What’s the Link Between Narcissism and Alcoholism?

The co-occurrence may be affected by the degree of each condition.

Doctors may refer people with Narcissist Personality Disorder (NPD) to a psychiatrist to determine whether they suffer from Alcohol Use Disorder (AUD). A psychiatrist might administer a standard psychiatric interview to diagnose personality disorders. Healthcare professionals might use the Narcissistic Personality Inventory to diagnose narcissism.

Narcissism and alcohol use can coexist, and some symptoms might overlap. These conditions can be challenging to deal with, but there are specific approaches that might help.

Individuals with narcissism or alcoholism may both display similar characteristics. They may seek help in managing these conditions if they recognize these links.

Let us look at the diagnostic criteria for narcissism and alcoholism and their similarities and differences.

It is common for people to exhibit narcissistic character traits. Still, narcissistic personality disorder (NPD) is a mental health condition in which people are excessively self-involved, lack empathy, and seek admiration. Self-absorbed people seek attention and respect. They may pay little heed to the wants and needs of others. They may also be cold and indifferent to the suffering of others. 

People who suffer from alcoholism are unable to control or cease consuming alcohol. Despite their recognition of the damaging effects of alcohol, those with an alcohol use disorder may not be able to reduce or stop drinking alcohol. 

There are several similarities between the two animals.

Those with narcissism or NPD may exhibit the following behaviours:

  • An elevated sense of self-importance
  • The desire for adoration is an issue
  • Lack of compassion is a problem
  • decreased pain sensitivity
  • Having difficulties keeping up relationships
  • Being overly emotional or unpredictable.
  • Feeling unique or special compared to others
  • Being selfish 
  • Being overly ambitious

There are two types of narcissism: grandiose and vulnerable narcissism. 

A grandiose narcissist may:

  • Have high self-esteem
  • Show dominance in relationships or communication with others
  • Overestimate their abilities

Vulnerable narcissists may:

  • Be defensive
  • Avoidant
  • Are hypersensitive in relationships or communication with others

The following symptoms and behaviours can identify alcohol use disorders (AUDs):

  • A person may drink more alcohol than intended initially
  • Are unable to decrease or quit drinking
  • Cannot think about anything other than alcohol and how to get the next drink
  • Their excessive drinking interferes with home life, work, studies, or relationships 
  • Instead of enjoying hobbies or other activities, alcohol is replacing them
  • Someone who drinks too much alcohol might put themselves in risky situations
  • Alcohol wearing off can cause vomiting, nausea, and difficulty sleeping, among other symptoms

According to the National Institute of Mental Health (USA), 22.6% of people with a personality disorder also have an alcohol use disorder.

In a 2019 study, researchers examined the connection between narcissism and alcohol use in 345 college students using a questionnaire. Both grandiose and vulnerable narcissism was linked with alcohol consumption and alcohol-related problems.

The study revealed that people who display grandiose characteristics might benefit from alcohol consumption, where this trait is common. Narcissists with low self-esteem may try and gain acceptance from others or a sense of security through alcohol use or consumption or use it as a coping mechanism for dealing with distress.

Someone struggling with mental health issues and addiction should seek help from a professional.

Dual Diagnosis

People with an AUD co-occurring with a mental health condition are referred to as having dual diagnoses.

A 2018 study reported that because personality disorders and alcohol use disorders frequently coexist, substance abuse services should screen for personality disorders and vice versa.

AUD and NPD may have the following features in common:

  • A compulsion to re-create some aspects of an alcohol-induced altered state of consciousness.
  • Avoidant behaviours, such as avoiding emotions such as shame or guilt
  • Blaming others 
  • Destructive to either themselves or others
  • Unpredictable behaviour or mood swings may be a sign of bipolar disorder.
  • Problems with work or relationships 

A person with NPD has a personality disorder, while someone with AUD has a substance use disorder.

People’s behaviour may change depending on whether they are sober or drunk with AUD. With NPD, an individual displays a consistent pattern of narcissistic behaviour.

Having AUD, people may want to change. However, people with NPD may not recognize how their actions affect others.

The process of identifying a disease

Healthcare professionals and psychologists may utilize the DSM-5 to diagnose narcissistic personality disorder or substance abuse disorder.

A healthcare professional may conduct an AUD assessment and ask people about their drinking behaviour. Doctors may refer people with NPD to a psychiatrist for diagnosis. Using a standard psychiatric interview, healthcare professionals may diagnose personality disorders or using Narcissistic Personality Inventory may also be used to diagnose narcissism.


People with dual diagnoses can receive treatment for both NPD and AUD. It is essential to discuss how these conditions can impact each other with their doctor.

Individuals may require different forms of treatment for alcohol dependence, but:

Those who wish to detox from alcohol will need to be monitored around the clock for a week to manage withdrawal symptoms. This can be done in a clinical setting or through professional home detox services.

People requiring mental health care, medication, therapy, and support to treat AUD’s underlying causes may need to stay in a rehabilitation centre.

People with dual diagnoses may benefit from cognitive behavioural therapy (CBT) by learning healthy coping techniques and altering thought patterns to overcome substance abuse.

Certain medications may help mental illness or substance abuse withdrawal symptoms be treated.

Support groups can help people feel less isolated during their recovery and connect with others who are going through similar experiences.

NPDs usually require long-term treatment, which may include therapies such as:

  • psychodynamic treatment
  • CBT is an effective treatment for depression
  • schema therapy is a type of therapy.
  • couples therapy

If you or a loved one is affected by alcohol-related issues, call Freephone 0800 140 4044

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