Borderline Personality Disorder vs. Narcissistic Personality Disorder: Similarities and Differences

Borderline Personality Disorder (BPD) and Narcissistic Personality Disorder (NPD) are two personality disorders you wouldn’t necessarily associate with each other. But because the two disorders share the same “B cluster” grouping in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) – including erratic, dramatic, and emotional behaviors – they may be confused.

BPD and NPD actually 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 traits, they are distinct disorders with their own set of diagnostic criteria.

The National Institute of Mental Health (NIMH) characterizes Borderline Personality Disorder as, “a serious mental illness characterized by pervasive instability in moods, interpersonal relationships, self-image, and behavior.” The Mayo Clinic describes Narcissistic Personality Disorder as, “a mental disorder in which people have an inflated sense of their own importance and a deep need for admiration.”

Similarities between BPD and NPD

People with a diagnosis of Borderline Personality Disorder or Narcissistic Personality Disorder share many similar characteristics. They often exhibit a distorted sense of self, struggle with anger issues, and vacillate between idealizing others and devaluing them.

Similarities in people diagnosed with BPD or NPD also include the following:

  • A lack of concern for how their behavior impacts others
  • A tendency to believe the world revolves around them
  • A fear of abandonment
  • A need for constant attention
  • A constant struggle with work, family, and social relationships
  • Displaying overly emotional, erratic, or self-dramatizing behaviors

Both BPD and NPD occur in about 1 to 2 percent of the population, according to NAMI.

Differences between BPD and NPD

Despite their many similarities, because Borderline Personality Disorder and Narcissistic Personality Disorder are two different psychiatric disorders, they also have a number of differences.

For example, people with BPD tend to be highly impulsive and may engage in such compulsive behaviors as excessive spending, binge eating, and risky sexual behavior. People with BPD are also more likely to engage in self-harming behaviors, such as cutting or suicide attempts.

People with NPD, on the other hand, have an inflated sense of self-importance and may take advantage of others to get their needs met.

Here are some other differences between Borderline Personality Disorder and Narcissistic Personality Disorder:

  • People with NPD think they are “special” and that they can only be understood by other special or high-status people, while people with BPD feel misunderstood and mistreated
  • More men tend to be narcissists, while women tend to be diagnosed more often with BPD
  • People with NPD expect others’ lives to revolve around them, while those with BPD will devote their lives to another person
  • People with BPD will frantically try to avoid what they consider to be abandonment, while narcissists are more likely to do the abandoning

Personality Disorder Treatment

Treatment for both Borderline Personality Disorder and Narcissistic Personality Disorder revolves around psychotherapy, including Cognitive Behavioral Therapy (CBT) and Dialectical Behavior Therapy (DBT). Antidepressants or anti-anxiety medications may be used to help treat co-occurring symptoms of depression, anxiety, or other mental health disorders. Treatment may involve individual therapy sessions, group therapy, or a residential treatment center for personality disorders.

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3 Responses to “Borderline Personality Disorder vs. Narcissistic Personality Disorder: Similarities and Differences”

  1. Jeani Weenie 10. Aug, 2011 at 8:06 pm #

    Love your article. I work at a lockdown MHRC (Mental Health Rehab Center) and we have many BPD and NPD. It is exhausting. I never saw NPD, but they certainly go hand in hand. I believe that my mother was or is bpd. She is 76 and recently boasted that she punched my stepdad in the face at a restaurant and told him, “I’m not going to be abused by anyone.” My thoughts were, “Of course not, because you are the abuser.” She was my schooling into this business. She was very abusive to me as I was growing up beating me with metal coathangers and giving me enemas and making me hold it on hardwood floors while on all fours. She taught me how to walk on eggshells and become a human camellion. (Woody Allen’s Zelig) anyway, I took off work early tonight because I am burned out and am drinking a sixer of beer. I was sober for 23 years to raise my kids, and now they are 28 and 31.Now my 28 year old daughter who’s pregnant, married and having her 4th child tells me how she needed a mother and not a friend. It has been devistating. I am blessed to still have my grandmother at 94 and has all her faculties. We get along so well. My mom bags on her constantly. All I want to do is break the chain. Any suggestions? Thanks, Jeani

  2. Jeremy 16. Mar, 2012 at 12:37 am #

    Limit your alcohol intake :) Be honest with your daughter. Limit contact with your mother. Learn cognitive-behavioral strategies to challenge and overcome distortions. Join a group of other survivors. Give yourself credit for breaking the chain. Find a GOOD therapist, they are out there. I have done these things and become a therapist. My mother was a narcissist and I have battled back from borderline symptoms myself as a result. Most importantly, believe in yourself.

  3. QtrAcreGal 27. Oct, 2013 at 9:34 am #

    I grew up with one biological sister, in a home where abuse gave me my first memories. Now 53, I’m 25 yrs sober, a self-mutilator in recovery, & have come to view even compulsive overeating as a form of self-harm. Of course, for MANY years, I was diagnosed as a Borderline. Returning home, however, 4 yrs ago, I saw something I DIDN’T WANT to BELIEVE: My sister (2yrs younger) displays signs OF NARCISSISM. A home health care nurse, she has surrounded herself with others she considers ” impaired”: From the husband who’s been cheating on her for 17 years to the Fetal Alcohol Syndrome babies that she adopted that ended up with the LONGEST juvenile records in the history of her state, she prides herself in her functionality. When asked if SHE has EVER hurt anyone, her response is to cut the person out of her life as punishment for the accusation.

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