What Is A Bipolar Narcissist: Can You Have Both Bipolar Disorder and Narcissistic Personality Disorder?

Bipolar disorder is generally classified as a lifelong mental health condition that can cause severe mood shifts, or mood instability, that may interfere with a person’s quality of life. These shifts in mood are often referred to as manic and depressive episodes. While narcissistic personality disorder is normally a separate diagnosis, it can also be considered a lifelong condition, and it is not uncommon for a person living with bipolar disorder to exhibit narcissistic personality traits at times, such as extreme self-confidence and self-centeredness, for example. Proper treatment can alleviate many narcissistic and bipolar symptoms, and one way to address diagnostic concerns and begin mental health treatment may be to join an online therapy platform.

Bipolar disorder – Overview of the mental health condition

Bipolar disorder, as defined by the American Mayo Clinic, is normally a lifelong mental health condition that usually causes extreme mood swings that may include intense emotional highs (mania or hypomania) and extreme lows, or depressive periods. 

There can be several different types of bipolar disorder, all of which may include periods of mania, hypomania, or depression. The most common types of bipolar disorder may be: 

• Bipolar I: This mental illness is typically classified by having at least one manic episode that could potentially be preceded or followed by hypomanic or major depressive episodes. In certain cases, mania may trigger a break from reality (psychosis).
• Bipolar II: This mental illness is typically classified by having at least one major depressive episode and at least one hypomanic episode, but no manic episodes. 
• Cyclothymic Disorder: This mental illness is typically classified by having at least two years of many periods of hypomania symptoms and periods of depressive symptoms. 

Other types of bipolar disorder may be induced using certain substances, or they may present as the result of a medical condition, such as multiple sclerosis, Cushing’s disease, or stroke. 

Recognizing symptoms of mania, hypomania, and depression can be crucial in navigating the symptoms of bipolar disorder. According to researchers, “Hypomania and mania are periods of over-active and excited behavior that can have a significant impact on your day-to-day life. Hypomania is a milder version of mania that lasts for a short period (usually a few days). Mania is a more severe form that lasts for a longer period (a week or more).”

Symptoms of mania and hypomanic episodes in bipolar disorder and mental health

When diagnosing bipolar disorder, clinicians look for the following manic symptoms:

• An increase in activity, energy or agitation
• A sense of euphoria, or an elevated sense of well-being or self-confidence
• A decreased need for sleep
• Excessive talking, or speaking more quickly than usual
• Racing thoughts and difficulty concentrating
• Impulsive decision-making, such as risky spending or sexual behaviors

With certain bipolar disorders, symptoms of mania and hypomanic episodes may be followed by symptoms of depression or major depressive symptoms. Typically, when people with bipolar disorder experience these depressive periods, it can impact their day-to-day life. This could look like noticeable difficulty at work, school, or within social situations and relationships. 

Symptoms of a depressive period in bipolar disorder and narcissistic personality disorder

• Noticeably depressed mood; feelings of sadness, hopelessness, or excessive crying
• A loss of interest or pleasure in social, personal, or work-related activities
• Significant weight loss or weight gain.
• Difficulty sleeping, or sleeping too much
• Restlessness or slowed behavior
• Fatigue or general loss of energy
• Feelings of worthlessness or excessive or inappropriate guilt
• Difficulty concentrating
• Suicidal thoughts or ideation.

In individuals with both bipolar disorder and narcissistic personality disorder, these depressive symptoms can be intensified by underlying issues of self-worth and identity. Aside from conceptual commonalities, people with both disorders may also experience frequent mood changes, exhibit traits of a grandiose personality style, and display self-centered behavior. 

What is narcissistic personality disorder?

Narcissistic personality disorder can be a separate lifelong condition, and it is typically classified by a pattern of grandiosity, as well as a need for attention and a pervasive lack of empathy. 

According to the Mayo Clinic, symptoms of narcissistic personality disorder may include: 

• An unreasonably high sense of self-importance or a desire for excessive admiration
• Feeling that certain privileges and special treatment are deserved
• The expectation to be recognized as superior even without achievements
• A tendency to make personal achievements or talents seem bigger than they are
• A preoccupation with success, power, brilliance, beauty, or the perfect mate
• Feelings of superiority
• Unrealistic demands or expectations of others
• A tendency to take advantage of others without guilt or remorse
• An inability or unwillingness to recognize the needs and feelings of others
• Excessive feelings of envy toward others, or an unfounded belief that others envy you

Navigating relationships with narcissism and bipolar narcissist traits

Narcissistic personality disorder can present significant challenges and risk factors in a partnership. In some cases, it may lead to narcissistic abuse, in which the individual with narcissistic tendencies attempts to exert control in the relationship through various forms of emotional, physical, and verbal abuse. A person with narcissistic personality disorder may manipulate their partner by isolating them from friends and family, making threats, name-calling, and ignoring previously set relationship boundaries. Dramatic mood shifts, self-centered behaviors, and problems with emotional regulation could make the relationship volatile. 

Again, narcissistic personality disorder is normally a separate diagnosis from bipolar disorder despite conceptual commonalities, but studies show that some of these symptoms can present in people living with bipolar disorder, particularly when people with bipolar disorder experience periods of mania or hypomania. 

Protecting Your Mental Health When Supporting a Loved One 

When a loved one has a mental illness, it’s normal to want to help. However, you may need to set emotional boundaries with your loved one in order to protect yourself. Both NPD and bipolar disorder could present risk factors for relationship abuse. If your loved one hasn’t yet sought professional help such as therapy with a mental healthcare provider, this could be an important first step. Treatment adherence may be crucial to the success of the relationship. You might also want to consider expanding your self-care routine so you can better care for others. 

Bipolar disorder and a narcissist’s personality traits

During manic and hypomanic episodes, individuals with bipolar disorder can exhibit significant mood changes alongside some of the same symptoms experienced by someone with narcissistic personality disorder. This may include an inflated sense of self-esteem, increased goal-directed behavior, and impulsivity. The exaggerated sense of self-confidence associated with both narcissism and mania, however, often arises out of different concerns. In people with narcissistic personality disorder, a seemingly inflated sense of self is actually thought to be due to a lack of self-worth. In individuals experiencing mania, however, feelings of superiority or elevated importance are typically connected to elevated mood and delusions of grandeur, which are beliefs that aren’t grounded in reality. When mood changes resolve, these narcissistic traits usually subside. 

Differences between bipolar narcissism and narcissistic personality disorder

Differences between bipolar narcissism and narcissistic personality disorder are often subtle but important to recognize. Another primary difference between bipolar disorder and narcissistic personality disorder (NPD) is the pervasiveness of narcissistic behaviors. While narcissistic traits in bipolar disorder are typically episodic and tied to mood shifts during periods of mania or hypomania, in NPD, these traits are a constant and defining feature of the individual's personality and are not dependent on mood instability.

NPD and bipolar disorder share similar risk factors and sometimes, symptoms. This can present diagnostic concerns for clinicians, and misdiagnosis can be common. 

Living with bipolar disorder and hypomanic episodes

Recognizing bipolar disorder in yourself or your partner can be challenging due to its complex nature. While bipolar disorder can be a lifelong condition that likely won’t go away on its own, there can be treatment options available, as well coping methods you may implement to better navigate symptoms. This includes understanding the specific challenges of hypomanic episodes, which can be less obvious but still impactful.

Typically, bipolar disorder is treated with a combination of psychotherapy and medication. For this reason, consulting a doctor or mental health professional often plays a vital role in navigating the disorder. 

How Brain Chemistry Impacts Both Conditions

 Brain chemistry can be a factor in many mental health conditions, including bipolar disorder and narcissistic personality disorder. Bipolar individuals have imbalances in certain neurotransmitters such as dopamine and serotonin, causing severe mood changes. On the other hand, someone with a narcissistic personality style may have less gray matter in the area of the brain responsible for empathy. In both disorders, oxidative stress could be to blame for mood instability and severe mood shifts. Thus, there are conceptual commonalities in how these disorders change brain chemistry, but different mechanisms may be at play. 

Recognizing Narcissistic Traits in Someone With Bipolar Disorder 

Can someone with bipolar disorder experience narcissistic traits? Yes. Bipolar disorder and narcissistic personality disorder share similar risk factors, and it is possible for someone to experience both. In other cases, symptoms such as rapid mood changes can overlap, making it difficult to distinguish someone with a narcissistic personality disorder from a bipolar individual experiencing a hypomanic episode. One way to distinguish the two is to ascertain whether the person is always self-centered or only while experiencing bipolar symptoms (i.e., mania). 

Managing Mood Instability and Seeking Treatment

Mood instability can be common with both narcissistic personality disorder and bipolar disorder. For someone experiencing bipolar symptoms, severe mood shifts ranging from depressed to elevated mood, could be the result of manic and depressive episodes. Either way, it is possible to manage these symptoms with the support of a mental health care provider. Depending on your diagnosis, your provider may recommend psychotherapy, antidepressant or antipsychotic medications, or even electroconvulsive therapy. 

Self-care and support for managing bipolar disorder and mental health

Aside from professional help with a mental healthcare provider (e.g., therapy options, electroconvulsive therapy, medication treatment plan), many people living with bipolar disorder find that self-care can help them manage their symptoms. Participating in enjoyable hobbies can be especially helpful in relieving certain symptoms. Journaling can also be a helpful tool in tracking symptoms, identifying possible mood swing triggers, and prioritizing self-care. Keeping a journal can also help a therapist or mental health professional better understand the nature of your symptoms. 

Additionally, research shows that social support plays an important role in our emotional well-being. Maintaining healthy relationships with your loved ones can help you develop a robust support system. If you’re seeking more social connection, consider reaching out to a friend or family member you haven’t spoken to in a while. You can also find support groups centered around living with bipolar disorder or narcissism. Additionally, a mental health care provider can be a valuable member of your support network. A therapist can provide you with professional support, help you address narcissism in your relationship, and connect you with tools for bipolar individuals, those with narcissistic personality disorder, or other mental health concerns. 

Benefits of online therapy for narcissistic personality disorder and bipolar disorder

If you or a loved one are experiencing symptoms of bipolar disorder or exhibiting narcissistic personality traits, it is typically best to consult a therapist or mental health professional. Due to the nature of these mental disorders, it is often crucial to receive professional guidance and treatment. Those who reject therapy or other forms of professional treatment may have a harder time managing their symptoms. 

Because of its increased availability, online therapy may be a good place to begin the process of seeking a proper diagnosis and ongoing treatment. An online therapy platform can make it easy to connect with a licensed mental health professional at a time that fits your schedule.

Effectiveness of online therapy

According to research, online therapy is usually equally as effective as in-person therapy. If you’re interested in seeking professional guidance for your mental health, please know that both in-person and online therapy can be valid options.