Narcissistic Personality disorder is highly comorbid with the remainder of the Cluster B personality disorders, Histrionic (HPD), Borderline (BPD) and Antisocial (APD). The grandiosity criteria of NPD is the essential factor in ruling out between other disorders. It is possible however, for other personality disorders to be diagnosed alongside NPD.
Differentiating HPD from NPD depends on the lack of emotional affect, disdain for others’ feelings and great pride in oneself. These are all characteristics that would only be present in NPD.Those with narcissistic and antisocial personality disorder can be superficial and exploitative. However people with NPD are not necessarily aggressive nor impulsive. Another criteria …show more content…
In the manic phase, the individual can exhibit hyperactivity, lack of empathy, euphoria and self-centeredness; all of which are NPD criteria. The mania in bipolar is generally followed by a depressive episode but why would an individual with NPD have a depressive episode? For example. if their narcissistic needs are not met, that could impact their fragile self esteem. Additionally, they feel shame and humiliation when criticized, if that prolongs, it may also send them into a dysphoric state. There are several key features that aid in ruling out. First, a narcissist never loses sight of his grandiosity and sense of entitlement. The core of pathological narcissism survives its temporary depressions. On the contrary, when a bipolar is depressed, he completely loses his manic attributes and is no longer hyperactive and grandiose. Second, narcissistic depression is much shorter in time than bipolar depressive episodes. More importantly, narcissistic depression is reactive. It is in response to things in the narcissists world. One dose of narcissistic supply such as words of praise, are enough to lift the individual with NDP out of their depressive episode. This does not hold true for bipolar, as the source of their fluctuations depend on brain …show more content…
It helps build a healthy self-image and create realistic expectations of self and others. It also addresses negative beliefs and schemas and attempts to replace them with positive one. Incorporating group therapy is generally a recommended practice to help the patient relate, and see others as worthy of empathy. In group therapy, the individual with NPD can foster his sense of individuality as well as see others as being independent individuals with their own thoughts and feelings. Furthermore in groups, the therapist has less power, which reduces the potential threat on the narcissists grandiosity, making them more likely to accept