BPD vs NPD: Understanding the Differences

A personality disorder is a chronic mental health condition in which someone’s personality, patterns of behavior, and beliefs about themselves and others interfere with relationships and daily functioning. Two of the most common personality disorders are Borderline Personality Disorder (BPD) and Narcissistic Personality Disorder (NPD). 

BPD and NPD can sometimes present with similar symptoms because they are both considered cluster B personality disorders. However, they vary greatly in their motives, sense of self, and empathy levels. Read on to learn more about the two and how they differ. 

What is Borderline Personality Disorder (BPD)? 

BPD affects around 1.4% of the population and is characterized by emotional instability, lack of a sense of self, and fears of abandonment. People with BPD often have a negative self-image, and they might change their thoughts, interests, or behaviors to better fit in a situation or feel accepted [1]. 

They often engage in self-destructive behaviors to manage emotional distress from chronic fears of rejection or low self-esteem. 

9 Traits of Borderline Personality Disorder 

1. Fears of abandonment or rejection
2. Inability to regulate emotions
3. Sudden, frequent mood swings
4. Chronic feelings of emptiness 
5. Intense anger or frustration, aggressive outbursts, especially if perceived abandonment or rejection 
6. Feeling disconnected from their environment, the people around them, or even their own thoughts 
7. Unstable sense of self, sudden shifts in thoughts, feelings, or opinions 
8. Reckless or impulsive behavior, such as unprotected sex or drug use
9. Threats of suicide, chronic self-harming 

What is Narcissistic Personality Disorder (NPD)?

NPD, also called pathological narcissism, is a psychiatric condition characterized by patterns of entitlement, grandiosity, and a lack of empathy. People with NPD often crave admiration and special treatment to boost their ego and compensate for their deeply low self-esteem. They often struggle to build and maintain meaningful relationships or retain employment. 

Narcissism exists on a spectrum, with many subtypes presenting with their own subset of symptoms. Some of these include [2]: 

• Grandiose: Entitled, arrogant, need for admiration, lack of empathy.

• Vulnerable: Shame, insecurity, hypersensitive to criticism, often appear shy or quiet, but struggle with feelings of resentment. 

• Malignant: Sociopathy and narcissism. Combines narcissistic traits with cruel, destructive behaviors such as lying, manipulation, and, in many cases, abuse. 

10 Traits of Narcissistic Personality Disorder 

1. Constant need for praise and validation 
2. Feelings of being special or unique 
3. Overstating or exaggerating their own accomplishments 
4. Entitled or arrogant 
5. Obsessing over how they are perceived by others
6. Fixated on success and wealth  
7. Lack of empathy for others 
8. Manipulate others to get their way 
9. Feeling envy of others or believing others are envious of them 
10. Fantasies about power, status, beauty 

When Symptoms Overlap Between BPD and NPD: The Similarities 

BPD and NPD both include unhealthy patterns of behavior, distorted thoughts or a sense of self, and often problems with self-esteem. People with both of these conditions often desire positive attention and validation from others, and usually react poorly if they don’t receive this. NPD seeks this kind of attention to boost their ego, while BPD often desires this attention to cope with fears of abandonment. 

Both people with BPD and NPD struggle with sensitivity to criticism or negative feedback, which can disrupt their functioning in the workplace. People with both disorders also tend to see the world in black and white, leading to higher rates of emotional distress and increasing the risk of substance abuse in both.  

There is the case where some people struggle with both of these personality disorders, as they have a strong correlation due to their similar roots of disorganized attachments in childhood, temperament, and trauma. Research found that around 13% of BPD patients also met diagnostic criteria for NPD [3]. 

The Difference Between Borderline Personality Disorder and Narcissism  

Although some of the traits of each personality disorder overlap, they are still distinct and present with their own clinical features. 

Effective Treatment Approaches for BPD and NPD

Treating personality disorders is a challenge, as many individuals see their symptoms as “permanent” pieces of their personality, rather than a mental health condition that deserves treatment. This distorted perception is a common barrier to seeking treatment. 

However, the good news is that when they do seek treatment, the outcomes are often successful. Some common treatment approaches for BPD and NPD include [4][5]: 

• Dialectical Behavior Therapy (DBT) is a first-line treatment for borderline personality disorder, helping patients develop skills such as mindfulness, distress tolerance, interpersonal skills, and emotional regulation. It also focuses on reducing self-harm behaviors and building healthy coping skills. 

• Transference-Focused Therapy (TFP) can be helpful for those with NPD, in which they “project” their feelings onto the therapist to reveal distorted thought patterns and beliefs. 

• Mentalization-Based Therapy (MBT) helps narcissists increase empathy for themselves and others, by encouraging them and challenging them to have different perspectives. 

• Trauma Therapy can help patients with both disorders process and understand early life experiences that contribute to unconscious patterns of behavior. 

Personality Disorder Treatment at AnchorPoint in Arizona 

At AnchorPoint, we are committed to integrating the power of spiritual support with clinical care. Our treatment philosophy is guided by the book NeuroFaith, a holistic model that integrates polyvagal-informed therapies such as Internal Family Systems (IFS) and HeartMath with biblical principles to find hope, build resilience, and spark transformation at the intersection of faith. 

Through a blend of evidence-based therapies, social supports, case management, integrated wellness, and Christ-centered services, we help individuals with Narcissistic and Borderline Personality Disorder foster self-awareness, strengthen empathy, and heal their relationships. 

We understand the complex nature of personality disorders and that healing can be a lifelong journey. Our dedicated team of faith-based clinicians, therapists, and support staff is committed to helping you grow emotionally and setting goals for long-term recovery. Contact our admissions team to begin your healing journey today. 

Sources 

[1] NAMI. 2023. Borderline Personality Disorder.

[2] Newsome, J. 2022. Unpacking Narcissism and Stigma. NAMI. 

[3] Pedneault, K. 2023. Borderline Personality Disorder and Narcissism. VeryWellMind. 

[4] Keefe, J. R. (2021). Transference-Focused Psychotherapy for Pathological Narcissism and Narcissistic Personality Disorder (TFP-N). Psychodynamic psychiatry, 49(2), 244–272.

[5] Bateman A, Fonagy P (2016). Mentalization-based treatment for personality disorders: A practical guide. Oxford, UK: Oxford University Press.