Borderline and Narcissism
BORDERLINE PERSONALITY DISORDER
Borderline personality disorder (BPD) is a mental health disorder that generates significant emotional instability. This can lead to a variety of other stressful mental and behavioral problems.
With borderline personality disorder, you may have a severely distorted self-image and feel worthless and fundamentally flawed. Anger, impulsiveness and frequent mood swings may push others away, even though you may desire to have loving and lasting relationships.
If you have borderline personality disorder, don’t get discouraged. Many people with this disorder get better with treatment and can live satisfying lives.
Borderline personality disorder affects how you feel about yourself, how you relate to others and how you behave.
Signs and symptoms of borderline personality disorder may include:
• Impulsive and risky behavior, such as risky driving, unsafe sex, gambling sprees or illegal drug use
• Awareness of destructive behavior, including self-injury, but sometimes feeling unable to change it
• Wide mood swings
• Short but intense episodes of anxiety or depression
• Inappropriate anger and antagonistic behavior, sometimes escalating into physical fights
• Difficulty controlling emotions or impulses
• Suicidal behavior
• Feeling misunderstood, neglected, alone, empty or hopeless
• Fear of being alone
• Feelings of self-hate and self-loathing
When you have borderline personality disorder, you often have an insecure sense of who you are. Your self-image, self-identity or sense of self often rapidly changes. You may view yourself as evil or bad, and sometimes you may feel as if you don’t exist at all. An unstable self-image often leads to frequent changes in jobs, friendships, goals and values.
Your relationships are usually in turmoil. You may idealize someone one moment and then abruptly and dramatically shift to fury and hate over perceived slights or even minor misunderstandings. This is because people with borderline personality disorder often have difficulty accepting gray areas — things seem to be either black or white.
When to see a doctor or counselor
If you’re aware that you have any of the signs or symptoms above, talk to your doctor or a mental health provider. Proper treatment can help you feel better about yourself and help you live a more stable, rewarding life.
If you notice signs or symptoms in a family member or friend, talk to that person about seeing a doctor or mental health provider. But you can’t force someone to seek help. If the relationship causes you significant stress, you may find it helpful to see a therapist yourself.
As with other mental disorders, the causes of borderline personality disorder aren’t fully understood. Experts agree, though, that the disorder results from a combination of factors. Factors that seem likely to play a role include:
Genetics. Some studies of twins and families suggest that personality disorders may be inherited or strongly associated with other mental disorders among family members.
Environmental factors. Many people with borderline personality disorder have a history of childhood abuse, neglect and separation from caregivers or loved ones.
Brain abnormalities. Some research has shown changes in certain areas of the brain involved in emotion regulation, impulsivity and aggression. In addition, certain brain chemicals that help regulate mood, such as serotonin, may not function properly.
Personality is shaped both by inherited tendencies and environmental factors, as well as experiences during childhood. Some factors related to personality development can increase the risk of developing borderline personality disorder. These include:
Hereditary predisposition. You may be at a higher risk if a close family member — your mother, father, brother or sister — has the same or a similar disorder, particularly a mood or anxiety disorder.
Childhood abuse. Many people with the disorder report being sexually or physically abused during childhood.
Neglect. Some people with the disorder describe severe deprivation, neglect and abandonment during childhood.
Also, borderline personality disorder is diagnosed more often in young adults and adult women than in men.
Borderline personality disorder can damage many areas of your life. It can negatively affect intimate relationships, jobs, school, social activities and self-image. Repeated job losses and broken marriages are common. Self-injury, such as cutting or burning, can result in scarring and frequent hospitalizations. Suicide rates among people with BPD are high.
In addition, you may have other mental health disorders, including:
Alcohol or substance abuse and dependency
Because of risky, impulsive behavior, you are also more vulnerable to unplanned pregnancies, sexually transmitted infections, motor vehicle accidents and physical fights. You may also be involved in abusive relationships, either as the abuser or the abused.
By Mayo Clinic staff
NARCISSISTIC PERSONALITY DISORDER
Narcissistic personality disorder is a mental disorder in which people have an inflated sense of their own importance and a deep need for admiration. Those with narcissistic personality disorder believe that they’re superior to others and have little regard for other people’s feelings. But behind this mask of ultra-confidence lies a fragile self-esteem, vulnerable to the slightest criticism.
Narcissistic personality disorder is one of several types of personality disorders. Personality disorders are conditions in which people have traits that cause them to feel and behave in socially distressing ways, limiting their ability to function in relationships and in other areas of their life, such as work or school.
Narcissistic personality disorder treatment is centered around psychotherapy.
Narcissistic personality disorder is characterized by dramatic, emotional behavior, which is in the same category as antisocial and borderline personality disorders.
Narcissistic personality disorder symptoms may include:
Believing that you’re better than others
Fantasizing about power, success and attractiveness
Exaggerating your achievements or talents
Expecting constant praise and admiration
Believing that you’re special and acting accordingly
Failing to recognize other people’s emotions and feelings
Expecting others to go along with your ideas and plans
Taking advantage of others
Expressing disdain for those you feel are inferior
Being jealous of others
Believing that others are jealous of you
Trouble keeping healthy relationships
Setting unrealistic goals
Being easily hurt and rejected
Having a fragile self-esteem
Appearing as tough-minded or unemotional
Although some features of narcissistic personality disorder may seem like having confidence or strong self-esteem, it’s not the same. Narcissistic personality disorder crosses the border of healthy confidence and self-esteem into thinking so highly of yourself that you put yourself on a pedestal. In contrast, people who have healthy confidence and self-esteem don’t value themselves more than they value others.
When you have narcissistic personality disorder, you may come across as conceited, boastful or pretentious. You often monopolize conversations. You may belittle or look down on people you perceive as inferior. You may have a sense of entitlement. And when you don’t receive the special treatment to which you feel entitled, you may become very impatient or angry. You may insist on having “the best” of everything — the best car, athletic club, medical care or social circles, for instance.
But underneath all this behavior often lies a fragile self-esteem. You have trouble handling anything that may be perceived as criticism. You may have a sense of secret shame and humiliation. And in order to make yourself feel better, you may react with rage or contempt and efforts to belittle the other person to make yourself appear better.
When to see a doctor or counselor
When you have narcissistic personality disorder, you may not want to think that anything could be wrong — doing so wouldn’t fit with your self-image of power and perfection. But by definition, a narcissistic personality disorder causes problems in many areas of your life, such as relationships, work, school or your financial affairs. You may be generally unhappy and confused by a mix of seemingly contradictory emotions. Others may not enjoy being around you, and you may find your relationships unfulfilling.
If you notice any of these problems in your life, consider reaching out to a trusted doctor or mental health provider. Getting the right treatment can help make your life more rewarding and enjoyable.
It’s not known what causes narcissistic personality disorder. As with other mental disorders, the cause is likely complex. The cause may be linked to a dysfunctional childhood, such as excessive pampering, extremely high expectations, abuse or neglect. It’s also possible that genetics or psychobiology — the connection between the brain and behavior and thinking — plays a role in the development of narcissistic personality disorder.
Narcissistic personality disorder is rare. It affects more men than women. Narcissistic personality disorder often begins in early adulthood. Although some adolescents may seem to have traits of narcissism, this may simply be typical of the age and doesn’t mean they’ll go on to develop narcissistic personality disorder.
Although the cause of narcissistic personality disorder isn’t known, some researchers think that extreme parenting behaviors, such as neglect or excessive indulgent praise, may be partially responsible.
Risk factors for narcissistic personality disorder may include:
Parental disdain for fears and needs expressed during childhood
Lack of affection and praise during childhood
Neglect and emotional abuse in childhood
Excessive praise and overindulgence
Unpredictable or unreliable caregiving from parents
Learning manipulative behaviors from parents
Children who learn from their parents that vulnerability is unacceptable may lose their ability to empathize with others’ needs. They may also mask their emotional needs with grandiose, egotistical behavior that’s calculated to make them seem emotionally “bulletproof.”
Complications of narcissistic personality disorder, if left untreated, can include:
Suicidal thoughts or behavior
Problems at work or school
By Mayo Clinic staff
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