Is narcissism misdiagnosed as bipolar disorder or autism?

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Answer

It most definitely is.

NPD (Narcissistic Personality Disorder) is often diagnosed with other mental health disorders (such as the Borderline, Histrionic, or Antisocial personality disorder). This is called "co-morbidity". It is also often accompanied by substance abuse and other reckless and impulsive behaviours and this is called "dual diagnosis".

Bipolar patients in the manic phase exhibit most of the signs and symptoms of pathological narcissism - hyperactivity, self-centeredness, and control freakery.

More about this connection here:

Stormberg, D., Roningstam, E., Gunderson, J., & Tohen, M. (1998) Pathological Narcissism in Bipolar Disorder Patients. Journal of Personality Disorders, 12, 179-185

Roningstam, E. (1996), Pathological Narcissism and Narcissistic Personality Disorder in Axis I Disorders. Harvard Review of Psychiatry, 3, 326-340

NPD has been associated with Attention Deficit / Hyperactivity Disorder (ADHD, or ADD) and with RAD (Reactive Attachment Disorder). The rationale is that children suffering from ADHD are unlikely to develop the attachment necessary to prevent a narcissistic regression (Freud) or adaptation (Jung). Bonding and object relations ought to be affected by ADHD. Research, which supports this has yet to be made available. Still, many psychotherapists and psychiatrists use it as a working hypothesis. Another proposed linkage is between autistic disorders (such as Asperger's Syndrome) and narcissism.

Based on my book "Malignant Self Love - Narcissism Revisited"

(c) 2003 Lidija Rangelovska Narcissus Publications

Answer

It would seem to me that Bipolar and some forms of Autism are equally likely to be misdiagnosed as NPD.

Psychiatry is, in many ways, an inexact science, and diagnosis can often be prettyy subjective, relating as much to the specialisation and intellectual preferences if the practitioner as to the nature of the patient.

For instance a neurochemical specialist is unlikely to diagnose any personality disorder as the very concept argues with his core philosophy...likewise a behaviourist is extremelly unlikely to be comfortable diagnosing autism or neurochemical bipolar.

This is why it is SO important not to generalise too much about any mental disorder, because there will always be a varied spectrum of individuals presenting with entirely different symptoms hung with the same label ... some of whom would never have been hung with that label AT ALL by many other practitioners.

The DSM is an imperfect "color chart" for the spectrum of human nature.

There are no absolutes.

Answer

I have added these two articles which you may find of interest:

http://www.narcissistic-abuse.com/journal71.html

http://www.narcissistic-abuse.com/journal72.html

Take care.

Sam

Based on my book "Malignant Self Love - Narcissism Revisited"

(c) 2003 Lidija Rangelovska Narcissus Publications

Answer

Fabulous article!

I am medicated for a bipolar condition (together with anxiety/compulsive disorders) and diagnosed with Autism. I get extremely manic and euphoric but know crashing nutso lows too in which I am certainly far far from narcissistic... in fact I doubt I have ever been worth the air I breathe when I'm in that state... but mania is certainly a state in which I have had immense idiotic ideas about changing huge world events (as us nutters do) and whilst that's narcissistic, mine are always really generous, like I think I could bring about world peace and solve all religious differences and bonkers like that... and my father had this and sometimes thought he could cure cancer or was Jesus or Elvis but he was not actually a narcissist. There isn't anyone I know who has had mania who hasn't driven someone nuts with 'me me me' stuff. that doesn't make them narcissists though and some of the loveliest, most giving people I know have bipolar.

I know that my father didn't have NPD because he loved people in their own right, not just for what they could give/do for him. I also had the contrast around me of a relative who was extremely solitary and very much saw pretty much all human beings as inferior and looked for their 'use'/reflection upon them and for that person it was not a happy space for them or anyone like me who loved people or life or the world like some mad optimist. I'd like to say this was the last one like this, but it wasn't. So I can recognise both bipolar relatives without narcissism and narcissistic ones without clear bipolar.

As for Autism and narcissism,I have met some Auties who would qualify as having both as Autism is not a personality state so an autie can have any personality trait as well as Autism. There is also a new work coming out called Spoiled Child Syndrome which has been confused with Autism.

I doubt very much whether anyone who JUST had narcissistic personality disorder could be diagnosed with Autism as that's pretty full on and the language disorder aspect wouldn't be accounted for by NPD if the person had clearly dysfunctional language or regression at age two but its possible that some with late speech may have felt others were 'unworthy' of their communication, but that would be soooooooo easy to confuse with others who couldn't dare to speak out of excessive shyness or anxiety such as those with Sensitive-Avoidant Personality or those who simply couldn't handle intimacy like Solitary-Schizoid folks or those who couldn't handle entanglement and struggled to trust like Vigilant-Paranoid folks or or or so it is way too hard to simply associate non-speech with NPD as even if its got ANYTHING to do with personality it could be a range of other personaity issues, not to mention depression.

And when it comes to personality if someone were Solitary and Vigilant and had no interest in intimacy or entanglement they could easily be mislabelled as NPD unless they also had traits that opened them up to giving to others like the Self Sacrificer trait or the generosity of the Artistic type. So It'd be sad if folks who were simply very Solitary and Vigilant were considered 'selfish' as this is always such a sad social judgement placed on these people just because they prefer to remain relatively uninvolved.

Anyway, that's my view....

Donna Williams *) every the naughty autie www.donnawilliams.net

Answer

As a mother of a child who is 14 and has struggled all throughout his school years with several diagnosis all clinical (meaning diagnosed by a survey on behaviors) I have fought schools, gone through therapy, read books, changed everything about my life and home to meet the diagnosis of ADHD. This child we have now discovered is possible autistic in he is intellegent, and is able to learn, but has a problem socially. Now after discovery he was in a court ordered probation due to me calling to protect all children involved in my own home the system penalized him instead of helping him. When the discovery came about that the school failed to access in all areas of disability back when the child was in 4th grade we bring this to the attention of the new school and the placement to have them kick him out for things that were not suppose to get you kicked out and then to have to fight to make the wrong for everyone who did not do there job right. I would say after medicating my child, letting them add more labels blaming his poor academics on his "Bad Behavior" as the school puts it. If a child has Aspergers they have a hard time relating to their peers, expressing themselves verbally, the list goes on. When this placement kicked him out they made this minor signed a paper that he was narcissitic and egocentric. Which is an excuse not to properly identify in all areas of disabilities and an excuse to not have to admit to but blame the child for Failure to Adjust.

Neurological Disorders need to be diagnosed by Nuerologist and NueroPsychs not just Psychiatrist or Psychologist. The psychotropic meds are harming our childrens growing brains. To many slip through the cracks and our juvenile penal system believes in rehabilitation but yet they are not helping by keeping children doped up on psychotropic meds instead of making sure the diagnosis was correct to began with. It would save our budget and our future.

Answer

My father seems to me to clearly have NPD. However my eldest sister recently took him to a professional to ask if he may have Aspergers. She thought this likely as he is wierd in a high functioning autistic way and she believes that he is brilliant. She would not have mentioned that he sexually abused others of us (he has seven children) as he has strongly denied this and she believes him, and I presume she did not ask for a diagnoses of anything other than Aspergers. One of the tests was to judge emotions by looking at photoes of peoples eyes, which he failed spectacularly. I have heard of this second hand as I do not have anything to do with my Dad and do not talk about this to my eldest sister. While I can see that he has many traits of someone with Aspergers, his abuse of us, and clear pursuit of narcissistic supply, and particularly the fact that the way to stop him pushing himself into my life was simply to be clear and strong about what he did to me seems that NPD is still a good diagnosis. Autism/Aspergers may be misdiagnosed as NPD, but might it be possible that someone has both, or that the misdiagnosis could be the other way.

diagnoses

No matter what the disorder or condition. You should allways see a medical physician to rule out any and all physical problems. Children in particular. Hearing and eyesight problems are notorious for "creating" disorders. and don't trust the school system to give you an accurate diagnoses. Also Allergies to food cause "hyperactivity".

In adults things like Thyroid imbalance, cancer, or brain tumors cause personality problems and depression etc., or can excacerbate an already pre-exisiting condition.

and last of all Narcisssists are physically human so likey to suffer other disorders like the rest of us. If anything it makes them suffer more because it reminds them they too are not imortal.

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I would think that because NPD is difficult to track down and diagnose.. that it would be far more common to have a narcissist be wrongly "diagnosed" as Bipolar or Autistic as oposed to the other way around. I had a roomate long ago who was originally diagnosed treated for Bulimia. After another year of psychiatric treatment and evaluations she was diagnosed as having Narcissistic Pesonality Disorder. The bulimia was just a symptom. Ironically I was just recovering from my first run in with an N when i was hooked up with her. (not my idea) She did things to stab me in the back then came back to me as a friend and i rejected her. She was very upset and went on a bulemic binge again. Once you get burned by an N you tend to be on guard for other postential N's diagnosed or not. Let's just say you should be on guard for anyone with Narcisssitic traits.

answer

I do not believe they are the same. I've worked with both. The lies, manipulation, and bizarre attention seeking behavior does not seem essential to autism. There may be a relation of empathy, vigilant behavior, some obsessions, and other behaviors that may be appear with both. That said, I wouldn't be surprised if many are misdiagnosed. I also can relate to the previous answer. Someone with NPD can wear you down quickly and put you on defense for similar behaviors.

First answer by Sam Vaknin. Last edit by SonicKuz. Contributor trust: 9 [recommend contributor]. Question popularity: 234 [recommend question]