(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...
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