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Bipolar and Narcissism: What’s the Connection?

Bipolar disorder is a lifelong mental health condition. It causes severe mood shifts from highs (mania or hypomania) to lows (depression). These mood shifts interfere with a person’s quality of life and ability to carry out daily tasks.

There are several types of bipolar disorder, each with its own characteristic symptoms. These include:

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Bipolar I disorder: With this type, a person must have experienced at least one manic episode, which may be followed by a hypomanic or major depressive episode. This sometimes triggers a break from reality (psychosis).

Bipolar II disorder: The person has had at least one major depressive episode and at least one hypomanic episode. They’ve never had a manic episode.

Cyclothymic disorder: Adults with this disorder have experienced many episodes of hypomania symptoms and periods of depressive symptoms over a two-year period. For young people, the symptoms have to have occurred over only one year. These symptoms are less severe than major depression.

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Treatment for bipolar disorder involves medication and psychotherapy to regulate mood.

Narcissism is a lifelong personality disorder. A person with this disorder has these traits:

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  • high sense of their own self-importance
  • desire for admiration from others
  • lack of empathy for others

People with narcissism may seem very confident. But in reality, they have a problem with self-esteem. This makes them vulnerable to even the smallest criticism. This condition can cause problems in many areas of a person’s life, such as work, relationships, schools, or finances.

A person with this disorder may feel unhappy and disappointed when others don’t pay special attention to them or do them special favors. Often, others don’t enjoy spending time with those exhibiting narcissistic personality disorder. People with the condition don’t have fulfilling relationships.

What is the connection between bipolar disorder and narcissism?

Mental health experts have found that some key features of bipolar disorder and narcissism overlap. These include setting high, sometimes unattainable, goals and being very impulsive. As a result, people with bipolar disorder often also have narcissistic personality disorder.

But there is a debate over how much the conditions overlap or if they’re actually occurring separately. Most experts say both conditions occur separately, but that people with bipolar disorder may present narcissistic personality traits.

For example, a person may present signs of narcissism during mild to moderate hypomania. They may particularly show grand perceptions of self. The person with bipolar disorder experiencing such a mood probably doesn’t have narcissistic personality disorder. Instead, they display narcissism during one or some of their moods.

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Comparing the symptoms

To get a better idea of the connections between bipolar and narcissistic personality disorder, it’s a good idea to compare the symptoms of both. As mentioned before, the symptoms of bipolar disorder vary, but generally include:

  • mania and hypomania:
    • abnormally upbeat attitude
    • wired or jumpy energy level
    • increased activity or energy level
    • easily agitated
    • an exaggerated sense of well-being and self-confidence (euphoria)
    • a decreased need for sleep
    • extreme talkativeness
    • racing thoughts
    • easily distracted
    • poor decision-making
  • major depressive episodes:
    • depressed mood
    • loss of interest or pleasure in almost all activities
    • significant weight loss or gain, or decrease in appetite
    • insomnia or sleeping too much
    • restlessness or slowed-down behavior
    • loss of energy
    • feeling worthless or guilty
    • lack of concentration
    • indecisiveness
    • thinking about, planning, or attempting suicide
  • other signs:
    • anxious distress
    • melancholy
    • psychosis

Those with narcissistic personality disorder may display these symptoms:

  • an abnormally large sense of self-importance
  • expecting to be recognized as superior without reason to warrant that treatment
  • exaggerating talents and past achievements
  • feeling preoccupied by fantasies about success and power, intelligence, good looks, or the perfect mate
  • thinking they’re superior and can only be associated and understood by people with equal superiority
  • need for constant admiration
  • feeling entitled
  • expecting others to give special favors and comply with expectations
  • taking advantage of others to get what they want
  • having an inability or being unwilling to recognize the needs and feelings of others
  • being jealous of others and believing that other people envy them
  • acting arrogant or haughty

How can people who have bipolar disorder with narcissism control their narcissism?

Everyone has a different personality. That personality usually doesn’t change much over a lifetime. Your personality may be less or more intense some days, but it doesn’t change.

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This is the same for people with bipolar disorder and narcissism. They may display their narcissism more at certain times, especially during manic or hypomanic episodes. So those around them may not notice their narcissism all the time.

There are ways to cope with both conditions. Psychotherapy is an effective treatment for both bipolar disorder and narcissistic personality disorder. The focus of therapy should be to:

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  • help manage moods and narcissistic tendencies
  • reduce the intensity of manic and hypomanic episodes
  • work on narcissism in therapy when symptom-free

It’s especially important for those with both conditions to understand the causes of their emotions. It can also help for people with both conditions to learn to relate better to others. This may lead to forming and maintaining more rewarding and intimate relationships.

The bottom line

It’s not always possible to change personality traits. But psychotherapy can help people with both conditions control the expression of their narcissistic traits. Seeking treatment can improve your quality of life, so it’s important to do so if you need help. See your doctor or mental health expert for more information.

Article resources
  • Fulford D, et al. (2008). Commonalities and differences in characteristics of persons at risk for narcissism and mania. DOI:
  • Mayo Clinic Staff. (2017). Bipolar disorder: Overview.
  • Mayo Clinic Staff. (2014). Narcissistic personality disorder: Definition.
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