Alcoholic Narcissist | Alcohol And Narcissistic Personality Disorder

An alcoholic can exhibit symptoms of Narcissistic Personality Disorder (NPD), but usually not enough to be diagnosed. In addition, a person with NPD is not always an alcoholic.

Alcoholism is a chronic, progressive, complicated disease that is hallmarked by an unmanageable compulsion to drink alcohol. Regardless of consequences, an alcoholic will find a reason to drink, even if they have to make one up and deny the actual repercussions.

Confronting someone while they are intoxicated is rarely productive. Alcohol impairs the cognitive functions needed for meaningful self-reflection. Similarly, people with NPD often become defensive or hostile when confronted directly. In both cases, conversations are more likely to be productive when the person is sober and calm.

Someone who has a diagnosis of Narcissistic Personality Disorder (NPD) experiences grandiose, arrogant behavior patterns that are coupled with a lack of empathy and need to be admired. These behaviors are at the expense of other people, including loved ones.

These behaviors are also seen in people with alcoholism (also known as a severe alcohol use disorder) and drug use or substance use disorders.

What Is A Narcissistic Personality Disorder?

NPD affects almost every part of a person’s life. It is a personality disorder, which is a mental health disorder. Common narcissistic traits of NPD include grandiosity, inflated self-image and self-worth, as well as a lack of empathy.

Individuals with a NPD feel they can only be understood by special people. They take advantage of others, especially to accomplish their own goals. These individuals have a lack of concern for the well-being of others or how others may be affected by their actions.

Many of the symptoms of NPD are thought to be the result of a sensitive or vulnerable ego. While they may not show it outwardly, criticism is especially unbearable for a narcissist. They may dwell on it, or be haunted by it, and end up enraged or retaliating.

When mental health professionals are exploring a potential Narcissistic Personality Disorder diagnosis, they are explicitly forewarned to make sure that a person is not struggling with an addiction or substance use disorder, since the symptoms are very similar.

Alcoholism And Narcissism

​​​​When someone is deep in an alcohol addiction, they become very self-absorbed. Everything becomes about alcohol, every day. To friends, family, and even coworkers, it can seem as though the alcoholic will sacrifice everything to be able to drink.

Drinking when consequences are obviously damaging or will cause major losses, are both signs of severe alcohol use disorder. In some cases, the person can fail to recognize how drinking is negatively affecting their life, and accuse others of being extreme.

A person struggling with alcoholism can appear to dismiss friends and family to spend time with others that support their need to drink excessively. To family, it can appear that their loved one is putting these newfound friends ahead of them (similar to what a narcissist would do).

However, it is more likely that the alcoholic is trying to surround themselves with others that support these extreme drinking habits.

Alcohol addiction mimics some symptoms of NPD.

The following is a list of narcissistic behaviors that are often shown by alcoholics:

• denial
• lack of responsibility
• entitlement
• self-absorbed
• superficial relationships
• spiteful
• manipulative
• self-destructive
• insecure
• lack of empathy
• self-esteem problems
• no interest in self-reflection
• extreme behavior changes
• shame

Research suggests that people with NPD are at elevated risk for developing substance use disorders, possibly because alcohol temporarily relieves the anxiety underlying narcissistic traits or reinforces grandiose feelings.

However, the behaviors listed above can appear in anyone with severe alcohol use disorder regardless of personality disorder status. A formal NPD diagnosis requires clinical evaluation and can’t be made based on behaviors observed during active alcohol use disorder alone.

Signs Of Alcoholism

When a person is struggling with alcohol addiction, there are several symptoms that reveal that their alcohol consumption has become a problem, such as:

• cravings or compulsions for alcohol
• withdrawal symptoms without alcohol
• being unable to stop drinking
• tolerance (needing more alcohol to get the same effects)

Individuals who are experiencing these symptoms would benefit from considering a treatment program for alcohol use disorder.

Additional Facts About Alcoholism

According to SAMHSA’s 2023 National Survey on Drug Use and Health, approximately 28.9 million Americans aged 12 and older had alcohol use disorder in the past year.

For many of these individuals, alcohol leads to significant disruptions in their everyday life. And in some cases, alcoholism can be fatal.

Dual Diagnosis: Alcoholism And NPD

There are cases of individuals who are addicted narcissists. These individuals struggle with both addiction and NPD.

People who display addictive behaviors in addition to narcissistic traits may require a substance use disorder treatment program that is equipped to treat co-occurring disorders.

Treating co-occurring alcohol use disorder and NPD is clinically complex. Standard 12-step approaches that emphasize humility and powerlessness can feel threatening to people with NPD traits, reducing engagement.

Dialectical behavior therapy (DBT) and schema therapy have shown promise for personality disorder treatment alongside addiction treatment. A dual diagnosis program with clinicians experienced in both conditions produces better outcomes than treating each separately.

Alcoholism Treatment Options

When seeking treatment for alcohol addiction, it is important to locate a treatment program that offers a medically supervised detox program to help manage the dangerous withdrawal symptoms of alcohol.

Once a person has flushed the alcohol out of their system, continuing on to a well-rounded, thorough substance use disorder program that includes mental health services, as well as addiction counseling, have historically been successful. Following up with an outpatient or 12-step program can be incredibly helpful as well.

Living with someone who has both alcohol use disorder and narcissistic traits can be particularly exhausting and confusing. Al-Anon (al-anon.org) and therapy with a clinician experienced in personality disorders can help family members set effective limits, process the emotional impact, and make decisions that protect their own wellbeing regardless of whether their loved one chooses treatment.

Find Treatment Today

Whether a person is a covert narcissist, alcoholic with narcissistic personality traits, or a person with a dual diagnosis, finding a treatment program that meets their needs is very important.

Browse our directory or reach out to the Substance Abuse and Mental Health Services Administration (SAMHSA) for more information about addiction recovery.

Written by the Addiction Resource Editorial Staff