Bipolar disorder is completely distinct from narcissism; however, it is not unusual for a person to have co-occurring bipolar disorder and narcissism,[13] a combination that can result in the grandiosity persisting long after the manic episode has passed. Irritable mood is often a presenting characteristic of depression, and irritability is a quality observed in many narcissistic people. While we know that narcissism and depression are associated,[14] it is not uncommon for the depression observed in vulnerable narcissism to be so pronounced that the therapist misses the narcissistic patterns,
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