What’s the short answer?

It’s possible to be a narcissist and abuse alcohol. Some research suggests that alcohol abuse may be more common among people with narcissistic tendencies.

Narcissism and alcohol abuse may share some signs and symptoms.

The Similarities

Some people with narcissistic tendencies abuse alcohol. It’s possible to have narcissistic personality disorder (NPD) in addition to alcohol use disorder (AUD).

In some cases, a person who abuses alcohol may exhibit similar tendencies to narcissists — or at least, it may appear that way to those around them.

For example, they may be:

Willing to manipulate or exploit others to maintain their alcohol use
Appear self-absorbed, because they focus on alcohol
Appear unempathetic, because they prioritize their alcohol use over the needs of others
Intolerant of criticism, especially when their alcohol use is criticized
Be more arrogant and less self-aware when drunk
Lack self-awareness and are unwilling to seek help
Avoid taking responsibility for their actions to avoid shame or guilt
Appear entitled, especially if they use other people’s money or resources to maintain their alcohol use

These overlapping traits can make it difficult to distinguish between alcohol abuse and narcissism.

Differences

Not everyone with narcissistic traits or narcissistic personality disorder abuses alcohol. Some narcissists may not drink at all. Likewise, many people who abuse alcohol may show very few signs of narcissism.

Traits like narcissism and personality disorders like narcissistic personality disorder have been around for a long time. To receive a diagnosis of narcissistic personality disorder, they must consistently display the relevant symptoms over many years.

Although alcohol abuse and alcohol use disorder can cause someone to exhibit narcissistic-like behavior, this behavior may change when they are sober or in recovery. The behavior may also only appear when they begin abusing.

Quick Note on Terminology

Before we move on, it is important to understand the terminology used in this article.

Narcissism vs. Narcissistic Personality Disorder

Narcissism is a personality trait, while narcissistic personality disorder is a mental health condition. It is possible to be somewhat narcissistic without meeting the diagnostic criteria for narcissistic personality disorder.

Narcissism is defined as excessive self-love or selfishness. A narcissist may be self-absorbed and have an exaggerated sense of self-importance.

Related : 6 smart ways to deal with someone who complains about everything

However, narcissistic personality disorder includes other traits, such as a need for constant praise and special treatment, responding negatively to criticism, and manipulating others. People with narcissistic personality disorder may be unwilling or unable to recognize the feelings and needs of others.

Alcohol Abuse vs. Alcohol Use Disorder

Many people use the terms “alcohol use disorder” and “alcohol abuse” interchangeably, but they refer to two different things.

Alcohol abuse refers to situations where you drink excessively or when you drink alcohol when it is harmful — for example, when you are pregnant or when you have a medical condition that makes drinking alcohol dangerous.

Alcohol use disorder (AUD) is the medical term for alcohol addiction. If your alcohol use begins to affect your life, health, or well-being, you may have an alcohol use disorder.

To receive a diagnosis of alcohol use disorder, you must meet certain diagnostic criteria as outlined in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR).

People can misuse alcohol without developing an alcohol use disorder or alcohol dependence. They may have occasional episodes of heavy drinking, for example, but find that it doesn’t interfere with their lives and that it’s easy to cut back (or stop drinking altogether).

It’s worth noting that the DSM-5-TR does not use the term “alcoholism,” but the term is still used colloquially to refer to alcohol use disorder.

What are the symptoms of each condition?

If you think you or a loved one has narcissistic personality disorder or alcohol use disorder, knowing the symptoms can help you better understand both conditions.
Narcissistic Personality Disorder

People with narcissistic personality disorder may experience the following symptoms:

Appearing arrogant or boastful

A willingness to manipulate or exploit others for personal gain
Feeling entitled to other people’s time, resources, and energy
Difficulty handling criticism
Frequently fantasizing about achieving power and success
Difficulty understanding or prioritizing the feelings and needs of others
A need for admiration or praise

There are two types of narcissistic personality disorder: overt and covert. People with covert narcissistic personality disorder are less likely to appear narcissistic to others, as they have traits not typically associated with narcissistic personality disorder. For example, they may be shy.
Alcohol Use Disorder

People with alcohol use disorder may experience the following symptoms:

Crawling for alcohol

Withdrawal symptoms (such as shaking, nausea, and vomiting) when the effects of alcohol wear off

Shaking after drinking

People with alcohol use disorder may engage in the following behaviors:

Drinking alone

Being defensive when asked about their drinking habits

Not eating or eating poorly

Neglecting personal hygiene

Missing work, school, or other obligations because of drinking

Not being able to control or cut down on alcohol

Making excuses for drinking

Continuing to drink even when it interferes with their relationships and obligations

Cutting down or giving up activities they normally enjoy because of alcohol use

Overlapping Signs and Symptoms

People with Narcissistic Personality Disorder and people with Alcohol Use Disorder may share some symptoms.

These overlapping signs and symptoms include:

Exhibiting manipulative or exploitative behavior

Appearing selfish

Lack of empathy for others

Lack of self-awareness

Exhibiting excessive entitlement

Unwillingness to ask for help
Intolerance of criticism

Not everyone with alcohol use disorder or narcissistic personality disorder will experience all of the symptoms listed above.

What causes each condition — can one cause the other?

It appears that many people with Narcissistic Personality Disorder may also have an alcohol use disorder, but it’s not clear why. As such, we don’t yet know if one causes the other.

According to the National Institute of Mental Health, 22.6% of people with a personality disorder also have a substance use disorder (SUD), which can include alcohol abuse.

A 2018 study examined the relationship between narcissism and alcohol use based on a survey of 345 college students. The study found that narcissism was a predictor of alcohol use and alcohol-related problems.

In other words, those with narcissistic tendencies were more likely to use alcohol and experience problems due to alcohol use.

A 2018 study found that people with personality disorders were more likely to develop an alcohol use disorder at some point in their lives.

Another 2018 study suggested that while more research is needed to understand the relationship between personality disorders and alcohol use disorder, mental health professionals who treat people with personality disorders should screen for alcohol use disorder, and alcohol use disorder services should screen for personality disorders.

NarcissisticPersonalityDisorder

It’s not entirely clear what causes narcissistic personality disorder. However, research from 2014 tells us that genetic factors may play a role in whether some people develop narcissistic personality disorder.

Parenting styles can also contribute to the development of narcissistic personality disorder. According to recent research, you are more likely to develop narcissistic personality disorder if you:

• Were abused or neglected as a child
• Had overprotective parents
• Had overly pampered parents
• Had overly praising parents
• Had overly permissive parents

Research is still ongoing into the causes of narcissistic personality disorder.

Alcohol Use Disorder

It’s not clear why some people develop alcohol use disorder while others don’t.

Research suggests that genes may play a role in how your body responds to alcohol, making it a pleasant or unpleasant experience for you.

Related : How to Treat Narcissistic Personality Disorder

People who are genetically predisposed to experiencing unpleasant side effects from drinking are less likely to drink frequently, making alcohol use disorder unlikely.

However, other factors also play a role. You may also be at higher risk for alcohol use disorder if you:

Live in a family or culture where alcohol use is common and accepted

Have a relative with an alcohol use disorder
Experience high levels of stress
Have a mental health condition
Experience trauma as a child

More research into the causes of alcohol use disorder may help experts develop more treatment options.

Overlapping causes and risk factors

In both narcissistic personality disorder and alcohol use disorder, childhood trauma — including abuse and neglect — may be a risk factor.

Genetic factors also appear to play a role in the development of both conditions.

How is each condition diagnosed?

Both alcohol use disorder and narcissistic personality disorder must be diagnosed by a health care professional. In the United States, the DSM-5-TR is used to diagnose both conditions.

Narcissistic Personality Disorder

To meet the DSM-5-TR diagnostic criteria for narcissistic personality disorder, a person must exhibit at least five of the following traits:

An exaggerated sense of self-importance and entitlement

A need for constant admiration and praise

Expecting special treatment because they see themselves as superior

Exaggerating their accomplishments and talents

Responding negatively to criticism

Being preoccupied with fantasies about power, success, and beauty

Manipulating or exploiting others

An inability or unwillingness to recognize the needs and feelings of others

Exhibiting arrogance

As with all personality disorders, narcissistic personality disorder is a long-term condition. To receive a diagnosis of narcissistic personality disorder, a person must exhibit the symptoms listed above over several years. Narcissistic personality disorder often appears in childhood.

Alcohol Use Disorder

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), you may have an alcohol use disorder if you have had at least two of the following symptoms in the past year:

You have ended up drinking more or for longer than you intended on some occasions.
You have been unable to cut down or stop drinking even though you wanted to.
You have spent a lot of time drinking or being sick because of drinking.
Your desire to drink has been so persistent and distracting that you have been unable to focus on anything else.
Your drinking or hangovers have often interfered with your responsibilities at work, family, home, or school.
Your drinking has negatively affected your relationships.
You have given up or cut back on activities that are important to you to drink.
You have engaged in risky behavior while intoxicated (such as driving, using machinery, or having unprotected sex).
You have continued drinking even when it has caused depression, anxiety, health problems, or blackouts.
You needed to drink more to get the same effect you had in the past.

You experienced withdrawal symptoms when the effects of alcohol wore off, such as restlessness, tremors, insomnia, nausea, sweating, rapid heartbeat, or seizures.

Your doctor may diagnose you with mild, moderate, or severe alcohol use disorder depending on how many criteria you meet:

Mild alcohol use disorder: Meets two to three criteria.

Moderate alcohol use disorder: Meets four to five criteria.

Severe alcohol use disorder: Meets six or more criteria.

Overlapping tools for diagnosis

Healthcare professionals can diagnose narcissistic personality disorder and alcohol use disorder. If you think you have either or both conditions, it’s best to talk to a mental health professional for a diagnosis.

Because alcohol abuse is common among people with personality disorders, and vice versa, researchers suggest screening people who are receiving treatment for alcohol use disorder for personality disorders and screening people who are receiving treatment for personality disorders for alcohol use disorder.

Questions to Ask Yourself

If you think you’re abusing alcohol, or if you think you might have Narcissistic Personality Disorder, reach out to a mental health professional. Anyone can benefit from talking to a therapist, regardless of whether they fit the criteria for a mental health condition.

The online self-tests for narcissism are not a substitute for mental health care. However, you may find it helpful to ask yourself the following questions:

Do others view me as arrogant or boastful?
Do I have difficulty caring about or prioritizing other people’s feelings?
Do I have difficulty accepting criticism, even when it’s kind?
Have my relationships been affected by my sense of entitlement or lack of empathy (real or perceived)?
Do I have difficulty maintaining close, healthy, meaningful relationships?
Do I manipulate or exploit others frequently?

Related : 8 phrases that immediately turn people off when you first meet them

Similarly, the online test can’t help diagnose alcohol use disorder. But you may find it helpful to ask yourself:

Do I find myself drinking even when I tell myself I won’t?
Is my drinking affecting my relationships, home commitments, finances, or career?

Has my tolerance for alcohol increased?

Have I stopped or cut back on enjoyable activities to drink?
Do I engage in harmful or dangerous behaviors while drinking or during a hangover?

Is my drinking affecting my health?
Have I experienced alcohol withdrawal symptoms?

If you answered “yes” to most of the questions above, it may be a good idea to talk to a therapist. Regardless, it’s always a good idea to seek mental health help if you’re experiencing something that’s causing you distress.

What are the treatment options for each condition?

Both alcohol use disorder and narcissistic personality disorder are treatable. People with alcohol use disorder can successfully stop using alcohol when they get the right support and treatment.

People with alcohol use disorder or narcissistic personality disorder may resist getting treatment or seeking help. This is a common symptom of both conditions.

People with narcissistic personality disorder tend to have difficulty taking criticism from others, and as a result, they may have difficulty sticking to psychotherapy and lifestyle changes.

However, treatments such as psychotherapy, group support, and self-care strategies can help people with either condition feel much better.

To get started, contact a doctor or other health care professional, or reach out to a therapist.

Narcissistic Personality Disorder

The main treatment for narcissistic personality disorder is talk therapy, also known as psychotherapy.

There are no medications to treat narcissistic personality disorder, but if you also have depression or another mental health condition, your doctor may prescribe medications to treat the other condition.

Different types of treatment can be used for narcissistic personality disorder, including:

Cognitive behavioral therapy (CBT)

Dialectical behavioral therapy (DBT)

Eye movement modification and reprocessing (EMDR) therapy (which is often used to treat trauma)

Psychoanalysis

Transferential-focused psychotherapy (TFP)

Treatment can help you:

Identify existing defense mechanisms

Explore past trauma and its impact on your current behavior

Explore how your behavior affects others

Examine behavior and thinking patterns

Learn and practice new behavior patterns

Learn how to cope with shame and vulnerability

You may also engage in lifestyle changes and self-care strategies to make progress. One of these changes may be to avoid substances such as alcohol if they tend to trigger harmful behavior.

Alcohol use disorder

There are many treatments for alcohol use disorder. Treatments can occur at different stages. Each person needs a different approach to treatment depending on their unique situation, so not everyone will have the same treatment program.

You may go through:

Initial detoxification or withdrawal to get rid of alcohol from your body

Rehabilitation to learn new coping skills and behaviors

Counseling or talk therapy to address emotional issues and stressors

Support groups, including Twelve Step programs

Medical treatment for any health problems caused by alcohol use

Medications to help control your addiction

If your alcohol use is severe, you will likely need to go to an inpatient facility so you can safely withdraw from alcohol. Alcohol withdrawal can be dangerous, so it is important to seek medical help.

After withdrawal, you may seek inpatient or outpatient care depending on your needs and the services provided by the facilities available to you.

Overlapping Treatment Options

Talk therapy can be a helpful treatment for both narcissistic personality disorder and alcohol use disorder. In both cases, the benefits of treatment depend on your willingness to work on yourself. You get what you sow.

What is the outlook for people with narcissistic personality disorder or alcohol use disorder?

Although narcissistic personality disorder cannot be cured, anyone with narcissistic personality disorder can change their behavior if they are willing to put in the time and effort, according to a 2018 research by Trusted Source. Treatment and self-care strategies can help them do so.

Likewise, people with narcissistic personality disorder can successfully recover from the disorder. Therapy, a strong support system, and self-care strategies can help you make a full recovery.

Relapse is a common experience for people recovering from alcohol use disorder. You can take steps to prevent relapse, such as recognizing your triggers and joining a support group. If you relapse, try seeking help again — full recovery is still possible.

Related : If you feel like someone is trying to manipulate you, look for these 7 clues

There is little data on whether people with both narcissistic personality disorder and alcohol use disorder have a different outlook than people with just one condition. However, it is recommended that you treat both conditions at the same time to improve your chances of recovery.

Where to Find Support If You Have Narcissistic Personality Disorder or Alcohol Use Disorder

If you think you have an alcohol use disorder, you might want to try these resources:

Alcohol Addiction Support Groups
The Best Alcohol Addiction Recovery Apps
The Healthline FindCare Tool

If you think you have narcissistic personality disorder, try making an appointment with a mental health professional. You can connect with a mental health professional using the Healthline FindCare tool.

How to Support a Loved One with Narcissistic Personality Disorder or Alcohol Use Disorder

Support from loved ones can help people with narcissistic personality disorder or alcohol use disorder change their behavior and work toward recovery.

While it’s good to try to help someone with narcissistic personality disorder or alcohol use disorder, remember that the change has to come from them, not you: You can’t do the work for them.

You can:

Gently encourage them to seek help in the form of therapy, support groups, or rehab. Helping them identify a therapist or rehab can be a great start.

Take care of yourself and set boundaries. Enabling their behavior makes it easier for the behavior to continue.

Find your sources of support. Join support groups, such as Al-Anon Family or Adult Children of Alcoholics.

Read more about living with someone with alcohol use disorder and managing a relationship with someone with narcissistic personality disorder.

Conclusion

People with narcissistic personality disorder may be more likely to misuse alcohol and develop an alcohol use disorder. Also, people with alcohol use disorder may seem to act similarly to people with narcissistic traits.

Both conditions are treatable. If someone has an alcohol use disorder in addition to a personality disorder, it’s a good idea to treat both at the same time to improve their chances of recovery.