Bipolar disorder and narcissistic personality disorder are different diagnoses but may share some characteristics. Some people live with both conditions.
Bipolar disorder and narcissistic personality disorder (NPD) can both result in impulsive and overconfident behaviors.
For example, you might know someone who doesn’t heed warnings or tends to ignore other people’s opinions. Maybe they don’t seem concerned about the impact of their actions or tend to set unrealistic goals.
But are these seemingly rushed behaviors a symptom of bipolar disorder, NPD, or both?
Yes. Bipolar disorder and narcissistic personality disorder are two different mental health conditions but symptoms of both can co-occur.
The Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) says bipolar disorder symptoms include mood episodes. These moods may involve hypomania, mania, or depression.
On the other hand, NPD is one of 10 personality disorders. It’s part of the cluster B disorders, characterized by dramatic, emotional, and erratic behaviors.
People living with narcissistic personality may not typically experience sudden mood episodes. Instead, the condition may mean living with a persistent inflated self-image, a sense of entitlement, and a need for praise and admiration.
It’s possible to live with both bipolar disorder and narcissistic personality disorder symptoms.
In other words, they can often coexist. This connection may have to do with challenges in emotional regulation experienced by people with all these conditions.
Yes, some behaviors could be interpreted as both a symptom of bipolar disorder or a symptom of narcissistic personality disorder.
For example, a person with bipolar disorder who may be experiencing mania could act impulsively, leading them to ignore some rules. In the same way, a person with NPD might also ignore or fail to comply with some social or specific rules.
The reason for this behavior, however, can be very different for both people.
On one hand, someone experiencing mania may have a difficult time controlling their impulses, which could lead to overlooking some safety rules.
On the other hand, someone with NPD might believe some rules don’t apply to them because they feel they deserve special treatment.
Bipolar disorder and NPD can also be confused with one another because some people experiencing hypomania or mania in bipolar disorder can develop signs of grandiosity, a common symptom of NPD.
Grandiosity refers to a persistent belief that one is superior to everyone else.
In fact, research from 2011 suggests that as many as two-thirds of people with bipolar disorder also experience these grandiose delusions.
Since behaviors can often be misinterpreted, only a trained mental health professional can offer you an accurate diagnosis. For that, they will likely explore other significant behaviors and persistent sources of distress for you.
Symptoms of NPD
- fantasies of superiority and sense of entitlement
- persistent need for praise and admiration
- constant use of manipulation tactics
- low empathy
- envy, jealousy, and difficulty trusting others
- tendency to act arrogantly and with scorn
- belief one is unique or special, more so than others
Symptoms of bipolar disorder
During an episode of mania, symptoms may include:
- high energy and euphoria
- racing thoughts
- difficulty following a conversation
- not needing sleep
- difficulty focusing or completing tasks
- impulsive behavior
- inflated sense of self or grandiose delusions
During an episode of depression, symptoms may include:
- feeling hopeless
- negative thinking
- loss of interest in enjoyable activities
- low motivation and fatigue
- thoughts of suicide or self-harm
It’s possible for someone with bipolar disorder to exhibit several narcissistic traits. There’s no concrete information regarding how many people with bipolar disorder rank high in narcissism, though.
Narcissism is a spectrum and most people may develop one or more traits in this spectrum. This isn’t the same as having narcissistic personality disorder, though, and it isn’t exclusive of people with bipolar disorder.
In this sense, someone with bipolar disorder could live with narcissistic traits without getting an NPD diagnosis. For example, someone experiencing mania could rank high in grandiosity.
An NPD diagnosis would be at the high end of the narcissism spectrum. It would mean that narcissistic traits:
- are evident across situations
- over time result in high levels of distress for you
- are a greater impact on your self-image and how you see others and the world
Some people with either NPD or bipolar disorder, particularly in an episode of mania, may experience any or all of these symptoms:
- exaggerated sense of competence or importance
- disregard for boundaries or rules
- conversations centered on themselves
- impatience when not getting what they want
- difficulty regulating emotions
- disregard for other people’s experiences or opinions
But, again, these behaviors have different causes in each condition.
Even if mood episodes aren’t a formal symptom of narcissistic personality disorder, it’s also possible some people with this condition experience significant changes in mood.
For example, someone may experience narcissistic collapse, which could make them go from an elevated mood to temporarily experiencing symptoms similar to depression, such as angry outbursts, hopelessness, and sadness.
Narcissistic personality disorder and bipolar disorder are two separate mental health conditions. They can co-occur, though.
Only a mental health professional can provide an accurate diagnosis, which includes a closer look at specific behaviors, sources of distress, and persistent thoughts and attitudes.
Both bipolar disorder and narcissistic personality disorder can be treated, although people with NPD may be less likely to seek support because they often lack the ability to link their distress with their own behaviors.