Other Therapies

A fear of abandonment, struggle with anger issues, and difficulty with relationships are common symptoms of Borderline Personality Disorder (BPD). But they are also characteristic of another diagnosis: Narcissistic Personality Disorder (NPD).

The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) places BPD and NPD in the same “B cluster” grouping, which is characterized by emotional, erratic, and dramatic behaviors. Though BPD and NPD are distinct disorders with their own set of diagnostic criteria, they are often confused.

In fact, BPD and NPD co-occur at a rate of nearly 25 percent, according to the National Alliance on Mental Illness (NAMI). Both BPD and NPD occur in about 1 to 2 percent of the population, according to NAMI.

BPD and NPD: Similarities

Besides the characteristics mentioned above, Borderline Personality Disorder and Narcissistic Personality Disorder have many other similarities. People diagnosed with BPD or NPD often experience the following symptoms:

• Distorted sense of self
• A tendency to believe the world revolves around them
• A constant need for attention
• A lack of concern for how their behavior impacts others
• Vacillating between idealizing other people and then devaluing them
• Exhibiting overly erratic, emotional, or self-dramatizing behaviors

BPD and NPD: Differences

Though there are many similarities between Borderline Personality Disorder and Narcissistic Personality Disorder, they are two different psychiatric disorders with significant differences.

Borderline Personality Disorder is described by the National Institute of Mental Health (NIMH) as, “a serious mental illness characterized by pervasive instability in moods, interpersonal relationships, self-image, and behavior.” People with BPD are typically very impulsive and may engage in compulsive behaviors, such as binge eating, excessive spending, and risky sexual behavior. People diagnosed with BPD are also more prone to engage in self-harming behaviors, such as cutting or suicide attempts.

Narcissistic Personality Disorder is described by the Mayo Clinic as, “a mental disorder in which people have an inflated sense of their own importance and a deep need for admiration.” People with NPD expect others’ lives to revolve around them and may take advantage of others to get their needs met.

Other differences between Borderline Personality Disorder and Narcissistic Personality Disorder include the following:

• People with BPD often feel misunderstood and mistreated, while people with NPD believe they are “special” and can only be understood by other special or high-status people
• People with BPD constantly try to avoid any sense of abandonment, while narcissists are likely to abandon others
• Women are more often diagnosed with BPD, while more men are diagnosed with NPD

Personality Disorder Treatment

Treatment for both Borderline Personality Disorder and Narcissistic Personality Disorder revolves around psychotherapy that uses Dialectical Behavior Therapy (DBT) and Cognitive Behavior Therapy (CBT). Personality disorder treatment can include individual therapy, group therapy, outpatient treatment, or a residential treatment center for personality disorders.

Because personality disorders often co-occur with other disorders, such as depression or anxiety, antidepressants or anti-anxiety medications may be prescribed.