Narcissism and alcoholism are two distinct conditions but share some traits. They can also occur together.
If you know someone who regularly uses alcohol, it’s possible that narcissism might be one of the influencing factors. Research supports the link between some narcissistic traits and alcohol use.
Narcissism and alcoholism also share some symptoms, although what drives these traits is a little different between the two conditions.
People use alcohol for a variety of reasons. It can be a part of celebratory occasions and fun, or an occasional way to unwind after a long day. For some people, alcohol use becomes regular and problematic and may lead to dependence.
There isn’t a single cause of alcohol use disorder (AUD), but factors that may contribute include:
- home environment
- peer interactions
- psychiatric disorders
- personality disorders
Personality disorders are mental health conditions involving pervasive and often destructive personality traits. Narcissism is one such example.
Narcissistic personality disorder (NPD) is one of the Cluster B personality disorders, which are characterized by unpredictable and emotional behavior. Personality disorders are grouped into clusters based on similar traits.
Personality disorders and substance use disorders occur together about 22.6% of the time, according to the
A 2019 study found a link between vulnerable narcissism, shame, and an increased likelihood of problem drinking and gambling. Vulnerable narcissism features traits like low self-esteem, helplessness, and rejection sensitivity.
Aggressive behavior and pathological narcissism were linked to alcohol overuse in a 2017 study of Canadian men. The association remained intact even when researchers accounted for general psychological distress as a trigger for coping responses like alcohol use.
To determine whether a person simply has narcissistic or alcoholism traits instead of a disorder, clinicians use the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, text revision (DSM-5-TR) to see if a person meets the criteria for an official diagnosis.
The DSM-5-TR lists
- symptoms of withdrawal
- desire or attempts to reduce amount or stop
- larger quantities, longer time
- sacrificing important activities to use alcohol
- a lot of time spent using alcohol
- continued alcohol use despite physical or psychological problems
- alcohol cravings
- alcohol use that is physically hazardous
- inability to meet obligations to work, home, or school because of alcohol use
- persistent interpersonal or social problems
The number of criteria a person meets determines whether they have AUD, and if so, the severity of the condition.
|Number of criteria
|6 and higher
For a person to meet the requirements of an
- grandiose behaviors or fantasies
- a lack of empathy
- a need for admiration
These tendencies need to have begun early in adulthood, and be embodied by five or more of the following signs:
- arrogance and haughtiness
- entitlement and expectation of preferential treatment
- envy, either toward others or the belief that others envy them
- unwillingness to recognize the needs of others
- exploitation of people to reach their own goals
- a need for admiration from others
- elitist perspective
- preoccupation with success, brilliance, power, perfect love, or beauty
- grandiose self-importance and exaggerated view of their own achievements
A trained mental health professional is usually able to diagnose personality disorders using standardized psychiatric interview methods.
NPD and AUD have some shared traits. The underlying cause of each is sometimes not the same, but the behaviors can seem very similar.
|Person with NPD
|Person with AUD
|thinks they can do no wrong
|thinks their alcohol use is under control
|Lack of accountability
|blames other people for their problems
|blames other people for their alcohol use
|feels entitled to do what they want
|feels entitled to indulge in alcohol use
|Rapidly changing behavior
|experiences changing moods if their self-esteem is threatened
|experiences behavioral instability from the effects of alcohol
|manipulates others to get what they want
|manipulates people and situations to enable their alcohol use
|is concerned primarily with satisfying their own emotional needs
|is concerned primarily with maintaining their ability to use alcohol
|masks their own shame by projecting inflated self-importance
|masks their own shame with alcohol use
|Lack of introspection
|is unwilling to consider their imperfections
|is unwilling to examine the reasons they use alcohol
Both AUD and NPD can be treated.
AUD treatment options include:
- behavioral treatments, like counseling
- medications to help a person reduce or stop their alcohol use
- support groups, like Alcoholics Anonymous
NPD treatment is usually ongoing therapy.
There are no medications approved by the FDA to treat NPD. But, a person with NPD may benefit from medication for any accompanying issue they may be dealing with, such as:
- transient psychosis
- mood volatility
- impulse control issues
When AUD and NPD occur together, it can increase a person’s hostility and aggression. This can make treatment more challenging than it would be to treat each issue separately.
A person with both AUD and NDP may wish to try therapy.
- dialectical behavior therapy (DBT)
- dual-focused schema therapy (DFST)
- dynamic deconstructive therapy (DDT)
If you or someone you know is interested in exploring treatment for AUD and NPD, there are resources available.
The first step is to consult with a primary care doctor, who can recommend a treatment plan or suggest a referral. Other healthcare professionals who may be able to help include:
- alcohol counselor
- social worker
You can also visit Psych Central’s mental health resource hub, which has information about how to find mental health support.