Borderline and narcissistic personality disorder (more precisely, narcissistic personality disorder, or NPD) are both personality disorders. When both occur, symptoms of both may worsen. Diagnosing and treating cases can be more difficult. However, treatment for borderline personality disorder (BPD) can help relieve some of the symptoms of BPD.
Narcissism by itself is not a symptom of borderline personality disorder listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). However, up to 40% of people with BPD may also have narcissistic personality disorder, 1 so people with BPD may also show signs of narcissism.
The term “borderline narcissist” is sometimes used to refer to people with both conditions, but it is important to note that it is not a diagnosis. It can be used informally to refer to someone wi
Differences between borderline personality disorder and narcissism
Both borderline personality disorder (BPD) and narcissistic personality disorder (NPD) are both personality disorders and they can share some characteristics. Both involve dramatic, overly emotional, or unexpected thinking or behavior. However, the two situations are very different, says Avigail Lev, PsyD, founder and director of the Bay Area CBT Center.
Ego sync means that people’s thoughts, feelings, and behaviors align with their self-image. People with BPD or BPD have a poor view of their circumstances and see nothing wrong with their behaviors and perceptions. This can play a role in complicating treatment.
People with both types of disorders may have very low self-esteem. But in the case of narcissistic personality disorder, this leads to selfish behavior and a lack of empathy. In the case of borderline personality disorder, anger may turn inward, leading to frequent changes in behavior and mood.
“Individuals with BPD tend to score extremely high on cognitive or “cold” empathy but far below average in emotional or “warm” empathy. Conversely, those with BPD score generally Below average in cognitive empathy and about or slightly below average in warm empathy,” Leaf explains.
Cognitive empathy versus emotional empathy
Narcissistic personality disorder (NPD)
Narcissistic personality disorder (NPD) is one of 10 personality disorders recognized in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Narcissistic personality disorder is one of the “Cluster B” personality disorders, or dramatic/disorderly personality disorders.
Narcissistic personality disorder is characterized by the presence of five or more of the following symptoms: 3
A sense of entitlement
An inflated sense of self-importance
Arrogant, selfish, or arrogant behaviour
Envies others or thinks others envy them
lack of empathy
Preoccupation with fantasies of success, strength, intelligence, beauty, or an ideal love
require excessive admiration
Take advantage of others
Believing that they are “special” and can only be understood by people who are special or of high status
In short, people with narcissistic personality disorder can be described as self-absorbed or egotistical. This self-preoccupation rises to the level of a clinical disorder when it significantly interferes with a person’s relationships, job, or other important areas of life. Many experts believe that this selfish approach is actually an attempt to deal with a poor sense of self-worth.
borderline personality disorder (BPD)
Borderline personality disorder (BPD) is also a group B personality disorder. It is characterized by persistent changes in behavior, mood, and self-image. Outbursts of anger, depression, and anxiety lasting a few days are common in people with BPD.4
People with BPD frequently change their opinion of themselves, others, and their interests. Drastic changes of opinion often lead to turbulent or unstable relationships with others. Other symptoms of borderline personality disorder include:
Especially in times of stress, people with BPD may experience detachment. The person experiencing the separation may feel as if they have no sense of self or identity. 5 They may feel disconnected from their emotions, memories, and thoughts. They can also experience significant memory loss of their life times, people, and events.
How often does borderline personality disorder and borderline personality disorder occur together?
While the overlap between BPD and BPD is discussed frequently in the popular psychology literature and on the Internet, very few careful studies have been done on the incidence of BPD and BPD. One older study reported that approximately 39% of people with BPD also had BPD
Another 2018 study showed a strong association between BPD and a specific type of narcissism: vulnerable narcissism, which is characterized by hypersensitivity, defensiveness, and low self-esteem. The same study also found that male patients had higher narcissism scores than female patients. However, the sample size was small (65 people).
How does NPD affect borderline personality disorder?
There are a number of theoretical reasons to believe that a person with BPD will be less likely to improve over time. People with BPD may be resistant to treatment and often have a poor understanding of the ways in which their behaviors harm themselves or others.
Also, people with narcissistic personality disorder may cause more emotional pain to others than they do themselves. This may mean that their motivation to change their behavior is very low.
“They have a high level of emotional intelligence, which enables them to understand other people’s thoughts and feelings and to adopt their viewpoints,” Leaf explains. “But they are not affected emotionally or physiologically by the pain and suffering of others.”
One study that followed patients with BPD over six years found that rates of concurrent BPD were fairly low, about 6%, in patients whose BPD eventually cleared up (remitted).
However, rates of concurrent BPD were higher (about 19%) in patients whose BPD had not remitted after six years. 8 Therefore there is a subset of people with non-remitting BPD that have higher rates of BPD.
NPD and BPD in relationships
The relationships of people with BPD are often completely dysfunctional. Adding NPD to the mix can create even more turbulent circumstances. One study, for example, suggests that as the severity of narcissistic personality disorder increases, so do aggressiveness (directed toward oneself or toward others), interpersonal difficulty, and moral functioning.9
In addition to the chaotic emotional lives and fears of abandonment associated with BPD, a person with BPD may take advantage of or manipulate others without having little empathy for other people’s fears. This combination can be incredibly destructive in relationships.
“People with a high degree of narcissism, including those with antisocial personality disorder, may take pleasure in the suffering of others, which is not the cause of BPD,” says Leaf.
If you’re in a relationship with someone who has BPD, BPD, or both, encourage them to seek treatment. Individual therapy for each partner and couples therapy may help you deal with symptoms of personality disorders that make relationships difficult.
Treating NPD and BPD
There are currently no experimentally supported therapies for NPD10 and no published clinical trials of treatments for NPD alone or co-occurring with BPD.
Published research on BPD treatment is limited to a few case studies or anecdotes, but these types of studies tend to be unreliable and subject to bias. The case study literature on BPD treatment has focused primarily on the use of modified psychoanalytic techniques and has acknowledged the challenges of successfully treating the disorder.
Some researchers suggest that because there is some overlap between symptoms of BPD and BPD (such as impulsivity and destructive behaviors), treatments designed for BPD, including Dialectical Behavior Therapy (DBT), mindfulness-based therapy, and schema-focused therapy Conversion-based therapy, psychotherapy, may also work for narcissistic personality disorder. However, more research is needed on this topic.
Word from Verywell
Personality disorders, including borderline personality disorder and narcissistic personality disorder, can be difficult to deal with. The presence of personality disorders or other psychiatric conditions makes diagnosis and treatment more complex. However, there are some treatments that can be effective. If you live with BPD or BPD, or have a loved one, seek support to help manage the condition and its effects on both of you.
