Personality disorders like borderline personality disorder (BPD) and narcissistic personality disorder (NPD) have a significant impact on the way a person perceives the world around them. Both conditions can create a distorted view of reality, impacting someone’s thoughts and behaviors. While it’s true that there are clear similarities between BPD and NPD, the conditions are ultimately very different. 

Comparing borderline personality disorder vs narcissism reveals that while they do have some overlapping symptoms, there are also several aspects that make them distinct from one another. For example, though low self-esteem is common in both, this symptom typically causes people with BPD to feel anger toward themselves, leading to recurring shifts in mood or behavior. In contrast, those with NPD might instead develop an inflated view of themselves to cope, and then turn to others for validation and admiration. 

“Both BPD and NPD are very highly discussed and often stigmatized mental health conditions. Before you read further, it may be helpful in building empathy for yourself (if you struggle with BPD or NPD) by understanding that these conditions are often rooted in trauma and unmet needs from childhood and adolescence.”

Talkspace therapist Ashley Ertel, LCSW, BCD

Recognizing the similarities and differences between these two conditions is key to management. With a proper diagnosis, people with BPD and NPD can get the help they need. 

What Is Borderline Personality Disorder (BPD)?

BPD might affect up to 1.4% of the population, according to some research. It’s a cluster B personality disorder, which is a type of personality disorder distinguished by emotional volatility. Having BPD can lead to frequent and constant changes in mood, behaviors, and even self-identity. Typically, people with BPD have an extremely negative self-image, which can cause them to change thoughts, interests, and behaviors to better fit a situation. 

BPD can result in someone often struggling with fears of rejection and abandonment. These feelings can make them behave in volatile and self-destructive ways. Many people with BPD engage in a type of self-harm known as non-suicidal self injury (NSSI), which results in causing physical harm to the body without the intent of suicide.

BPD can also make it difficult for someone to maintain stable interpersonal relationships. They may feel lonely or isolated, even when they’re in a relationship. It’s common for their perceptions of others to shift dramatically. It’s also not unusual for those with BPD to have cycles of anxiety, depression, and anger that can last anywhere from a few hours to several days. 

Symptoms of borderline personality disorder

  • Difficulty with emotional regulation 
  • Sudden, frequent mood swings
  • Disproportionate feelings of anger
  • Intense fear of rejection and abandonment 
  • Pervasive feelings of emptiness
  • Feeling disconnected from events around them or from their own thoughts and behaviors
  • Unstable self-image
  • Sudden shifts in thoughts, feelings, or opinions of others
  • Impulsive, reckless, and self-destructive behaviors
  • Self-harm 
  • Chronic threats of suicide or suicide ideation 

What Is Narcissistic Personality Disorder (NPD)?

It’s estimated that NPD may affect up to 6.2% of the population. Like BPD, it’s also a cluster B personality disorder. The American Psychiatric Association defines NPD as characterized by feelings of entitlement, an inflated view of self, and low levels of empathy. While people with NPD are typically egotistical, they may also have low self-esteem, which can cause them to seek out validation and positive feedback from others. 

They will have a distorted perception of their own behavior and may blame others for their missteps or failures. Their low self-esteem could also stem from deep shame of their true self, which is why some of them develop a false self that they project when in company with other people.

People with NPD prioritize their own feelings and desires above those of others. They struggle to see things from anyone else’s perspective, a trait that can significantly interfere with their interpersonal relationships. It’s not unusual for someone with NPD to manipulate those around them in order to get what they want. There are even some with malignant narcissism that display extreme aggression (to the point of abuse) to others.

There are several types of narcissistic personality disorder, including: 

  • Overt (also known as grandiose and agentic)
  • Covert (or closet or vulnerable narcissism)
  • Antagonistic

While some people with NPD may strive to be in the spotlight, others might instead isolate themselves in order to avoid criticism or rejection. Not all people with narcissism will behave in exactly the same way, but they will still share general traits and symptoms that help differentiate borderline personality disorder vs narcissism.

Symptoms of narcissistic personality disorder

  • A constant need for praise and validation 
  • Feeling as though they’re special or unique
  • Overstating their own accomplishments
  • Entitled and arrogant behavior
  • Obsessing over how they’re perceived by others 
  • Fixating on success and wealth
  • Limited empathy for others
  • Manipulating others in order to get their way
  • Feeling envious of others or believing others are envious of them
  • Having chronic fantasies about power or beauty

The Co-Occurrence of BPD and NPD

Although BPD and NPD have distinct symptoms, research shows that there’s a strong correlation between BPD and clinical narcissistic personality disorder. One study found that approximately 13% of those with BPD also met the diagnostic criteria for NPD. Another report found that as many as 39% of people with BPD may have NPD as well. 

When BPD and NPD co-occur, someone is likely to have a specific subtype of NPD known as covert, or vulnerable, narcissism. People with this type of narcissism are extremely sensitive to criticism and rejection and may feel distrustful of others. They’re more prone to experience negative emotions and may be socially isolated. 

“Several people who have BPD and NPD share traits of the other diagnosis. This is very common and can be addressed as a separate goal in therapy.”

Talkspace therapist Ashley Ertel, LCSW, BCD

Borderline Personality Disorder vs Narcissistic Personality Disorder

Understanding as much as possible about each of these conditions can be instrumental in successfully navigating symptoms and getting treatment. 

Similarities of BPD and NPD

BPD and NPD can both cause distorted and unhealthy patterns of thoughts and behaviors. People with these conditions have a strong desire for positive attention and validation from others and may react poorly when they don’t receive the affirmation that they want. These behaviors can lead to volatile interpersonal relationships.

Both personality disorders can cause extreme sensitivity to criticism or negative feedback. This can result in someone projecting their own faults onto others. People with NPD and BPD have a tendency to see the world in black and white and may use others as scapegoats when they make mistakes. Another similarity with both personality disorders is people with either of these conditions also tend to develop substance abuse issues.  

Differences between BPD and NPD

Looking at BPD vs narcissism shows that people with these conditions have a general inaccurate view of themselves and the world around them. However, the nature of these distortions can vary significantly. 

Sense of self

People with NPD, for example, see themselves as superior to others. They have an inflated sense of their own abilities and their accomplishments. In contrast, those with BPD have an unstable self-image and often see themselves as “bad” or worthless. 

Relationships

BPD can cause people to struggle with self-identity and self-worth. This can make them reliant on others for their emotional needs. It’s common for people with BPD to seek out relationships and become attached to others quickly. 

When people with NPD manipulate others, it’s to fulfill their own wants and needs or to maintain a sense of control. Narcissistic personality disorder is also marked by a lack of empathy, which makes it difficult for someone to understand how their actions impact others. Those with NPD are drawn to relationships because of their desire for admiration or personal gain.

People living with NPD want intimate relationships, but their intense emotions and dramatic mood shifts can make them difficult to maintain. While they can care about others on some level, they may become angry or destructive when they fear abandonment. When someone with NPD lashes out at others, it’s often because they felt that their self-image was threatened. 

Treatment for BPD and NPD

Treating personality disorders can be challenging. When people have conditions like BPD or NPD, they tend to perceive their symptoms as their personality, rather than a mental health condition that warrants treatment. Looking closely at BPD vs narcissism, we see that this distorted perception of reality common to both conditions can be a real barrier to treatment. 

There is some good news, though. When and if people do seek treatment, the outcome can be very positive. While there’s no approved medication for these conditions, certain ones are sometimes used to address various symptoms people may experience with BPD or NPD, often in relation to a coexisting condition. The first line of treatment for borderline personality disorder and narcissistic personality disorder is usually psychotherapy. 

Behavioral therapies, such as dialectical behavioral therapy (DBT) and cognitive-behavioral therapy (CBT), can help people first become more aware of unhealthy patterns of behavior, then show them how to change them. Over time, treatment can make symptoms more manageable, which can greatly enhance quality of life, self-image and sense of self, and relationships. 

Find Professional Help with Talkspace

While it can be difficult to distinguish between borderline personality disorder vs narcissism, a mental health professional can evaluate symptoms and provide an accurate diagnosis. It’s really important that you don’t try to self-diagnose if you feel like the symptoms listed here align with something you or a loved one is experiencing. 

If you or someone you know has shown symptoms of BPD or NPD, it’s critical that you seek help as soon as possible. There is no cure for these conditions, but there are incredibly effective forms of treatment. A diagnosis can give you more insight into and understanding of symptoms, making it easier to access the care you need.

If you’re looking for a therapist but aren’t sure where to start, or if you feel overwhelmed at the thought of trying to get help, you’re not alone. Talkspace is an online therapy platform that makes therapy easy. Our virtual approach to mental health care means therapy is convenient and accessible, right from wherever you are. It’s also affordable and easy to get started. You don’t have to live with the struggles of BPD or NPD. Help is available, and Talkspace will be with you every step of the way.