In the manic phase of Bipolar Disorder, patients exhibit many of the signs and symptoms of certain personality disorders, such as the Narcissistic, Borderline, Histrionic, or even Schizotypal Personality Disorders: they are hyperactive, self-centered, lack empathy, and are control freaks. The manic patient is euphoric, delusional, has grandiose fantasies, spins unrealistic schemes, and has frequent rage attacks (is irritable) if her or his wishes and plans are (inevitably) frustrated.
The Bipolar Disorder got its name because the mania is followed by - usually protracted - depressive attacks. A similar pattern of mood shifts and dysphorias occurs in many personality disorders such as the Borderline, Narcissistic, Paranoid, and Masochistic. But whereas the bipolar patient sinks into deep self-deprecation, self-devaluation, unbounded pessimism, all-pervasive guilt and anhedonia - patients with personality disorders, even when depressed, never lose the underlying and overarching structure of their primary mental health problem. The narcissist, for instance, never foregoes his narcissism, even when down and blue: his grandiosity, sense of entitlement, haughtiness, and lack of empathy remain intact.
"Narcissistic dysphorias are much shorter and reactive - they constitute a response to the Grandiosity Gap. In plain words, the narcissist is dejected when confronted with the abyss between his inflated self-image and grandiose fantasies - and the drab reality of his life: his failures, lack of accomplishments, disintegrating interpersonal relationships, and low status. Yet, one dose of Narcissistic Supply is enough to elevate the narcissists from the depth of misery to the heights of manic euphoria."
