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.