A personality disorder is a type of Mental health condition where a person thinks, feels, behaves, and relates to others in maladaptive ways. These patterns are long-lasting, often starting in childhood or adolescence, and they can cause problems in relationships, work, and everyday life.
According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), there are 10 recognized personality disorders. Of these, borderline personality disorder (BPD) and narcissistic personality disorder (NPD) are the best known. These are separate personality disorders, although they are often confused because they share overlapping traits. There are significant differences between the two of them as well. Let’s take a look at some of these similarities and differences.
How are BPD and NPD similar?
People with BPD or NPD experience a disconnection from reality, which is often characterized by a distorted view of themselves and others. This manifests as disassociation, delusions, and a tendency to live in a fantasy world. BPD and NPD share similarities in that both disorders involve emotional dysregulation. Emotional regulation is a person’s ability to manage and exert control over their own emotional experiences and expressions. This involves recognizing, understanding, and responding appropriately to emotions in a way that promotes effective functioning. Both BPD and NPD involve dramatic, overly emotional, or unpredictable thinking and behaviors. Impulsivity is a common trait of these conditions, involving a tendency to act on a whim, without thinking or consideration of the consequences. These individuals often engage in behaviors with short-term rewards, but long-term costs.
Unstable interpersonal relationships are signs of both disorders, referring to a pattern of intense highs and lows, fluctuating emotions, and behaviors that can cause significant difficulties in maintaining healthy connections with others. These challenges can lead to cycles of idealization and devaluation, where sufferers shift between perceiving someone as either perfect or completely flawed, often in a rapid and extreme manner. (This behavior is often called “splitting.”) People with BPD or NPD might have frequent mood swings and outbursts of anger or unreasonable rage, while they may express hostility indirectly through passive aggression or engaging in silent treatment. People with these disorders tend to be unable to admit when they are at fault and instead use others as scapegoats when they make mistakes. Both conditions are also characterized by the use of gaslighting and manipulation, but these tactics are used for different reasons.
How are they different?
The two disorders are differentiated from each other in a number of ways. A prominent symptom of BPD is a fear of abandonment. As a result, people with this disorder engage in manipulative behaviors as a way to cope with their intense emotions and fear of abandonment, to seek control and validation in situations where they feel powerless. On the other hand, those with NPD manipulate to gain control over situations and take advantage of people. NPD is characterised by narcissism, involving a sense of self-importance, attention-seeking behaviors, and a constant need for flattery and admiration. (Fossati et al., 2016.)
People with NPD believe they are entitled to special treatment, they exaggerate their abilities and achievements, and have a strong sense of superiority over others. Those with NPD frequently display arrogant and condescending behavior, and they lack empathy and consideration for the feelings of other people. Another core trait of NPD is a pervasive pattern of grandiosity, in which narcissists possess an unrealistic and overconfident self-image. In contrast, people with BPD have an unclear or unstable sense of self. They experience feelings of worthlessness or inadequacy, while they are prone to self-harming behaviors and suicidality.
Why do these differences matter?
As we can see, BPD and NPD are two distinct disorders, although they clearly share some similarities. In terms of cause, both are likely influenced by a complex interplay of genetic predisposition, childhood experiences, and neurobiological factors. Furthermore, it’s not uncommon for personality disorders to co-occur, and a considerable percentage of individuals meet the criteria for both BPD and NPD. (Hörz-Sagstetter, 2018.) Ultimately, it’s vital to distinguish between the two conditions, or to establish if they are comorbid, in order for people to receive an accurate diagnosis and effective treatment.
BPD and NPD are different disorders although at their core, both reflect deep struggles with relationships, self-image, and self-worth.
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