Narcissistic Personality Disorder and Borderline Personality Disorder: Understanding the Differences
Individuals who want to know about narcissistic personality disorder and borderline personality disorder typically search for answers as to why they have these difficult emotions, what is going wrong in their relationship, or why their behavior is so erratic. While different disorders they can have some similar traits, such as difficulties in relationships, emotional symptoms and rejection sensitivity. The lessons learned could help you to decide whether further professional assistance is required.
Personality disorders are patterns of thinking, feeling, relating and reacting that are chronic. They’re not simply personality traits or labels attached to a person that displays negative behavior. A diagnosis should be made by a trained mental health provider who would take into account the person’s history, symptoms, interpersonal functioning and functioning in general.
Key Takeaways
- There are two personality disorders: NPD and BPD.
- NPD is often linked with a sense of self-importance, desire for admiration and feelings of being entitled, and lack of empathy with others.
- Emotional instability, lack of sense of self, impulsivity, fear of abandonment and strong relationships are closely associated with BPD.
- An individual may suffer from NPD and BPD.
- Both conditions can only be diagnosed by a trained mental health practitioner.
- Psychotherapy is an important part of the treatment for both conditions.
- BPD is treated with a number of evidence-based psychotherapies, such as dialectical behavior therapy (DBT).
- Establishing healthy boundaries and having a professional guide can also help those living with or supporting anyone with either of these disorders.
What is Narcissistic Personality Disorder (NPD)?
Narcissistic personality disorder is a personality disorder in which a person has a persistent pattern of self-involvement, attention-seeking behavior, and an inability to consider others’ feelings.
The NPD individual may appear very self-assured. But their self-esteem is much more fragile than it appears. Emotional reactions may be elicited to criticism, rejection, failure or situations challenging their sense of importance.
They can encompass some common characteristics like:
- A high level of self-esteem
- The need to be idolized to the max
- Feelings of entitlement
- Expecting special treatment
- Exaggerating accomplishments or skills
- To despise someone who they feel is less important than they are.
- Difficulty identifying needs or emotions of others
- Good reaction to criticism and/or perceived disrespect
- Patterns of relational problems
That doesn’t mean that they are confident and enjoy praise and sometimes act selfishly, and they don’t have NPD. To diagnose persistent patterns are required that result in substantial impairments in relationships, work or other important life activities.
Other mental health problems may also be a complication of NPD. One of the reasons why professional assessment through a formal psychological evaluation is important is because of this.
What is Borderline Personality Disorder (BPD)?
BPD is a mental illness that may significantly impact emotional, self-perceived, behavioral and relational aspects. Even people with BPD can experience intense and overwhelming emotions.
Symptoms include:
- A strong sense of insecurity and fear of abandonment.
- Quick mood swings; temper tantrums.
- Unstable, unstable, or changing feeling of the self.
- Intense relationships
- Impulsive behavior
- Difficulty regulating anger
- Feelings of emptiness
- Having a “glass half empty” or “glass half full” attitude
- In some, self harm/suicidal behaviour
BPD is not a sign of being manipulative or an intentional effort to be dramatic. For those experiencing the emotional responses, they may seem very real and intense.
Above all else, BPD can be treated. Psychotherapy is an important aspect of treatment, and skills learnt in DBT include techniques for the management of intense emotions, reduction of harmful behaviour and the development of healthy relationships.
Narcissistic Personality Disorder vs. Borderline Personality Disorder
The biggest difference between NPD and BPD is the pattern underneath the behavior.
| Feature | NPD | BPD |
| Self-image | Often centered on importance, superiority, or achievement | Often unstable or rapidly changing |
| Main emotional concern | Self-esteem, recognition, criticism, or status | Abandonment, rejection, emotional instability |
| Relationships | May involve entitlement, admiration-seeking, or difficulty with empathy | May shift between intense closeness and conflict |
| Emotional changes | Can occur around threats to self-esteem | Often intense and rapidly changing |
| Impulsivity | May occur but is not the central feature | Common and can be significant |
| Fear of abandonment | May occur but is not the defining feature | Often a major concern |
| Treatment focus | Self-esteem, relationships, emotional awareness, and accountability | Emotional regulation, relationships, impulsivity, and coping skills |
The differences can be helpful to understand the conditions but not as a checklist for diagnosis of another person.
Diagnosis can also be complicated because of the overlap that exists among the various personality disorders. A comprehensive evaluation may be required to differentiate BPD from other personality disorders, mood disorders, trauma-related disorders and other issues.
What Are the Similarities Between NPD and BPD?
While NPD and BPD are distinct disorders, they have some common characteristics.
Both are able to impact nearness connections. There may be conflict issues, problems of trust, emotional problems and problems with safe relationships.
In both, there may be problems of self-esteem and emotional anguish. An attack on his/her self-image can elicit strong responses from a person with NPD. A person with BPD might feel distressed and distressing when they feel rejected or abandoned.
Some of the other similarities might be:
- Difficult relationship patterns
- Strong emotional reactions
- Need to approve of others and please others
- Problems with self-image
- Anger stemming from a conflict with others
- Trying to suppress some of your emotions
- The depression or anxiety may sometimes occur in addition to the epilepsy in some people.
It is one of the reasons why labels that may be included in the internet may be misleading because of the similarity in outward behavior. In one argument two people may be doing the same thing and have completely different thoughts and feelings going on in their heads.
NPD vs. BPD: Differences in Emotions and Relationships
The differences are more easily understood in terms of relationships.
Relationship issues, in narcissistic personality disorder (NPD), may be connected with feeling adored, special or recognised or controlling the self-image. When they are questioning their self-image, criticism might be threatening.
Relationship issues are also typically associated with fears of abandonment and changes of feeling. An individual can feel very close to another person, and then all at once feel rejected, betrayed, even angry towards the other person.
For example, when your boyfriend doesn’t respond to text messages for several hours.
The silence can be a message for a BPD individual that it’s time to end the relationship. This can lead to heightening anxiety, anger, sadness and/or frantic attempts at reconnecting.
The same ‘hushedness’ that a NPD feels may be experienced as disrespectful, rejected or not receiving the attention they believe they are owed.
Below are some examples of smaller versions. Individuals are actual and may have differing symptoms.
What is important is that by looking at behavior you can’t tell what type of disorder a person has.
Can Someone Have Both Narcissistic and Borderline Personality Disorder?
Yes. Some people can have NPD and BPD at the same time.
Some people may have more than one personality disorder and personality disorders can overlap. This can render diagnosis more difficult, and is another benefit of having a professional evaluation.
If both of these conditions exist, a person can exhibit symptoms of unstable relationships, strong emotional reactions, low self-esteem, need for admiration, fear of rejection, or not knowing others’ viewpoints.
If someone has both, it does not imply that they can’t improve. Treatment can focus on specific symptoms and behaviors, which are causing distress or disrupting relationships and functioning.
How are NPD and BPD Diagnosed?
There isn’t one blood test or brain scan to diagnose NPD or BPD.
A mental health worker will review:
- Abnormalities in thoughts and behavior that persist over time.
- Emotional responses
- Relationship patterns
- Self-image
- The tendency of being impulsive and coping.
- Personal/Family History
- Other mental health symptoms include
- How symptoms impact living from day to day
Structured interviews or questionnaires may be used by the clinician as well.
It can be challenging to diagnose since a number of mental health disorders can have similar symptoms. Depression, anxiety, trauma related disorders, substance abuse and other personality disorders can also have some symptoms of personality disorders.
Trying to use content found on social media or online checklists to diagnose the problem isn’t accurate, so it’s not advisable to try to with a spouse, partner, parent, friend or co-worker.
How are Narcissistic and Borderline Personality Disorders Treated?
Treatment will vary by individual based on their symptoms, the goals of treatment, a person’s safety, relationships, and other mental health issues.
Psychotherapy for NPD
Psychotherapy is the main form of treatment for NPD. It can help a person be more aware of triggers to their emotions, improve their relationships, be more aware of their strengths and weaknesses, increase self-esteem and be better equipped to deal with criticism.
Change can take time, particularly if things have been going on for a long time and relationships have been impacted.
Psychotherapy for BPD
Psychotherapy is also an important component of BPD treatment. One popular approach and one that focuses on skills is DBT, which focuses on skills and coping strategies such as emotional regulation, distress tolerance, mindfulness and healthier communication.
Other types of psychotherapy can be used, depending on the person’s needs.
Medication
There are no drugs that are effective for NPD or BPD. However, a psychiatrist might prescribe medication if it is appropriate to do so to treat some symptoms or if there are any other issues that need treatment, such as depression or anxiety.
It is essential to have a customized assessment prior to beginning or altering psychiatric treatments.
Need help understanding difficult relationship or emotional patterns?
It’s not all up to you. WellMind Therapy Center offers expert mental health assistance to help people identify patterns of emotions and relationships, as well as symptoms they may be experiencing that could be impacting their daily lives. Discuss concerns and the options for support with WellMind Therapy Center.
When Should You Seek Professional Help for NPD or BPD?
If emotional and/or relationship issues persist and are interfering with functioning, get professional help.
Consider getting a evaluation if you or someone that you care for has any of the following symptoms:
- Repeated relationship conflicts
- Severe emotional reactions
- Lack of self-esteem or self-worth continuing feelings of emptiness
- Difficulty controlling anger
- Fear of abandonment, disrupts relationships,
- Impulsive or self-destructive behaviour
- Issues that are occurring now regarding criticism/rejection issues
- Depression, anxiety or drug/alcohol use and personality problems.
- An increase in thoughts about harming or dying by suicide.Thoughts of self-harm or suicide.
There’s no need to wait until a crisis to get assistance.
If there is imminent danger of harm to self or others contact emergency services or an appropriate crisis service in your community.
So it’s acceptable to ask for help even if the person you are worried about isn’t interested in an evaluation. A therapist can assist you to identify relationship patterns, establish boundaries, communicate more effectively and safeguard your own well-being.
Frequently Asked Questions
What are the top 3 worst personality disorders?
No scientific basis for ranking the “worst” personality disorders. NPD, or BPD, and other disorders can be debilitating, but the extent of the difficulty will depend on the individual, symptoms, risks and access to effective treatment.
How to tell if someone is borderline or a narcissist?
It is not possible to tell if someone has BPD or NPD just by a few behaviours. A mental health professional’s diagnosis is based on the continuity of symptoms, emotional reactions, relationships, history, and functioning.
Can you live with a narcissist husband?
Yes, but it can be challenging to live with a spouse that has a NPD. Professional support can facilitate understanding of relationship patterns, setting healthy boundaries, clearly communicating with others, and maintaining emotional well-being.
Do people with BPD like narcissists?
You can’t apply a single answer to every situation. Individuals diagnosed with BPD are of diverse personalities and relationship options. There can be unhealthy patterns in some of the relationships, but these relationships do not always mean that people with BPD are attracted to people with NPD.
What happens when a narcissist meets a BPD?
Relationships with someone with NPD and someone with BPD can include strong attraction, conflict, rejection sensitivity, emotional reactions or turbulent communication. But results are greatly variable and cannot be foretold by their diagnosis.
Final Thoughts
If you are unfamiliar with narcissism and borderline personality disorder, it all begins with knowing that neither condition is just a label slapped on the internet. Both are characterized by complex patterns that impact on emotions, self-image, behaviour and relationships.
The things that often come to mind when thinking of NPD are grandiose thinking, admiration seeking, feeling entitled, and feeling vulnerable. Emotional instability and fear of abandonment, impulsivity and an unstable sense of self are more strongly related to BPD.
Above all, a diagnosis is not a statement of limits. Individuals can learn healthy ways of handling emotions, expressing themselves, relating to others, and dealing with challenging situations with the right professional assistance.
It may be helpful to seek out a mental health professional who has experience in treating individuals with symptoms of a narcissistic personality disorder and/or a borderline personality disorder, or those who are experiencing troublesome relational patterns. Call WellMind Therapy Center to discover the mental health services available and a direction to go down that is right for you.
Disclaimer
This article is intended for general educational purposes and is not a substitute for professional diagnosis, treatment, or medical advice. NPD and BPD can look different from person to person, and only a qualified mental health professional can determine whether someone meets diagnostic criteria. If you are experiencing a mental health emergency or immediate safety concern, seek emergency assistance in your area.
References and Content Sources
- National Institute of Mental Health (NIMH): Borderline Personality Disorder — Information on BPD symptoms, diagnosis, and treatment.
- Mayo Clinic: Narcissistic Personality Disorder — Information on NPD symptoms, causes, diagnosis, and treatment.
- Mayo Clinic: Personality Disorders—Diagnosis and Treatment — Overview of personality disorder assessment and treatment approaches.
- National Institute of Mental Health: Personality Disorders — Background information and definitions related to personality disorders.
