could be some with Narcissistic traits, I see nothing that would confuse me of being one or the other. Bipolar disorder is completely different than Narcissistic disorder and I have lived with one and worked with the other.

#17

[POST WAS DELETED]

There are messages in this thread from last year. There is a %0 tolerance policy in this forum in that I will most likely remove anybody from the forum who continues to discuss those events and people from the past, and I will delete any messages about it. The policy is not up for discussion either, and I’ll remove anybody who discusses it publicly.

Please repost your message with the irrelevant stuff left out…

#18

have i said anything that has caused any trouble here?as it was a response to my post?..thankyou.

#19

Nope, you’re doing fine =)

#20

i think these poor souls are stuck in thier past to be honest…they seem to’live inside thier own heads’so to speak.

they had people that wanted to bring them in to the now/future,to move on,to heal,but unfortunately their defences are so strong…that even with the best will in the world…it is near-on impossible to’reach’them…its almost like they are in an’altered reality"
Personally…though my own experiennnnces,i honestly feel that they have been either badly"traumatized"or "smothered"and that the traumatized ones are suffering a form of PTSD badly wounded souls,sadly.
BUT as the saying goes"you cant save those who dont want to be saved"they have to have the courage to face up to themselves!..we have.

#21

agreed WYouth, but arent we talking about sustained daily contact, spouse with spouse, parent with child, or teacher with student?