Understanding Bipolar Disorder and Narcissism

Learn how these disorders overlap.

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Bipolar disorder is a mood disorder that causes individuals to have intense mood swings ranging from euphoric mania or hypomania to devastating depression. Narcissism, also known as narcissistic personality disorder (NPD), is an illness marked by a lack of empathy, grandiosity, and a desperate need for validation.

These are two conditions that require lifelong treatment. While they are fundamentally different (bipolar disorder involves mood swings, and narcissism is a personality disorder), there is some overlap between the symptoms of each condition.

Bipolar Disorder Symptoms

The connection between bipolar disorder and narcissistic personality disorder lies in the symptoms of each condition. Someone diagnosed with bipolar disorder will experience manic or hypomanic and depressive episodes.

  • Mania: When someone is manic, they may need less sleep, begin engaging in risky behavior, feel hypersexual, and have an inflated sense of self-worth. Mania can become so severe that hospitalization is required. Individuals diagnosed with bipolar I can experience manic episodes that last about a week and depressive episodes that last two weeks.
  • Hypomania: Hypomania features the same symptoms as mania, just not to the same severity level. People with bipolar II will experience hypomanic episodes that can be as short as a few days and depressive episodes that last about a week.

Narcissistic Personality Disorder Symptoms

NPD is identified by a clear pattern of fantastical behavior or thinking, a need for praise and admiration, and a lack of empathy.

For example, someone with this illness may become obsessed with fantasies of immense success and power. Others might fixate on having a “perfect life,” complete with an attractive partner, big house, and a fancy job.

Furthermore, it isn’t uncommon for those experiencing this disorder to take advantage of others to meet their needs and not feel remorse. Grandiosity is also a clear indicator of this condition. Some experiencing this illness will be convinced they have a talent or quality that sets them above others.

What's the Connection Between Bipolar Disorder and Narcissism?

The behavior someone exhibits while experiencing a manic episode can look similar to that of someone who experiences narcissistic personality disorder. When someone is manic, they may have an inflated sense of self-esteem or display grandiose behaviors.

For example, they may believe they’re a genius or one of the most attractive people in the world. With grandiosity can come setting impossibly high goals, and strong impulsivity may be involved. Sometimes mania isn’t just intense feelings of confidence and excitement. People who are experiencing a manic episode may become irritable or angry. In moments of rage or severe impulsivity, it can appear that they lack empathy for those around them.

Symptoms That Overlap: Grandiosity and Lack of Empathy

Considering the aforementioned symptoms, it is clear where overlap occurs. Those experiencing manic or hypomanic bipolar episodes may present with narcissistic traits such as:

  • Grandiosity
  • Lack of empathy

However, when one receives consistent treatment for bipolar disorder and their condition is managed, the severity and frequency of the episodes can diminish significantly. As a result, narcissistic traits may not be as pronounced.

Bipolar Disorder and NPD Symptoms Start Around the Same Age

Another connection between bipolar disorder and narcissistic personality disorder is that they have a similar age of onset. Bipolar disorder begins to present in the late teen or early adulthood years.

Narcissistic personality disorder traits also begin to present around the same time, usually in early adulthood.

Bipolar Disorder
  • Onsets in early adulthood

    Grandiosity, uncharacteristically high self-esteem

  • Impulsivity and racing thoughts

  • Relationship issues due to manic or depressive symptoms

  • Attention-seeking or risky behavior

  • Onsets in early adulthood

    Inflated self-esteem

  • Fantasies of power, control, and intelligence

  • Rage in response to personal slights or criticism

  • Consistent hunger for attention and power

Diagnosis of Bipolar Disorder and Narcissism

Collaborating with a licensed mental health professional is essential to receive a correct mental health diagnosis.

Narcissistic personality disorder can present alongside a mood disorder like bipolar disorder, so it is critical to have a qualified clinician assess any presenting issues.

Diagnosing bipolar disorder and narcissistic personality disorder requires a mental health assessment.

In a mental health assessment, a professional will consult the DSM-5 and ask a series of questions that will help them evaluate your current mental state. They will also likely ask about your health history, upbringing, and lifestyle to ensure they get a full picture of what you’re experiencing. 

Bipolar Disorder and Narcissism Treatment

There isn’t a cure for either of these disorders. That being said, treatment options are available that can help folks manage each of these illnesses. With proper management, a balanced life with healthy relationships is completely possible. 

Bipolar Disorder Treatment

Bipolar disorder is treated with a combination of medication and psychotherapy. Mood stabilizers like lithium or off-label anticonvulsants like lamotrigine are often prescribed to manage bipolar symptoms. Sometimes antipsychotics may be prescribed as well.

Psychotherapy is recommended to help individuals learn how to manage their triggers, challenge disturbing thoughts, and tend to their personal relationships.  

NPD Treatment

There are no FDA-approved medications for the treatment of NPD. However, doctors have found that medication is sometimes necessary to treat the presenting symptoms. Similar to bipolar disorder, doctors may prescribe mood stabilizers or antipsychotics, and psychotherapy is recommended. However, unlike bipolar, some doctors may prescribe antidepressants to people with NPD.  

Coping With Bipolar Disorder and Narcissism

Living with bipolar disorder and narcissistic personality disorder can be very challenging. Unfortunately, each of these conditions is highly stigmatized, and there can be a lot of misinformation regarding people with these diagnoses.

In addition to finding a qualified mental health professional, it can be very helpful to find social support. Meeting others who experience the same challenges as you can minimize some of the stigmas and offer a supportive community.

2 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. National Institute of Mental Health (NIMH). Bipolar disorder.

  2. Mitra P, Fluyau D. Narcissistic personality disorder. Treasure Island, FL. StatPearls Publishing; 2022.

By Julia Childs Heyl, MSW
Julia Childs Heyl, MSW, is a clinical social worker and writer. As a writer, she focuses on mental health disparities and uses critical race theory as her preferred theoretical framework. In her clinical work, she specializes in treating people of color experiencing anxiety, depression, and trauma through depth therapy and EMDR (eye movement desensitization and reprocessing) trauma therapy.