This article will provide a detailed, empathetic, and informative comparison of Borderline and Narcissistic Personality Disorders, helping readers understand the differences, overlaps, and unique challenges associated with each disorder.
Personality disorders are categorized into three distinct clusters:
- Cluster A
- Cluster B
- Cluster C
Borderline and narcissistic personality disorders both fall under cluster B personality disorders.
Cluster B includes:
- Antisocial personality disorder: A personality disorder where an individual has a lack of respect for social rules or other people, and they can often cause physical or emotional harm to others without taking responsibility for the consequences of their behaviors.
- Borderline personality disorder: This is a personality disorder characterized by impulsivity, relationship problems, low self-esteem, and an inability to control emotions.
- Histrionic personality disorder: This personality disorder is where an individual struggles with a severely distorted view of themselves, one which is contingent upon approval from other people. They have no internal sense of self-esteem or self-worth and, as a result, usually engage in dramatic or inappropriate behavior in order to get attention and, by extension, validation from other people.
- Narcissistic personality disorder: this personality disorder is often characterized by very low self-esteem. Individuals compensate for that low self-esteem by seeking admiration and praise from others. Concurrently, someone with a narcissistic personality disorder usually lacks empathy for anyone else and feels superior to other people.
Common traits for borderline and narcissistic personality disorder
Cluster B refers to the four types of personality disorders, which are categorized by erratic behaviors, including emotional instability and impulsivity. As such, the common traits for borderline and narcissistic personality disorders include emotional instability, erratic behaviors, and impulsivity, but all three of those look slightly different and affect relationships differently.
At their core both conditions are often rooted in low self-esteem but that low self-esteem or low self-worth manifests in narcissistic personality disorder as a need for admiration obtained through exaggerating accomplishments and self-worth whereas for BPD it manifests as anger or fear of abandonment.
As such, it’s quite common for individuals who struggle with any personality disorder listed in cluster B to also struggle with a substance abuse disorder or impulse control disorder.
Borderline personality disorder
Borderline personality disorder was a term applied across the United States in 1938. The main feature of borderline personality disorder is a pattern of instability in terms of self-image, relationships, and the effects of both. Additionally, individuals who struggle with borderline personality disorder have marked impulsivity that often begins in early adulthood and can affect several contexts of daily life.
Someone with borderline personality disorder will go out of their way to avoid being rejected, even if those feelings of rejection are not real.
They often have intense perceptions of impending rejection or separation that can affect their self-image, cognition, and behavior. This also has a significantly negative impact on interpersonal relationships.
Borderline personality disorder can manifest as a high sensitivity to environmental changes. When environmental changes happen, someone who has borderline personality disorder will experience intense feelings of anger or fear.
Teresa is meeting her friend for coffee. While she is getting ready, Theresa receives a text from her friend saying that she has to cancel because her friend’s child is sick. Teresa immediately responds with extreme and inappropriate anger toward her friend, cussing at her and telling her off for being a bad friend.
Matthew has a regular appointment with his therapist at 4:00 p.m. every Wednesday. Every Wednesday at 4:50 p.m., when his therapist announces that they only have 10 minutes left, Matthew struggles with sudden despair, feeling as though his therapist is abandoning him.
The intense fear of abandonment and inappropriate anger usually stems from the fact that that individual believes that their perceived abandonment means they are, in fact, a bad person. Someone with BPD might feel:
- Overwhelmed by how quickly their emotions change
- Like there is something wrong with them, and the bad things that happen to them are all because they are a bad person
- Like their emotions are impossible to understand
- As though they don’t know what they want or don’t want, like or don’t like
- Like a child living amongst grown-ups
Such individuals are usually terrified of being alone, and they must have other people around them, so they will go to extreme efforts to avoid being abandoned, even if that means self-mutilation or suicidal threats.
Narcissistic personality disorder
The main feature of narcissistic personality disorder is a pervasive pattern of no empathy for others, grandiosity, and a need for admiration. Individuals who have narcissistic personality disorder have an exaggerated or unrealistic sense of their self-importance, and they often overestimate their abilities to try and enhance their accomplishments, but they typically come off as pretentious instead.
Those who struggle with narcissistic personality disorder assume that everyone around them values them to the same degree and will comply with anything they request.
They are often preoccupied with fantasies of long overdue privilege, power, or admiration, especially from people who have achieved great things in their lives.
Individuals living with narcissistic personality disorder believe that they are unique, and they expect everyone around them to recognize that uniqueness. They often require excessive admiration, and their self-esteem is, internally, very fragile, which is why they go out of their way to exaggerate accomplishments and seek the admiration of others.
Someone who struggles with narcissistic personality disorder usually has a deeply rooted sense of entitlement, and that entitlement means they have unrealistic expectations of how other people should treat them. they become angry or confused when people do not cater to them in this fashion.
Thomas believes that he is very important and should not have to wait in line. Whenever there is a line, and no one comes to help him and get him out of that line, he becomes furious, and when it’s his turn, he complains to management that he had to wait in line and they should know that he’s very important.
Margaret believes that she has the most important priorities, so everyone should defer to her. Margaret asks Nicholas to help her with a work project, but Nicholas declines, saying that he and his team are busy with their respective projects and cannot help her. Margaret is agitated that they will not help her with her work because Margaret believes that her work is more important than anything else happening at the company.
Individuals who struggle with narcissistic personality disorder expect great dedication from other people, and they are more likely to overwork people or exploit them without any regard for the impact that the exploitation is having on the lives of others.
This can severely impact friendships and romantic relationships when an individual is not given the privileges or the entitlement they believe they deserve from others in their relationships.
Those who struggle with narcissistic personality disorder generally don’t have empathy for other people, or at the very least, they are unwilling to identify with the feelings of others. they might be able to understand someone’s perspective on an intellectual level, but they are oblivious to the pain that their remarks or behaviors could have on others.
John and Carla were in a relationship for five years. During that time they lived together for three years and traveled regularly until Carla lost her parents in a car accident. Eventually, their relationship came to an end when Carla realized that John was not supportive of her emotional needs. John was under the belief that their relationship came to an end because Carla became too self-involved after her parents passed away.
At a party a few months later, John and Carla were talking, and John exuberantly told Carla that he was now in the best relationship he had ever been in and couldn’t believe he ever dated anyone before now, completely oblivious to how hurtful those remarks were on Carla.
Chantal went to work to learn that one of her co-workers, Sarah, had a husband recently diagnosed with stage 4 cancer. Instead of offering empathy or emotional support for Sarah, who confided her struggles and fears, all Chantal did was brag about how healthy she was and how great it felt to not have any health problems or need to go to the doctor.
Difference between narcissist and borderline personality for diagnostic criteria
With narcissist vs borderline personality disorders, clients must meet at least five of nine sets of criteria in order to get a diagnosis. However, the criteria are very different, with borderline personality disorder encompassing a complete lack of self-worth and narcissistic personality disorder encompassing a grandiose sense of self-worth.
A borderline personality disorder is a mental health condition marked by a pattern of unstable interpersonal relationships, self-image, and impulsivity. In order to be diagnosed with borderline personality disorder, symptoms must manifest in early adulthood across several contexts, and you must have five or more of the following:
- Frantic attempts to avoid abandonment, whether real or imagined.
- A pattern of intense interpersonal relationships where an individual alternates between devaluation and idealization.
- Persistently unstable sense of self or self-image.
- Impulsivity can be potentially damaging in at least two areas such as
- Binge eating
- Reckless driving
- Substance abuse
- Recurrent suicidal threats, behavior, or gestures
- Intense episodic moods that usually last for a few hours
- Chronic emptiness and feelings of worthlessness
- Inappropriate displays of anger or problems controlling anger
- Stress-related paranoid ideation or other dissociations
Narcissistic personality disorder is categorized by a pervasive pattern of grandiosity, a lack of empathy, and a need for admiration from everyone else. Symptoms usually begin in early adulthood across several contexts, and you must have five or more of the following to receive a diagnosis:
- A grandiose sense of self-worth such as regularly exaggerating talents or achievements and expecting to be recognized as superior to everyone else without actually having superior talents
- Preoccupation with fantasies of unlimited beauty, love, brilliance, power, or success
- Believing that you are special or unique and only people in high-status positions can understand that
- Requiring excessive admiration
- Having a sense of entitlement and expecting things like automatic compliance with expectations or setting unreasonable expectations for favorable treatment
- Being interpersonally exploitative, such as regularly taking advantage of others to achieve personal ends
- Lacking empathy and being unwilling to identify with the needs or feelings of others
- Being envious of other people and believing that other people are envious of them
- Showing arrogant and haughty attitudes and behaviors
Narcissistic and borderline prevalence
Narcissistic and borderline are both rare conditions, affecting a limited part of the population. However, one difference between borderline and narcissistic personality disorders is that there is a slightly higher prevalence of borderline personality disorder in females and a slightly higher prevalence of narcissistic personality disorder in males.
Several studies have found a prevalence of 2.7% of the population. Nearly 10% of people who participate in outpatient mental health treatment struggle with borderline personality disorder.
A borderline personality disorder is more common in women than it is in men in clinical samples.
It is estimated that, on average, 1.6% of the population in the United States struggles with narcissistic personality disorder.
Of those 18 and older who are diagnosed with narcissistic personality disorder, an average of 65% of them are men. Cultural gender expectations could contribute to this gender-related diagnostic issue.
Borderline vs. narcissist development
One difference between borderline and narcissistic personality disorders is the initial trigger of symptoms. In borderline personality disorder, symptoms can manifest in early adulthood at any time, whereas with narcissistic personality disorder, predominant symptoms are more likely to be triggered by a challenging life event in early adulthood.
A borderline personality disorder is typically characterized as an onset in early adulthood but people as young as 12 or 13 can manifest symptoms.
As individuals with borderline personality disorder get older, symptoms can slow down, particularly in their 30s and 40s, but it’s not uncommon for individuals to experience remission lasting between 1 and 8 years.
Without treatment, individuals are more likely to struggle with recurrent remission and poor physical and mental health.
There is no real difference between borderline and narcissistic personality disorders in terms of the time frame when symptoms manifest. Narcissistic personality disorder also tends to manifest in early adulthood, but younger people can show symptoms.
However, one difference between borderline and narcissistic personality disorders in terms of development is that the predominant traits of narcissistic personality disorder typically manifest in the context of an extremely challenging experience in life such as:
- Loss of work
Individuals who struggle with narcissistic personality disorder could have difficulties adjusting to any occupational or physical limitations as they get older, but life experiences like actual achievements or new relationships can all contribute to changes in the symptoms and their severity with time.
Narcissistic personality vs borderline risk factors
One difference between borderline and narcissistic personality disorders is the risk factor for developing the condition. With borderline vs narcissist personality disorders there are environmental and genetic factors but they have some differences.
Borderline personality disorder has a high association with children who struggle with emotional neglect or physical abuse. A history of sexual abuse is a significant risk factor in the development and severity of borderline personality disorder.
Borderline vs. narcissistic personality disorders share environmental risk factors, but one difference between narcissistic and borderline personality disorders is that individuals can develop narcissistic personality disorders based on mimicking the types of personality disorders they see growing up.
Tangentially, narcissistic personality vs borderline differs in terms of the influence parenting style can have. Overindulging or overprotecting children can cause children to demand that level of treatment from those around them as they grow up, and it can also prevent children from learning to regulate their emotions, which contributes to issues managing emotional well-being when things don’t go the way they want them to.
A borderline personality disorder is five times more common in people who have a first-degree relative with the same disorder. Individuals who struggle with borderline personality disorder have an increased risk of:
- Bipolar disorders
- Depression disorders
- Anxiety disorders
- Antisocial personality disorder
- Substance use disorders
Similarly with narcissistic and borderline personality disorders, narcissistic personality disorder is more likely in someone who has a first-degree relative with the same condition.
Narcissist vs borderline co-occurring disorders
With narcissistic personality vs borderline, there is a higher risk of co-occurring disorders in individuals with borderline personality disorder but not as much in narcissistic personality disorder. Instead, clients with narcissistic personality disorder are more likely to be misdiagnosed.
Borderline personality disorder often co-occurs alongside bipolar or depressive disorders. Given the high rate of depressive and bipolar disorders, it’s important to get a proper diagnosis and the right type of treatment for any and all mental health issues.
Some clients struggle with borderline personality disorder and separation anxiety disorder, with the fear of abandonment more heavily associated with separation anxiety, but issues of interpersonal functioning, identity, and impulsivity are attributed to borderline personality disorder.
Some individuals with narcissistic personality develop persistent depressive disorder, substance abuse disorders, or mania. However, it’s more common that individuals with a narcissistic personality disorder are misdiagnosed with other personality disorders that share common features.
Borderline vs narcissist treatment
With both conditions, treatment can include a combination of psychotherapy and medication.
The most significant part of any borderline personality disorder treatment will consist of psychotherapy. Psychotherapy can be individual therapy or group therapy with a psychiatrist to help you learn how to better interact and express yourself.
Dialectical Behavioral Therapy
One of the primary therapies used for borderline personality disorder and narcissistic personality disorder is dialectical behavior therapy (DBT). With this therapy, you can learn to:
- Control your emotions
- Be aware of your current emotional state
- Reduce self-destructive behaviors
- Relate better to those with whom you have relationships
- Understand what drives your emotions and what influences your self-image
- Improve communication in your relationships
- Recognize your actual skills and abilities
- Manage stress
- Set and meet realistic goals
Cognitive Behavioral Therapy
Cognitive behavioral therapy (CBT) is another common treatment for BPD that can help you to:
- Identify negative thought patterns and actions
- Change your core beliefs to improve your self-image and relationships
- Reduce anxiety
- Reduce self-destructive behaviors
In many cases, family therapy is important in treating borderline and narcissistic personality disorders because mental health disorders affect everyone, not just the individual. Both of these personality disorders impact interpersonal relationships, so family therapy can help you and your loved ones to:
- Recognize how borderline and narcissistic personality disorders work
- Support someone living with a personality disorder
- Offer emotional support and encouragement at home
- Determine which strategies help mitigate the impact of harmful symptoms
There are no current FDA-approved medications developed singularly to treat narcissistic personality disorder or borderline personality disorder. However, medications can be prescribed by a psychiatrist in conjunction with therapy to help overcome specific subsets of symptoms like anxiety or depression.
Working with a professional psychiatrist can help you get an appropriate diagnosis for the type of condition you have, as well as the treatment that best fits your needs. This could involve medication and therapy, medication management to review the efficacy of any medication you are currently on or just psychotherapy.
Getting a diagnosis and treatment plan from a mental health professional is your best course of action for learning how to manage and live with the symptoms of borderline personality disorder and narcissistic personality disorder.
Borderline and narcissistic personality disorders fall under the same category of Cluster B personality disorders, marked by impulsivity, erratic behavior, and emotional instability. Both narcissistic and borderline personality disorders have environmental and genetic risk factors and causes.
However, despite the difference between borderline and narcissistic personality disorders, there are treatment options for both. It is important that you seek professional intervention and get tailored therapy for your condition based on a correct diagnosis so that you can learn to control symptoms of narcissistic and borderline personality disorders.