Misdiagnosing Narcissism – The Bipolar I Disorder
(The use of gender pronouns in this text displays the scientific facts: most narcissists are males.)
The manic part of Bipolar I Disorder is customarily misdiagnosed as Narcissistic Personality Disorder (NPD).
Bipolar sufferers in the manic part express many of the signs and symptoms and signs and symptoms of pathological narcissism – hyperactivity, self-centeredness, loss of empathy, and handle freakery. During this Fairy Bread Farms Hemp Gummies routine bankruptcy of the infirmity, the sufferer is euphoric, has grandiose fantasies, spins unrealistic schemes, and has widespread rage assaults (is irritable) if her or his wishes and plans are (inevitably) annoyed.
The manic levels of the bipolar disorder, nevertheless it, are confined in time – NPD is absolutely not. Furthermore, the mania is accompanied by means of – frequently protracted – depressive episodes. The narcissist is additionally repeatedly dysphoric. But whereas the bipolar sinks into deep self-deprecation, self-devaluation, unbounded pessimism, all-pervasive guilt and anhedonia – the narcissist, even if depressed, in no way forgoes his narcissism: his grandiosity, experience of entitlement, haughtiness, and absence of empathy.
Narcissistic dysphorias are much shorter and reactive – they represent a reaction to the Grandiosity Gap. In simple phrases, the narcissist is dejected while confronted with the abyss between his inflated self-symbol and grandiose fantasies – and the drab fact of his lifestyles: his screw ups, lack of accomplishments, disintegrating interpersonal relationships, and occasional popularity. Yet, one dose of Narcissistic Supply is ample to elevate the narcissists from the depth of misery to the heights of manic euphoria.
Not so with the bipolar. The supply of her or his temper swings is thought to be mind biochemistry – now not the provision of Narcissistic Supply. Whereas the narcissist is in complete control of his faculties, even if maximally agitated, the bipolar customarily feels that s/he has lost management of his/her brain (“flight of standards”), his/her speech, his/her cognizance span (distractibility), and his/her motor services.
The bipolar is likely to reckless behaviors and substance abuse simply at some stage in the manic part. The narcissist does medicines, liquids, gambles, retail outlets on credit, indulges in unsafe sex or in different compulsive behaviors each when elated and whilst deflated.
As a rule, the bipolar’s manic section interferes along with his/her social and occupational functioning. Many narcissists, in distinction, achieve the best rungs in their group, church, firm, or voluntary employer. Most of the time, they function flawlessly – notwithstanding the inevitable blowups and the grating extortion of Narcissistic Supply on the whole positioned an stop to the narcissist’s career and social liaisons.
The manic section of bipolar many times calls for hospitalization and – greater generally than admitted – entails psychotic points. Narcissists are not ever hospitalized because the menace for self-hurt is minute. Moreover, psychotic microepisodes in narcissism are decompensatory in nature and manifest in simple terms less than unendurable tension (e.g., in extensive healing).
The bipolar’s mania provokes ache in either strangers and within the patient’s nearest and dearest. His/her fixed cheer and compulsive insistence on interpersonal, sexual, and occupational, or skilled interactions engenders unease and repulsion. Her/his lability of temper – faster shifts among uncontrollable rage and unnatural superb spirits – is downright intimidating. The narcissist’s gregariousness, via comparison, is calculated, “bloodless”, managed, and target-oriented (the extraction of Narcissistic Supply). His cycles of mood and affect are far less pronounced and less fast.
The bipolar’s swollen shallowness, overstated self-self belief, obtrusive grandiosity, and delusional fantasies are reminiscent of the narcissist’s and are the source of the diagnostic confusion. Both types of patients purport to present suggestion, carry out an mission, accomplish a challenge, or embark on an business enterprise for which they may be uniquely unqualified and absence the competencies, abilities, expertise, or experience required.
But the bipolar’s bombast is a ways extra delusional than the narcissist’s. Ideas of reference and magical thinking are normal and, in this sense, the bipolar is toward the schizotypal than to the narcissistic.
There are other differentiating symptoms:
Sleep problems – drastically acute insomnia – are time-honored in the manic section of bipolar and exclusive in narcissism. So is “manic speech” – burdened, uninterruptible, loud, immediate, dramatic (incorporates making a song and funny asides), in some cases incomprehensible, incoherent, chaotic, and lasts for hours. It reflects the bipolar’s inner turmoil and his/her incapability to manage his/her racing and kaleidoscopic ideas.
As opposed to narcissists, bipolar within the manic section are usually distracted by the slightest stimuli, are unable to attention on principal statistics, or to retain the thread of communication. They are “everywhere in the location” – concurrently initiating lots of commercial enterprise ventures, becoming a member of a myriad enterprise, writing umpteen letters, contacting hundreds of thousands of associates and flawless strangers, appearing in a domineering, irritating, and intrusive approach, extremely brushing aside the desires and feelings of the unlucky recipients of their undesirable attentions. They rarely practice up on their projects.
The transformation is so marked that the bipolar is customarily described by using his/her closest as “no longer himself/herself”. Indeed, some bipolars relocate, modification name and look, and lose touch with their “former lifestyles”. Antisocial and even prison conduct isn't very uncommon and aggression is marked, directed at both others (attack) and oneself (suicide). Some biploars describe an acuteness of the senses, comparable to reports acknowledged by means of drug users: smells, sounds, and attractions are accentuated and attain an unearthly exceptional.
As opposed to narcissists, bipolars regret their misdeeds following the manic section and try and make amends for their activities. They have an understanding of and settle for that “some thing is wrong with them” and are seeking aid. During the depressive part they are ego-dystonic and their defenses are autoplastic (they blame themselves for their defeats, failures, and mishaps).
Finally, pathological narcissism is already discernible in early childhood. The complete-fledged bipolar defect – which include a manic segment – not often happens formerly the age of 20. The narcissist is regular in his pathology – now not so the bipolar. The onset of the manic episode is rapid and furious and effects in a conspicuous metamorphosis of the patient.
More approximately this matter right here:
Stormberg, D., Roningstam, E., Gunderson, J., & Tohen, M. (1998) Pathological Narcissism in Bipolar Disorder Patients. Journal of Personality Disorders, 12, 179-185
Roningstam, E. (1996), Pathological Narcissism and Narcissistic Personality Disorder in Axis I Disorders. Harvard Review of Psychiatry, 3, 326-340