Misdiagnosing Narcissism - The Bipolar I Disorder

Written by Sam Vaknin

(The use of gender pronouns in this article reflectsrepparttar clinical facts: most narcissists are men.)

The manic phase of Bipolar I Disorder is often misdiagnosed as Narcissistic Personality Disorder (NPD).

Bipolar patients inrepparttar 126110 manic phase exhibit many ofrepparttar 126111 signs and symptoms of pathological narcissism - hyperactivity, self-centeredness, lack of empathy, and control freakery. During this recurring chapter ofrepparttar 126112 disease,repparttar 126113 patient is euphoric, has grandiose fantasies, spins unrealistic schemes, and has frequent rage attacks (is irritable) if her or his wishes and plans are (inevitably) frustrated.

The manic phases ofrepparttar 126114 bipolar disorder, however, are limited in time - NPD is not. Furthermore,repparttar 126115 mania is followed by - usually protracted - depressive episodes. The narcissist is also frequently dysphoric. But whereasrepparttar 126116 bipolar sinks into deep self-deprecation, self-devaluation, unbounded pessimism, all-pervasive guilt and anhedonia -repparttar 126117 narcissist, even when depressed, never forgoes his narcissism: his grandiosity, sense of entitlement, haughtiness, and lack of empathy.

Narcissistic dysphorias are much shorter and reactive - they constitute a response torepparttar 126118 Grandiosity Gap. In plain words,repparttar 126119 narcissist is dejected when confronted withrepparttar 126120 abyss between his inflated self-image and grandiose fantasies - andrepparttar 126121 drab reality of his life: his failures, lack of accomplishments, disintegrating interpersonal relationships, and low status. Yet, one dose of Narcissistic Supply is enough to elevaterepparttar 126122 narcissists fromrepparttar 126123 depth of misery torepparttar 126124 heights of manic euphoria.

Not so withrepparttar 126125 bipolar. The source of her or his mood swings is assumed to be brain biochemistry - notrepparttar 126126 availability of Narcissistic Supply. Whereasrepparttar 126127 narcissist is in full control of his faculties, even when maximally agitated,repparttar 126128 bipolar often feels that s/he has lost control of his/her brain ("flight of ideas"), his/her speech, his/her attention span (distractibility), and his/her motor functions.

The bipolar is prone to reckless behaviors and substance abuse only duringrepparttar 126129 manic phase. The narcissist does drugs, drinks, gambles, shops on credit, indulges in unsafe sex or in other compulsive behaviors both when elated and when deflated.

As a rule,repparttar 126130 bipolar's manic phase interferes with his/her social and occupational functioning. Many narcissists, in contrast, reachrepparttar 126131 highest rungs of their community, church, firm, or voluntary organization. Most ofrepparttar 126132 time, they function flawlessly - thoughrepparttar 126133 inevitable blowups andrepparttar 126134 grating extortion of Narcissistic Supply usually put an end torepparttar 126135 narcissist's career and social liaisons.

The manic phase of bipolar sometimes requires hospitalization and - more frequently than admitted - involves psychotic features. Narcissists are never hospitalized asrepparttar 126136 risk for self-harm is minute. Moreover, psychotic microepisodes in narcissism are decompensatory in nature and appear only under unendurable stress (e.g., in intensive therapy).

The bipolar's mania provokes discomfort in both strangers and inrepparttar 126137 patient's nearest and dearest. His/her constant cheer and compulsive insistence on interpersonal, sexual, and occupational, or professional interactions engenders unease and repulsion. Her/his lability of mood - rapid shifts between uncontrollable rage and unnatural good spirits - is downright intimidating. The narcissist's gregariousness, by comparison, is calculated, "cold", controlled, and goal-orientated (the extraction of Narcissistic Supply). His cycles of mood and affect are far less pronounced and less rapid.

That's Not How It's S'posed To Be

Written by Susan Dunn, MA, Personal Life & EQ Coach

When things are not “how they’re supposed to he,” how we suffer. Life events which assault our assumptions of how life should be are difficult to handle and require patience inrepparttar recovery, and rely onrepparttar 126109 development of strong emotional intelligence.


We set out in our adult life with certain expectations about how things are supposed to be. It’s part of our upbringing, part of our culture, and part ofrepparttar 126110 values imparted to us by caring parents.

“You’re supposed to get your degree, then get a job, then get married,” says one parent. In another familyrepparttar 126111 formula may be “Follow your heart. If you love her, marry her. The rest will work out.” But behind these life rules passed down are certain assumptions, i.e., job, education, partner, marriage, children.

We learn it about little things as well as big. “He should have [was supposed to have] thanked you for that,” says your parent, or “He should’ve thought about that beforehand [that’s what he was supposed to have done].”

Basically we assume a natural order along with this. It may vary somewhat, but at midlife you’re supposed to find yourself (1) married, (2) with children, (3) with a good job, and (4) money inrepparttar 126112 bank. Some time after that, we expect to have grandchildren, we expect to be able to retire well, and we expect to be OK financially. Behind these assumptions isrepparttar 126113 fact that we’re supposed to have a good life if we do what we’re supposed to. 1 + 1 = 2.

When this natural order of things, and our sometimes unmindful expectations, are not met is when trouble occurs. We suffer when we are forced to retire sometimes more because ofrepparttar 126114 emotional affront than fromrepparttar 126115 actual deed.

I say “unmindful” because often we aren’t aware of what we assume to be our rights in life until they are violated. WE should never be burglarized, we assume, and are shocked when it happens. WE should never have a teenager in a rehab facility, we assume, until we find ourselves there. WE should get promotions, we assume, until we discover thatrepparttar 126116 corporation where we work values other qualities rather thanrepparttar 126117 fine ones we possess and ‘knew’ would take us far. WE should have grandchildren, because everyone does, we assume, untilrepparttar 126118 day our child informs us she plans to have no children.


What do we do when this occurs? It requiresrepparttar 126119 EQ competency of Resilience, which meansrepparttar 126120 ability to bounce back from failures, losses, rejections and adversity. The good news is that it will also build it. Most of all it requires emotional processing and growth.

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