Bipolar disorders are mood disorders that cause extreme high and low moods. During a manic episode, symptoms of bipolar might be confused with narcissistic traits, such as a heightened sense of importance or lack of empathy.
Narcissism is not a symptom of bipolar, and most people with bipolar are not narcissistic. However, some people with bipolar may display narcissistic traits as a result of their other symptoms.
In this article, we take a look at the relationship between bipolar disorder and narcissism, including symptoms and treatment.
Bipolar disorders are mood disorders that cause a person to cycle between extremely high moods, called mania, and in some cases, depression. A person may have bipolar I disorder or bipolar II disorder.
A related condition, called cyclothymic disorder, involves cycling between less intense manic and depressive episodes.
Narcissism is a personality trait that involves feelings of self-importance, grandiosity, and a need for validation. Narcissism can be a behavior that occurs in otherwise psychologically healthy people.
A person whose personality is characterized by narcissistic tendencies may have narcissistic personality disorder (NPD).
NPD is part of a group of personality disorders called cluster B disorders. These conditions are characterized by dramatic, emotional, or unpredictable thinking and behavior.
The Diagnostic and Statistical Manual of Mental Disorders 5 (DSM-5) does not list narcissism as a symptom of bipolar disorder. However, when a person with bipolar experiences an episode of mania, they may display some narcissistic behaviors, such as high levels of confidence, feelings of self-importance, elevated energy levels, and grandiose self-perceptions.
Because bipolar and NPD have some similar symptoms, the two conditions can be confused. This can result in people with bipolar being diagnosed with NPD and vice versa.
During periods of depression, a person with a bipolar disorder might also display narcissistic characteristics. For example, a person might neglect caring duties, avoid social contact, or appear insensitive to the needs of others.
This might seem to be narcissistic, but it is more likely that the person is so overwhelmed by their own negative emotions that they may not notice others people's feelings.
To diagnose someone with a personality disorder such as NPD, a doctor must be sure that another condition cannot better explain their symptoms. So, when narcissistic behavior is due to depression or mania, the DSM-5 argues that it is not appropriate to make a diagnosis of NPD.
The symptoms of bipolar disorders and NPD are different in the following ways:
People with bipolar disorders experience intense mood swings that last for a period of time. Mania must last at least 7 days or less if the symptoms are so severe that hospitalization is required. To receive a diagnosis for the major depressive episode, a person must exhibit the symptoms of depression for at least 2 weeks.
A person with bipolar I disorder may only have manic symptoms.
These mood swings that people with bipolar experience occur independently of other life circumstances that can cause high and low moods. Also, these fluctuations are more pronounced than the mood swings most people experience.
Symptoms of bipolar disorders include:
- Manic or hypomanic episodes: periods of a highly inflated mood that may include high self-esteem, increased sense of self-worth, high energy, little sleep, or aggression.
- Depressive episodes: periods of a depressed mood that may cause intense sadness, guilt, shame, excessive sleep, low energy, and hopelessness.
Narcissistic personality disorder
To be diagnosed with narcissistic personality disorder, a person must display narcissism that significantly interferes with their relationships or functioning.
Symptoms of NPD include:
- an exaggerated sense of self-worth or importance that may cause the person to disregard the feelings or needs of others
- fantasies of grandiose success or power
- a belief that one is special or unique, or should only associate with unique or special people
- a sense of entitlement
- low empathy
- arrogant behavior
- taking advantage of others to achieve one's goals
- a sense of entitlement
Bipolar is a chronic condition. There is no cure, but it is treatable. Most people with bipolar can learn how to manage their symptoms to lead a happy, healthy life.
Doctors may recommend the following treatments for bipolar disorders:
- Medication. Mood medication can help people with bipolar have fewer and less severe mood swings. Lithium, a mood stabilizer, is one of the most popular bipolar treatments. Some people also take antidepressant drugs, antipsychotic drugs, or anti-anxiety medication.
- Therapy. Talking therapy and behavioral therapy, such as cognitive behavioral therapy (CBT), can help people identify, understand, and better manage extreme emotions. It may also support people with bipolar to make healthy lifestyle changes.
- Alternative medicine. Complementary remedies may help some people with bipolar, though research is mixed or inconclusive. Herbal supplements such as St. John's wort may not be safe to use with some bipolar medications, so it is important to discuss alternative medicine with a doctor. Some people with bipolar also find that acupuncture and lifestyle changes, such as exercise and diet changes, can help.
- Electroconvulsive therapy (ECT). For people who do not see improvements in their symptoms with medication and treatment, electroconvulsive therapy (ECT) may help. ECT delivers a mild shock to the brain. Doctors are still not sure why or how it works, but it does reduce symptoms of bipolar and some other mental health conditions.
An accurate diagnosis is critical for managing bipolar, especially when it co-occurs with narcissistic personality traits. People who think they have a mental health condition should work with a skilled clinician and should not self-diagnose or self-medicate.
Narcissistic personality disorder and bipolar disorders can be frustrating both for the people they affect and for those who love them.
What looks like narcissism in a person with bipolar might be something else. Likewise, people with narcissistic personality disorder might be incorrectly diagnosed with bipolar.
Narcissistic traits that can come with bipolar disorders are not a choice. It does not mean someone is a bad person. Bipolar disorders are treatable medical conditions.
Using narcissism to label a person as bad can be harmful, may undermine the problematic reality many people with mental health problems face, and can even deter treatment. A 2014 report argues that stigma is a significant barrier to people accessing quality mental health care.
Quality treatment requires an accurate diagnosis. With proper treatment and a strong relationship with a skilled provider, people with narcissism and bipolar can heal, have good relationships with others, and live happy lives.