How Narcissism And Alcoholism Impact Mental Health
Co-occurring narcissism and alcohol use disorder can be disruptive, both for those experiencing the behaviors firsthand and for their loved ones. In this article, we will examine how these two behavioral patterns can influence emotional well-being, relationships, and everyday functioning. Additionally, we will explore how unpacking these conditions with a compassionate lens can build awareness and offer insight into the potential for healing.
What is alcoholism?
Alcoholism, clinically referred to as alcohol use disorder, is more than just drinking too much. It’s a chronic condition involving a strong urge to consume alcohol, difficulty managing drinking habits, and continuing to drink despite harmful consequences. People living with alcohol use disorder may sense they are caught in a cycle of guilt, denial, and compulsion that’s difficult to escape.
There isn’t a single cause of alcoholism. Genetics can play a part, as can trauma, stress, and co-occurring mental health disorders. Social pressures and early exposure to drinking might contribute as well. For many, alcohol becomes a coping mechanism or a way to escape emotional pain and numb difficult experiences. Over time, however, excessive alcohol consumption often worsens these difficulties.
Symptoms of alcohol use disorder
Some signs of alcohol use disorder might not be obvious at first. However, they can become difficult to ignore over time. Some of these symptoms include the following:
- Drinking more or longer than intended
- Wanting to cut down but being unable to
- Spending a lot of time drinking or recovering from the effects of alcohol
- Craving alcohol intensely
- Neglecting responsibilities at work, school, or home due to drinking
- Continuing to drink even when it causes problems in relationships
- Giving up activities once enjoyed
- Using alcohol in situations that are physically dangerous
- Developing a tolerance (needing more alcohol to experience the same effect)
- Experiencing withdrawal symptoms when not drinking
According to the Substance Abuse and Mental Health Services Administration, additional signs of alcohol use disorder include legal problems related to drinking and spending most of your time either drinking alcohol or thinking about drinking.
What is narcissism?
Narcissism generally refers to a pattern of thinking and behavior centered around an inflated sense of self-importance and a lack of empathy for others. While it exists on a spectrum and can include both healthy and unhealthy traits, narcissism usually becomes more concerning when it disrupts relationships, emotional balance, and daily life.
The word “narcissism” is often used casually, and it covers a wide range of narcissistic behaviors and traits. While many people have moments of self-focus, persistent narcissism can have a range of negative consequences on both the individual and those around them.
Narcissistic traits might include the following:
- An inflated sense of self-importance
- A deep need for admiration
- A lack of empathy
- Envy toward others or a belief that others are envious of them
- A tendency to exploit others for personal gain
It can be important to note that not everyone who exhibits narcissistic tendencies qualifies for a diagnosis of narcissistic personality disorder, and anyone may occasionally display narcissistic traits. These traits exist on a spectrum and can vary greatly between individuals.
Understanding narcissistic personality disorder (NPD)
While narcissistic traits appear in many people from time to time, narcissistic personality disorder (NPD) is a clinical, diagnosable personality disorder. Common narcissistic behaviors might include occasionally exaggerating accomplishments or expecting recognition for minor achievements. However, an intense or persistent need for admiration or a tendency to elevate oneself at the expense of others may indicate the possibility of an underlying personality disorder.
Ongoing patterns of superiority, manipulation, or intense anger when criticized may suggest a more entrenched condition involving persistent inner experiences and behaviors that interfere with functioning and relationships. An accurate diagnosis of NPD requires a thorough evaluation by a licensed mental health professional. Many people with NPD may go undiagnosed as they may not recognize their behavior as problematic.
Symptoms of narcissistic personality disorder
Common symptoms of narcissistic personality disorder include the following:
- Grandiose sense of self-importance that hides deep-rooted insecurity
- Preoccupation with fantasies of unlimited success, power, or beauty
- Belief that they are unique and can only be understood by high-status people
- Need for excessive admiration
- Sense of entitlement
- Interpersonally exploitative behavior
- Lack of empathy
- Envy of others, or belief that others envy them
- Arrogant or haughty behavior
The link between narcissistic personality disorder and alcohol misuse
When narcissistic personality disorder and alcohol use disorder co-occur, they can create a challenging pattern. Each may reinforce the other in subtle yet significant ways.
Here are five ways narcissistic personality disorder and alcohol use disorder can overlap:
- Alcohol may be used to mask a deep-seated sense of inadequacy that is common in NPD.
- Drinking may amplify narcissistic tendencies, such as impulsivity and entitlement.
- Individuals may use alcohol to sustain a grandiose self-image or avoid shame.
- Both conditions may involve denial, which can delay recognition and treatment.
- A person with NPD may resist feedback, making intervention for alcohol misuse difficult.
Impacts on mental health
Living with both alcohol use disorder (AUD) and narcissistic personality disorder can significantly complicate a person’s mental health. Alcohol’s depressant effects can worsen anxiety and depression symptoms, while NPD may lead to social isolation and a sense of emptiness.
When combined, these co-occurring disorders may prevent someone from developing insight into the state of their mental health and seeking help. Instead of building resilience and self-awareness, an individual with AUD and NPD might rely on substances or external validation to soothe their discomfort.
Impacts on relationships and family
Those close to someone with both alcohol use disorder and narcissistic personality disorder often face a complicated emotional landscape. Partners, children, and friends may feel emotionally neglected, manipulated, or harmed.
Due to the nature of these conditions, the person affected may shift blame or deny responsibility, which can make resolution difficult without outside support. Children of an individual with narcissistic personality disorder and alcohol use disorder might grow up questioning their self-worth or struggling to set boundaries. Loved ones may experience chronic stress, depression, or a sense of helplessness.
Recognizing narcissism, alcoholism, and their mental health impacts
For those who believe they may be living with narcissistic personality disorder and alcohol use disorder, self-reflection can serve as the first step toward recovery. Here are some questions that may offer clarity:
- Do you often experience the need to drink alcohol to feel confident or in control?
- Have others told you that you seem self-centered or emotionally distant?
- Do you find it hard to accept criticism without becoming defensive or angry?
- Have you noticed that your drinking habits cause problems in your relationships or work?
- Do you experience a strong need for admiration or recognition from others?
Navigating narcissistic personality disorder and alcohol use disorder in a loved one
Supporting someone with both NPD and AUD can be emotionally taxing, but there are several potential ways to manage the experience:
- Set and maintain clear personal boundaries.
- Avoid enabling behaviors, such as those that prevent the individual from experiencing the consequences of their actions.
- Seek out education on narcissistic personality disorder and alcohol use disorder.
- Use neutral, non-confrontational language when expressing concerns.
- Join support groups designed for families of those with substance misuse challenges.
How therapy can help
Therapeutic support, such as cognitive behavioral therapy (CBT), can be useful in addressing both NPD and alcohol use disorder. CBT typically encourages self-awareness, challenges distorted thinking, and promotes healthier patterns of behavior.
Someone with narcissistic traits may find it difficult to acknowledge fault or show vulnerability. A skilled mental health professional may foster trust and encourage progress throughout this process in a judgement-free environment. Additionally, CBT can help individuals focus on managing emotions, understanding the situations that lead them to engage in alcohol use, and building empathy.
Mental health support for family and loved ones of those with narcissistic personality disorder and alcohol use disorder
Family therapy or specialized counseling can be valuable for those impacted by a person with alcohol use disorder and NPD. These resources can provide a safe space to explore difficult emotions, strengthen boundaries, and rebuild self-esteem. Support groups can also offer shared experiences and reduce isolation. In many cases, healing for the family can be equally as important as treatment for the individual.
The benefits of online therapy
While research on online treatment specifically for NPD and alcohol use disorder is still growing, studies suggest online therapy is as helpful as in-person therapy for conditions like anxiety and depression, which can co-occur in individuals with AUD and NPD.
Online therapy can be more accessible for those with busy schedules or limited transportation. It may also serve as a lower-cost alternative to traditional therapy for those without insurance. Finally, it’s an option that often connects clients to more specialists, including mental health professionals who have experience providing dual diagnosis treatment, which may be necessary for individuals with both narcissistic personality disorder and alcohol use disorder.
BetterHelp currently accepts HSA/FSA cards and is recognized as an eligible expense by most HSA/FSA providers. Get started today.
Takeaway
What are the traits of an alcoholic?
A person with alcohol use disorder (sometimes referred to as alcohol abuse) usually struggles to decrease or stop their alcohol consumption despite the negative effects it has on their life. They may spend most of their time drinking or thinking about drinking, and they may experience withdrawal when they aren’t drinking.
Therapy, support groups like Alcoholics Anonymous, and medical treatment centers may all be helpful for individuals with alcohol use disorder (AUD) who want to stop drinking. The Substance Abuse and Mental Health Services Administration has many resources for those who want to learn more about AUD and treatment options.
Does narcissism get worse with alcohol?
It’s possible for alcohol consumption to intensify narcissistic traits. For example, the self-absorption often displayed by narcissistic individuals may increase when they have been drinking.
Is there a link between narcissism and alcoholism?
Alcohol use disorder may worsen traits associated with both vulnerable narcissism and malignant narcissism. In some cases, manipulative behavior can occur. It’s possible for these harmful behaviors to reach the level of emotional abuse, although this isn’t always the case.
How can you handle a narcissist alcoholic?
Setting and maintaining strong boundaries may help you navigate a relationship with someone who has alcohol use disorder and narcissistic personality disorder. It may be beneficial to speak to a therapist about the situation, as they may be able to provide more personalized guidance and coping skills.
How do narcissists act when they drink?
Every person with narcissistic personality disorder is an individual, so they may each act differently while drinking. It’s possible that risky behaviors or adverse consequences could arise.
Do alcoholics become self-centered?
Some people with alcohol use disorder may seem self-centered because of their focus on drinking and inability to stop drinking despite the effects their behavior has on loved ones. While many individuals manage stress with alcohol, frequent heavy drinking often has the opposite effect and can lead to alcohol dependence or even severe addiction.
Why are most narcissists alcoholics?
Many people with narcissistic personality disorder have a deep-rooted sense of inadequacy and low self-esteem. Drinking alcohol may temporarily numb the emotional distress they experience, and it can also enable them to reinforce a false sense of grandiosity.
What type of trauma causes narcissism?
Narcissistic traits often stem from trauma and adverse events in childhood. It can be important to note that not everyone who has narcissistic traits qualifies for a diagnosis of narcissistic personality disorder, and most people display these types of traits from time to time.
What kind of counseling does a narcissist need?
People with NPD don’t always seek professional help because they may not recognize their behavior as problematic. However, treatment programs that help them change negative thought patterns and beliefs, such as cognitive behavioral therapy (CBT), may be helpful.
What is the most effective treatment for narcissism?
Personalized treatment plans tend to be ideal because they also focus on treating co-occurring conditions. Many people with NPD also live with substance- or alcohol-related problems, depression, anxiety disorders, and other challenges. Cognitive behavioral therapy is a common choice that can treat many conditions in a supportive environment.
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