Narcissism and alcohol: Is there a link?

Some mental health conditions are likely to occur together, and when they do, they’re called co-occurring disorders. Alcohol use disorder and narcissism are common co-occurring disorders, and in some cases, the symptoms of the two conditions may present similarly ^[1].

How are narcissists and alcoholics similar?

When people use the term “narcissist,” they are most likely describing someone who has narcissistic traits, as narcissistic personality disorder is rare, but in many cases, they are referring to someone with narcissistic personality disorder (NPD). NPD is a mental health condition in which a person displays a pattern of grandiose behavior, lack of empathy for others, and need for excessive attention and admiration ^[2].

On the other hand, the term “alcoholic” describes someone who has an alcohol use disorder (AUD), which is the clinical term for an alcohol addiction. When someone has an AUD, they will give up other activities in favor of alcohol use and spend such a significant amount of time consuming alcohol and recovering from its effects, that relationships and work duties fall by the wayside ^[3].

Both narcissism and alcoholism can cause significant disruption in a person’s life, so people may wonder if there are similarities between narcissists and alcoholics. While NPD and AUD are distinct conditions, they may present similarly. For instance, narcissistic personality disorder and narcissism can overlap in the following ways ^{[2] [3]}:

• Lack of empathy for others is a key feature of NPD, and people struggling with alcohol use disorder may appear to lack empathy, because they are so focused on their compulsive desire to drink that they do not show concern for others.
• Narcissistic individuals are willing to exploit others for their own gain, and people who are addicted to alcohol may also take advantage of others (ie: convince them to give money or resources) in order to maintain their alcohol addiction.
• Narcissists feel entitled and believe that people should automatically comply with their demands; alcoholics may behave in the same way. Because an AUD is associated with a loss of control over drinking, a person may appear very entitled, because they feel that others should support them or provide them with money to obtain alcohol.
• Arrogance and haughty behavior are cornerstones of narcissistic personality disorder. Individuals who are addicted to alcohol may appear arrogant and haughty while under the influence.
• Narcissists and alcoholics can both blame others for their problems, in order to avoid feelings of shame. NPD is associated with an avoidance of shame, and people with this condition are likely to blame others so they do not feel shame or guilt for their wrongdoings. Alcoholics may also blame others because they are in denial of their problems with alcohol ^{[4] [5]}.

Can narcissism cause alcohol use disorder?

When two conditions like narcissism and alcoholism occur together, sometimes people believe that one disorder causes the other, but co-occurring disorders are more complex than that. Research has shown that there is an overlap between alcohol use disorder and personality disorders, including NPD. One study found that among individuals who reported alcohol use, 9.1% were diagnosed with NPD at some point during their lives ^[1].

Other research with individuals in addiction treatment for alcohol dependence has found that 60% of this population has at least one co-occurring personality disorder, and narcissism was one of the most commonly reported personality disorders, especially in men ^[1]. While alcohol use disorder and narcissism occur together relatively often, this doesn’t necessarily mean that NPD causes alcohol problems. It is, however, possible that individuals who experience distress or dysfunction as a result of NPD may turn to alcohol consumption as a coping mechanism, placing them at higher risk of developing AUD.

Can alcoholism cause narcissistic personality disorder?

Just as narcissism doesn’t necessarily cause alcohol use disorder, alcoholism doesn’t necessarily cause NPD. The two conditions may co-occur, but it is often difficult to determine which disorder occurred first.

Research suggests that narcissism is not caused by alcohol, but rather by other factors that occur during the early developmental period. For instance, research has shown that genetic predispositions can place a person at risk of NPD. Childhood rejection or experiences like child abuse and neglect are also linked to NPD ^[2].

Given that genetic factors and childhood history are strongly linked to narcissism, it doesn’t seem that alcohol alone can directly cause narcissism. Rather, NPD develops as a result of a combination of risk factors.

How to deal with narcissistic alcoholics

If a close friend, spouse, or family member has NPD and an alcohol addiction, it can be difficult to interact with this person. Both of these conditions can cause erratic, impulsive, and abusive behaviors. If you’re looking for tips for dealing with someone who has both NPD and AUD, the following strategies can be helpful:

• Remind yourself not to take the behavior personally: When you’re interacting with someone who has NPD and AUD, you may take their behavior personally. Remember that their behavior is a reflection of their own pain and distress, and it doesn’t mean you’ve done anything wrong. It can be helpful to take this perspective, so you do not blame yourself for the person’s behavior.
• Set strong boundaries and stick to them: Setting boundaries is essential if you’re dealing with someone who has AUD and NPD. This means you will need to be clear about what behavior you will and will not tolerate. You may have to walk away from conversations, or even refuse to engage with the person, if they cannot respect your boundaries.
• Encourage the person to seek treatment: Narcissism and alcoholism are both legitimate behavioral health conditions that can improve with treatment. Encouraging your loved one to engage in treatment is one of the best ways to support them in changing their behavior.
• Make time for self-care: If you’re in regular contact with a person who has narcissism and an alcohol addiction (e.: you’re the person’s spouse or parent), coping with their behavior can become quite stressful for you. It’s important for you to take time to care for yourself through regular self-care. Schedule time to relax and engage in your own hobbies andbe sure to take care of yourself through regular exercise, a consistent sleep schedule, and proper nutrition.

Treatment options for narcissistic alcoholics

Treatment can help someone with NPD and AUD to change their behavior and reduce the level of dysfunction that these two conditions have in their daily life. When a person has two conditions, the best option is often to treat the two conditions simultaneously.

People with both NPD and AUD are often treated with a combination of medication and psychotherapy. Medications for AUD can help to reduce cravings and withdrawal side effects, whereas therapy can be beneficial for reducing distorted thinking about alcohol and developing stronger coping skills. Therapy can also help people with NPD to process unresolved childhood trauma and develop skills for managing their symptoms ^[1].