Types of narcissists include:*

Classic
The classic narcissist is overly self-confident and sees themselves as superior than other people. Think of a child who has always been told by mom and dad that they would be great, and then that child takes and internally distorts that message into superiority.

Compensatory
The compensatory narcissist covers up with their grandiose behavior, a deep-seated deficit in self-esteem. Think of a child who felt devalued but instead of giving up on life, resorts to fantasies of grandeur and greatness. This person will either live in that fantasy world or decide to create that fantasy world in real life.

Inverted
The inverted narcissist is a co-dependent who caters to the emotional needs of a classic narcissist. Often a relative or mate of a narcissist– this person feeds the narcissistic supply of adulation, admiration, coddling etc. that the classic type requires.

Narcissists are also either:*

1. cerebral — people who feed their narcissistic needs from their intelligence, academic, or professional achievements.
Examples would be evangelists, CEOs, professors, physicians etc.

2. somatic — people who feed their narcissistic needs from their physicality, exercise, physical and sexual prowess including their “conquests”.
Examples would be models, professional athletes, actors etc.

To break it down even further, we can take a look at the 9-point model presented by Bruce Stevens in his article: ‘Narcissism: A Nine Headed Hydra? Exploring Types of Narcissism’. In it he describes:

1. The Craver has a lot of love to give but always with strings attached. This type has a great fear of abandonment and clings to people they can connect with, but they are never satisfied.

2. The Power Broker desires…well, power of course! They will do almost anything to gain power, and rarely consider any consequences of their actions. They can be bullies, arrogant, and cold. By any means necessary is their motto.

3. The Rager is someone on the edge, and when their narcissism is bruised, they will lash out. These types are often verbally and/or physically abusive. Very controlling.

4. The Fantasy Maker is the type that has retreated into their own reality, because they are living in defense of the painful reality of their lives. They do not live in truth and therefore have difficulty forming “real” relationships with others.

5. The Special Lover is the type that believe love is the answer to all things. They believe that they have a special capacity to love and tend to idealize love and the people whom they love. Of course, they face deep disappointment when they realize that their love and/or the ones they love are not perfect.

6. The Body Shaper is highly focused on their physical image. Fashion. glamour, Youth. Beauty. They live very shallow and empty lives, and they tend to deny ageing.

7. The Trickster is an extremely charming and social type. These types can trick people into trusting them, but is very malicious and ruthless in these relationships. They feel a sense of entitlement and are without remorse.

8. The Martyr revels in their suffering. They are victims and love telling people about it. THey totally identify with the pain they are dealing with in the present. They want care and support and will exploit others to get it. They tend to form relationships with others who have a need to be needed and then they are exploited. This is their way of controlling other people.

9. The Rescuer is virtuous. They always take the high road in relationships. They appear kind, considerate, and they try too hard. They find it easier to give than to receive. This could be because they were a parentified child in a dysfunctional family.

Recommended Reading:
Why Is It Always About You? : The Seven Deadly Sins of Narcissism
by Sandy Hotchkiss

Children of the Self-Absorbed: A Grown-Up’s Guide to Getting over Narcissistic Parents
by Nina W. Brown

*Content based on previous articles and book Malignant Self Love – Narcissism Revisited
by Sam Vaknin

Lisa Angelettie, M.S.W., is a psychotherapist, author, and life coach. She has been helping people make smarter life choices since 1998. Get more free tips like this when you subscribe to the GirlShrink newsletter .

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Narcissistic Personality Disorder

Narcissistic personality disorder (NPD) is a personality disorder that is characterized by extreme feelings of self-importance, a high need for admiration, and a lack of empathy. NPD can be considered as a pathological form of narcissism. It is estimated that 0.7-1% of the general population are afflicted with NPD. Most people with NPD (50-75%, according to the DSM) are men.

A narcissistic personality disorder as defined by the DSM is characterized by an all-pervasive pattern of grandiosity (in fantasy or behavior), need for admiration or adulation and lack of empathy, usually beginning by early adulthood and present in various contexts. Five (or more) of the following criteria are considered necessary for the clinical diagnosis to be met:

* Feels grandiose and self-important (e.g., exaggerates accomplishments, talents, skills, contacts, and personality traits to the point of lying, demands to be recognized as superior without commensurate achievements);
* Is obsessed with fantasies of unlimited success, fame, fearsome power or omnipotence, unequalled brilliance (the cerebral narcissist), bodily beauty or sexual performance (the somatic narcissist), or ideal, everlasting, all-conquering love or passion;
* Firmly convinced that they are unique and, being special, can only be understood by, should only be treated by, or associate with, other special or unique, or high-status people (or institutions);
* Requires excessive admiration, adulation, attention and affirmation — or, failing that, wishes to be feared and to be notorious (narcissistic supply);
* Feels entitled. Demands automatic and full compliance with their unreasonable expectations for special and favorable priority treatment.
* Is “interpersonally exploitative”, i.e., uses others to achieve their own ends;
* Devoid of empathy. Is unable or unwilling to identify with, acknowledge, or accept the feelings, needs, preferences, priorities, and choices of others;
* Constantly envious of others and seeks to hurt or destroy the objects of their frustration. Suffers from persecutory (paranoid) delusions stemming from a belief that others are envious of them and are likely to act similarly;
* Behaves arrogantly and haughtily. Feels superior, omnipotent, omniscient, invincible, immune, “above the law”, and omnipresent (magical thinking). Rages when frustrated, contradicted, or confronted by people they consider inferior to themselves and unworthy.

Recommendations:
Dr. Sam Vaknin is a great authority on narcissism. He has written several books on narcissism and you can learn more detail about whether you or someone you love is a narcissist. Go to Dr. Vaknin’s Site.

Lisa Angelettie, M.S.W., is a psychotherapist, author, and life coach. She has been helping people make smarter life choices since 1998. Get more free tips like this when you subscribe to the GirlShrink newsletter .

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Guest Author: Sam Vaknin

Pathological narcissism is a life-long pattern of traits and behaviours which signify infatuation and obsession with one’s self to the exclusion of all others and the egotistic and ruthless pursuit of one’s gratification, dominance and ambition.

As distinct from healthy narcissism which we all possess, pathological narcissism is maladaptive, rigid, persisting, and causes significant distress, and functional impairment.

Pathological narcissism was first described in detail by Freud in his essay “On Narcissism” (1915). Other major contributors to the study of narcissism are: Melanie Klein, Karen Horney, Franz Kohut, Otto Kernberg, Theodore Millon, Elsa Roningstam, Gunderson, and Robert Hare.

What is Narcissistic Personality Disorder (NPD)?

The Narcissistic Personality Disorder (NPD) (formerly known as megalomania or, colloquially, as egotism) is a form of pathological narcissism. It is a Cluster B (dramatic, emotional, or erratic) personality disorder. Other Cluster B personality disorders are the Borderline Personality Disorder (BPD), the Antisocial Personality Disorder (APD), and the Histrionic Personality Disorder (HPD). The Narcissistic Personality Disorder (NPD) first appeared as a mental health diagnosis in the DSM III-TR (Diagnostic and Statistical Manual) in 1980.

Diagnostic Criteria

The ICD-10, the International Classification of Diseases, published by the World Health Organisation in Geneva [1992] regards the Narcissistic Personality Disorder (NPD) as “a personality disorder that fits none of the specific rubrics”. It relegates it to the category “Other Specific Personality Disorders” together with the eccentric, “haltlose”, immature, passive-aggressive, and psychoneurotic personality disorders and types.

The American Psychiatric Association, based in Washington D.C., USA, publishes the Diagnostic and Statistical Manual of Mental Disorders, fourth edition, Text Revision (DSM-IV-TR) [2000] where it provides the diagnostic criteria for the Narcissistic Personality Disorder (301.81, p. 717).

The DSM-IV-TR defines Narcissistic Personality Disorder (NPD) as “an all-pervasive pattern of grandiosity (in fantasy or behaviour), need for admiration or adulation and lack of empathy, usually beginning by early adulthood and present in various contexts”, such as family life and work.

The DSM specifies nine diagnostic criteria. Five (or more) of these criteria must be met for a diagnosis of Narcissistic Personality Disorder (NPD) to be rendered.

[My amendments do not constitute a part of the text of the DSM-IV-TR, nor is the American Psychiatric Association (APA) associated with them in any way.]

Proposed Amended Criteria for the Narcissistic Personality Disorder

a.. Feels grandiose and self-important (e.g., exaggerates accomplishments, talents, skills, contacts, and personality traits to the point of lying, demands to be recognised as superior without commensurate achievements);

a.. Is obsessed with fantasies of unlimited success, fame, fearsome power or omnipotence, unequalled brilliance (the cerebral narcissist), bodily beauty or sexual performance (the somatic narcissist), or ideal, everlasting, all-conquering love or passion;

a.. Firmly convinced that he or she is unique and, being special, can only be understood by, should only be treated by, or associate with, other special or unique, or high-status people (or institutions);

a.. Requires excessive admiration, adulation, attention and affirmation – or, failing that, wishes to be feared and to be notorious (Narcissistic Supply);

a.. Feels entitled. Demands automatic and full compliance with his or her unreasonable expectations for special and favourable priority treatment;

a.. Is “interpersonally exploitative”, i.e., uses others to achieve his or her own ends;

a.. Devoid of empathy. Is unable or unwilling to identify with, acknowledge, or accept the feelings, needs, preferences, priorities, and choices of others;

a.. Constantly envious of others and seeks to hurt or destroy the objects of his or her frustration. Suffers from persecutory (paranoid) delusions as he or she believes that they feel the same about him or her and are likely to act similarly;

a.. Behaves arrogantly and haughtily. Feels superior, omnipotent, omniscient, invincible, immune, “above the law”, and omnipresent (magical thinking). Rages when frustrated, contradicted, or confronted by people he or she considers inferior to him or her and unworthy.

Prevalence and Age and Gender Features

According to the DSM IV-TR, between 2% and 16% of the population in clinical settings (between 0.5-1% of the general population) are diagnosed with Narcissistic Personality Disorder (NPD). Most narcissists (50-75%, according to the DSM-IV-TR) are men.

We must carefully distinguish between the narcissistic traits of adolescents – narcissism is an integral part of their healthy personal development – and the full-fledge disorder. Adolescence is about self-definition, differentiation, separation from one’s parents, and individuation. These inevitably involve narcissistic assertiveness which is not to be conflated or confused with Narcissistic Personality Disorder (NPD).

“The lifetime prevalence rate of NPD is approximately 0.5-1 percent; however, the estimated prevalence in clinical settings is approximately 2-16 percent. Almost 75 percent of individuals diagnosed with NPD are male (APA, DSM IV-TR 2000).”

From the Abstract of Psychotherapeutic Assessment and Treatment of Narcissistic Personality Disorder By Robert C. Schwartz,Ph.D., DAPA and Shannon D. Smith, Ph.D., DAPA (American Psychotherapy Association, Article #3004 Annals July/August 2002)

Narcissistic Personality Disorder (NPD) is exacerbated by the onset of aging and the physical, mental, and occupational restrictions it imposes.

In certain situations, such as under constant public scrutiny and exposure, a transient and reactive form of the Narcissistic Personality Disorder (NPD) has been observed by Robert Milman and labelled “Acquired Situational Narcissism”.

There is only scant research regarding the Narcissistic Personality Disorder (NPD), but studies have not demonstrated any ethnic, social, cultural, economic, genetic, or professional predilection to it.

Comorbidity and Differential Diagnoses

Narcissistic Personality Disorder (NPD) is often diagnosed with other mental health disorders (“co-morbidity”), such as mood disorders, eating disorders, and substance-related disorders. Patients with Narcissistic Personality Disorder (NPD) are frequently abusive and prone to impulsive and reckless behaviours (“dual diagnosis”).

Narcissistic Personality Disorder (NPD) is commonly diagnosed with other personality disorders, such as the Histrionic, Borderline, Paranoid, and Antisocial Personality Disorders.

The personal style of those suffering from the Narcissistic Personality Disorder (NPD) should be distinguished from the personal styles of patients with other Cluster B Personality Disorders. The narcissist is grandiose, the histrionic coquettish, the antisocial (psychopath) callous, and the borderline needy.

As opposed to patients with the Borderline Personality Disorder, the self-image of the narcissist is stable, he or she are less impulsive and less self-defeating or self-destructive and less concerned with abandonment issues (not as clinging).

Contrary to the histrionic patient, the narcissist is achievements-orientated and proud of his or her possessions and accomplishments. Narcissists also rarely display their emotions as histrionics do and they hold the sensitivities and needs of others in contempt.

According to the DSM-IV-TR, both narcissists and psychopaths are “tough-minded, glib, superficial, exploitative, and unempathic”. But narcissists are less impulsive, less aggressive, and less deceitful. Psychopaths rarely seek narcissistic supply. As opposed to psychopaths, few narcissists are criminals.

Patients suffering from the range of obsessive-compulsive disorders are committed to perfection and believe that only they are capable of attaining it. But, as opposed to narcissists, they are self-critical and far more aware of their own deficiencies, flaws, and shortcomings.

Clinical Features of the Narcissistic Personality Disorder

The onset of pathological narcissism is in infancy, childhood and early adolescence. It is commonly attributed to childhood abuse and trauma inflicted by parents, authority figures, or even peers. Pathological narcissism is a defense mechanism intended to deflect hurt and trauma from the victim’s “True Self” into a “False Self” which is omnipotent, invulnerable, and omniscient.

The narcissist uses the False Self to regulate his or her labile sense of self-worth by extracting from his environment narcissistic supply (any form of attention, both positive and negative). There is a whole range of narcissistic reactions, styles, and personalities – from the mild, reactive and transient to the permanent personality disorder.

Patients with Narcissistic Personality Disorder (NPD) feel injured, humiliated and empty when criticized. They often react with disdain (devaluation), rage, and defiance to any slight, real or imagined. To avoid such situations, some patients with Narcissistic Personality Disorder (NPD) socially withdraw and feign false modesty and humility to mask their underlying grandiosity. Dysthymic and depressive disorders are common reactions to isolation and feelings of shame and inadequacy.

The interpersonal relationships of patients with Narcissistic Personality Disorder (NPD) are typically impaired due to their lack of empathy, disregard for others, exploitativeness, sense of entitlement, and constant need for attention (narcissistic supply).

Though often ambitious and capable, inability to tolerate setbacks, disagreement, and criticism make it difficult for patients with Narcissistic Personality Disorder (NPD) to work in a team or to maintain long-term professional achievements. The narcissist’s fantastic grandiosity, frequently coupled with a hypomanic mood, is typically incommensurate with his or her real accomplishments (the “grandiosity gap”).

Patients with Narcissistic Personality Disorder (NPD) are either “cerebral” (derive their Narcissistic Supply from their intelligence or academic achievements) or “somatic” (derive their Narcissistic Supply from their physique, exercise, physical or sexual prowess and romantic or physical “conquests”).

Patients with Narcissistic Personality Disorder (NPD) are either “classic” (meet five of the nine diagnostic criteria included in the DSM), or they are “compensatory” (their narcissism compensates for deep-set feelings of inferiority and lack of self-worth).

Some narcissists are covert, or inverted narcissists. As codependents, they derive their narcissistic supply from their relationships with classic narcissists.

Treatment and Prognosis

The common treatment for patients with Narcissistic Personality Disorder (NPD) is talk therapy (mainly psychodynamic psychotherapy or cognitive-behavioural treatment modalities). Talk therapy is used to modify the narcissist’s antisocial, interpersonally exploitative, and dysfunctional behaviors, often with some success. Medication is prescribed to control and ameliorate attendant conditions such as mood disorders or obsessive-compulsive disorders.

The prognosis for an adult suffering from the Narcissistic Personality Disorder (NPD) is poor, though his adaptation to life and to others can improve with treatment.

Go Back To Main Article Directory
a.. Goldman, Howard H., Review of General Psychiatry, fourth edition, 1995. Prentice-Hall International, London.

b.. Gelder, Michael, Gath, Dennis, Mayou, Richard, Cowen, Philip (eds.), Oxford Textbook of Psychiatry, third edition, 1996, reprinted 2000. Oxford University Press, Oxford.

c.. Vaknin, Sam, Malignant Self Love – Narcissism Revisited, seventh revised impression, 1999-2006. Narcissus Publications, Prague and Skopje.

Sam Vaknin http://samvak.tripod.com is the author of Malignant Self Love – Narcissism Revisited and After the Rain – How the West Lost the East.

He served as a columnist for Global Politician, Central Europe Review, PopMatters, Bellaonline, and eBookWeb, a United Press International (UPI) Senior Business Correspondent, and the editor of mental health and Central East Europe categories in The Open Directory and Suite101.

Until recently, he served as the Economic Advisor to the Government of Macedonia. Visit Sam’s Web site at http://samvak.tripod.com

Lisa Angelettie, M.S.W., is a psychotherapist, author, and life coach. She has been helping people make smarter life choices since 1998. Get more free tips like this when you subscribe to the GirlShrink newsletter .

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Guest Author: Sam Vaknin

Author of “Malignant Self Love – Narcissism Revisited”

(The use of gender pronouns in this article reflects the clinical facts: most narcissists and most Asperger’s patients are male.)

Asperger’s Disorder is often misdiagnosed as Narcissistic Personality Disorder (NPD), though evident as early as age 3 (while pathological narcissism cannot be safely diagnosed prior to early adolescence).

In both cases, the patient is self-centered and engrossed in a narrow range of interests and activities. Social and occupational interactions are severely hampered and conversational skills (the give and take of verbal intercourse) are primitive.

The Asperger’s patient body language – eye to eye gaze, body posture, facial expressions – is constricted and artificial, akin to the narcissist’s. Nonverbal cues are virtually absent and their interpretation in others lacking.

Yet, the gulf between Asperger’s and pathological narcissism is vast.

The narcissist switches between social agility and social impairment voluntarily. His social dysfunctioning is the outcome of conscious haughtiness and the reluctance to invest scarce mental energy in cultivating relationships with inferior and unworthy others. When confronted with potential Sources of Narcissistic Supply, however, the narcissist easily regains his social skills, his charm, and his gregariousness.

Many narcissists reach the highest rungs of their community, church, firm, or voluntary organization. Most of the time, they function flawlessly – though the inevitable blowups and the grating extortion of Narcissistic Supply usually put an end to the narcissist’s career and social liaisons.

The Asperger’s patient often wants to be accepted socially, to have friends, to marry, to be sexually active, and to sire offspring. He just doesn’t have a clue how to go about it.

His affect is limited. His initiative – for instance, to share his experiences with nearest and dearest or to engage in foreplay – is thwarted. His ability to divulge his emotions stilted. He is incapable or reciprocating and is largely unaware of the wishes, needs, and feelings of his interlocutors or counterparties.

Inevitably, Asperger’s patients are perceived by others to be cold, eccentric, insensitive, indifferent, repulsive, exploitative or emotionally-absent. To avoid the pain of rejection, they confine themselves to solitary activities – but, unlike the schizoid, not by choice. They limit their world to a single topic, hobby, or person and dive in with the greatest, all-consuming intensity, excluding all other matters and everyone else. It is a form of hurt-control and pain regulation.

Thus, while the narcissist avoids pain by excluding, devaluing, and discarding others – the Asperger’s patient achieves the same result by withdrawing and by passionately incorporating in his universe only one or two people and one or two subjects of interest. Both narcissists and Asperger’s patients are prone to react with depression to perceived slights and injuries – but Asperger’s patients are far more at risk of self-harm and suicide.

The use of language is another differentiating factor.

The narcissist is a skilled communicator. He uses language as an instrument to obtain Narcissistic Supply or as a weapon to obliterate his “enemies” and discarded sources with. Cerebral narcissists derive Narcissistic Supply from the consummate use they make of their innate verbosity.

Not so the Asperger’s patient. He is equally verbose at times (and taciturn on other occasions) but his topics are few and, thus, tediously repetitive. He is unlikely to obey conversational rules and etiquette (for instance, to let others speak in turn). Nor is the Asperger’s patient able to decipher nonverbal cues and gestures or to monitor his own misbehavior on such occasions. Narcissists are similarly inconsiderate – but only towards those who cannot possibly serve as Sources of Narcissistic Supply.

More about Autism Spectrum Disorders here:

McDowell, Maxson J. (2002) The Image of the Mother’s Eye: Autism and Early Narcissistic Injury , Behavioral and Brain Sciences (Submitted)

Benis, Anthony – “Toward Self & Sanity: On the Genetic Origins of the Human Character” – Narcissistic-Perfectionist Personality Type (NP) with special reference to infantile autism

Stringer, Kathi (2003) An Object Relations Approach to Understanding Unusual Behaviors and Disturbances

James Robert Brasic, MD, MPH (2003) Pervasive Developmental Disorder: Asperger Syndrome

Sam Vaknin http://samvak.tripod.com is the author of Malignant Self Love – Narcissism Revisited and After the Rain – How the West Lost the East. He served as a columnist for Global Politician, Central Europe Review, PopMatters, Bellaonline, and eBookWeb, a United Press International (UPI) Senior Business Correspondent, and the editor of mental health and Central East Europe categories in The Open Directory and Suite101.

Until recently, he served as the Economic Advisor to the Government of Macedonia.

Lisa Angelettie, M.S.W., is a psychotherapist, author, and life coach. She has been helping people make smarter life choices since 1998. Get more free tips like this when you subscribe to the GirlShrink newsletter .

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Would you like to see your article here? Submit your articles for publication on our site and gain massive exposure, traffic and backlinks for your business. Learn more about our writer’s guidelines and good luck!

Guest Author: Sam Vaknin

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

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

Bipolar patients in the manic phase exhibit many of the signs and symptoms of pathological narcissism – hyperactivity, self-centeredness, lack of empathy, and control freakery. During this recurring chapter of the disease, the 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 of the bipolar disorder, however, are limited in time – NPD is not. Furthermore, the mania is followed by – usually protracted – depressive episodes. The narcissist is also frequently dysphoric. But whereas the bipolar sinks into deep self-deprecation, self-devaluation, unbounded pessimism, all-pervasive guilt and anhedonia – the 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 to the Grandiosity Gap. In plain words, the narcissist is dejected when confronted with the abyss between his inflated self-image and grandiose fantasies – and the 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 elevate the narcissists from the depth of misery to the heights of manic euphoria.

Not so with the bipolar.

The source of her or his mood swings is assumed to be brain biochemistry – not the availability of Narcissistic Supply. Whereas the narcissist is in full control of his faculties, even when maximally agitated, the 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 during the 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, the bipolar’s manic phase interferes with his/her social and occupational functioning. Many narcissists, in contrast, reach the highest rungs of their community, church, firm, or voluntary organization. Most of the time, they function flawlessly – though the inevitable blowups and the grating extortion of Narcissistic Supply usually put an end to the 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 as the 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 in the 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.

The bipolar’s swollen self-esteem, overstated self-confidence, obvious grandiosity, and delusional fantasies are akin to the narcissist’s and are the source of the diagnostic confusion. Both types of patients purport to give advice, carry out an assignment, accomplish a mission, or embark on an enterprise for which they are uniquely unqualified and lack the talents, skills, knowledge, or experience required.

But the bipolar’s bombast is far more delusional than the narcissist’s. Ideas of reference and magical thinking are common and, in this sense, the bipolar is closer to the schizotypal than to the narcissistic.

There are other differentiating symptoms:

Sleep disorders – notably acute insomnia – are common in the manic phase of bipolar and uncommon in narcissism. So is “manic speech” – pressured, uninterruptible, loud, rapid, dramatic (includes singing and humorous asides), sometimes incomprehensible, incoherent, chaotic, and lasts for hours. It reflects the bipolar’s inner turmoil and his/her inability to control his/her racing and kaleidoscopic thoughts.

As opposed to narcissists, bipolar in the manic phase are often distracted by the slightest stimuli, are unable to focus on relevant data, or to maintain the thread of conversation. They are “all over the place” – simultaneously initiating numerous business ventures, joining a myriad organization, writing umpteen letters, contacting hundreds of friends and perfect strangers, acting in a domineering, demanding, and intrusive manner, totally disregarding the needs and emotions of the unfortunate recipients of their unwanted attentions. They rarely follow up on their projects.

The transformation is so marked that the bipolar is often described by his/her closest as “not himself/herself”. Indeed, some bipolars relocate, change name and appearance, and lose contact with their “former life”. Antisocial or even criminal behavior is not uncommon and aggression is marked, directed at both others (assault) and oneself (suicide). Some biploars describe an acuteness of the senses, akin to experiences recounted by drug users: smells, sounds, and sights are accentuated and attain an unearthly quality.

As opposed to narcissists, bipolars regret their misdeeds following the manic phase and try to atone for their actions. They realize and accept that “something is wrong with them” and seek help. During the depressive phase 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 adolescence. The full-fledged bipolar disorder – including a manic phase – rarely occurs before the age of 20. The narcissist is consistent in his pathology – not so the bipolar. The onset of the manic episode is fast and furious and results in a conspicuous metamorphosis of the patient.

More about this topic 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

Sam Vaknin http://samvak.tripod.com is the author of Malignant Self Love – Narcissism Revisited and After the Rain – How the West Lost the East.

He served as a columnist for Global Politician, Central Europe Review, PopMatters, Bellaonline, and eBookWeb, a United Press International (UPI) Senior Business Correspondent, and the editor of mental health and Central East Europe categories in The Open Directory and Suite101.

Until recently, he served as the Economic Advisor to the Government of Macedonia.

Lisa Angelettie, M.S.W., is a psychotherapist, author, and life coach. She has been helping people make smarter life choices since 1998. Get more free tips like this when you subscribe to the GirlShrink newsletter .

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Would you like to see your article here? Submit your articles for publication on our site and gain massive exposure, traffic and backlinks for your business. Learn more about our writer’s guidelines and good luck!