Narcissistic personality disorder is a pattern of grandiose beliefs about oneself and arrogant behavior. People suffering from alcoholism may exhibit matching behaviors, as alcohol abuse and narcissistic personality disorder often co-occur.

Article at a Glance:

Alcohol abuse and narcissism have similar symptoms.

Narcissism may lead to alcoholism in some patients due to their grandiose view of themselves and denial of a negative outcome occurring.

Alcohol abuse can cause people to develop narcissistic personality disorder as they become defensive about their substance use and whether they have an addiction.

Narcissism and Alcoholism

Alcoholism is a progressive brain disease that involves a chemical and psychological reliance on alcohol. Alcohol abuse can cause job loss or strains on relationships and result in challenges functioning after lengths of time without consumption of the substance.

Narcissism involves feelings of self-importance and difficulty accepting fault for one’s mistakes. The disorder usually involves incorrect perceptions about their life and how people think of them. People with narcissism believe their version of reality is accurate and can be unconcerned with the damage that their arrogant and manipulative behavior does to other people.

Maintaining relationships and careers can be challenging when someone has either narcissism or alcoholism because the two conditions often cause arrogance, manipulation, belligerent behavior and lack of empathy.

How Narcissists and Alcoholics Are Similar

A person fighting alcoholism sometimes struggles to see things from their loved ones’  perspectives, which is similar to narcissistic personality disorder.

While alcoholism is an addiction and narcissism is a personality disorder, the two share many characteristics that may cause trouble in their personal, social and work lives.

Similarities of narcissism and alcoholism include:

  • Denial
  • Lack of self-examination
  • Refusal to take responsibility
  • Entitlement
  • Self-destructiveness
  • Behavior is at others’ expense
  • Behavior can switch rapidly
  • Superficial relationships
  • Manipulation of others
  • Self-absorption
  • Shame

Dual Diagnosis Treatment for Narcissistic Personality Disorder and Alcohol Abuse

People with an alcohol use disorder struggle to control their consumption of the substance. Alcohol abuse causes impairment and consistent use of the substance can lead to withdrawal symptoms when not in a person’s system. Alcoholism can cause people to be impaired in social settings or use alcohol despite risks to their professional goals or personal relationships. However, the need for alcohol can become overwhelming and result in people becoming defensive about their substance abuse and how they act due to their alcohol addiction. These narcissistic tendencies can reveal the existence of narcissistic personality disorder. When narcissistic personality disorder and substance abuse are co-occurring, symptoms of both issues are worsened.

Diagnosing co-occurring disorders can be difficult because the two conditions often affect each other and have overlapping symptoms. When two disorders are occurring, it is always vital to obtain treatment for both disorders at the same time. Treating only alcohol use disorder and not narcissistic personality disorder — or vice versa — will increase the chances of future substance abuse and the need for more professional treatment.

If you are or a loved one needs help or assistance in treatment, The Recovery Village can help. Alcohol rehabfacilities located throughout the United States have the staff and resources available to provide treatment for substance use disorders and a co-occurring mental health issue. For more information about co-occurring disorders such as narcissistic personality disorder and alcoholism, call to speak to one of the understanding staff members at The Recovery Village Drug and Alcohol Rehab.

How To Cope With An Alcoholic Parent With Co-Occurring Narcissistic Personality Disorder

About half of people with personality disorders also have some sort of addiction, so a parent with narcissistic personality disorder is more likely to have an alcohol use disorder. A parent who has narcissistic personality disorder with an alcohol addiction may exhibit lack of empathy, a belief that they are special, extreme arrogance, an expectation of special treatment and admiration, and a tendency to take advantage of other people for their own gain.

The traits that come along with narcissistic personality disorder can make it difficult to cope. It is important to practice self-care, recognize that their behavior is not your fault and set boundaries to prevent falling victim to manipulative tactics.

A narcissistic parent with an alcohol use disorder may attempt to guilt you into providing them with alcohol, or become cruel if you attempt to address their behavior or your concerns surrounding their addiction. You may have to distance yourself, and you’ll probably need the support of a professional interventionist if you want them to seek help.

How To Cope With an Alcoholic Spouse With Co-Occurring Narcissistic Personality Disorder

If your spouse lives with an alcohol use disorder, they are at risk of having a co-occurring mental health condition. If your spouse has narcissistic personality disorder, it can be even more difficult to cope with the behavioral side effects of alcohol addiction.

Someone with narcissism exhibits challenging traits, such as exploiting others for personal benefit, expecting excessive admiration, behaving in an extremely arrogant manner, and struggling to empathize with other people’s feelings.

If your spouse has co-occurring alcoholism and narcissistic personality disorder, it is important to take care of your own mental health. Exercising, following a nutritious diet, and making time for enjoyable activities are all small measures of self-care that can help. Remind yourself not to take your spouse’s behavior personally, and set clear boundaries around what behavior you will and will not tolerate. Your spouse may try to manipulate you into giving them things they want, and they will likely not see how their drinking affects you. However, your spouse’s behavior is unlikely to change without professional treatment.

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Devin Golden
Editor – Devin Golden
Devin Golden has worked for various print and digital news organizations. Devin's family has been affected by addiction and mental health disorders, which is a large part of why he wants to help others who have either directly or indirectly been affected by these diseases. Read more
Krisi Herron
Medically Reviewed By – Krisi Herron, LCDC
Krisi Herron is an Adjunct Psychology Professor, a Licensed Chemical Dependency Counselor and a freelance writer who contributes to several mental health blogs. Read more

Kock, P; Walter, M. “Personality disorder and substance use d[…]sorder — An update.” Mental Health & Prevention, December 2018. Accessed January 23, 2022.

Paroma, M; Fluyau, D. “Narcissistic personality disorder.” StatPearls, May 18, 2021. Accessed January 23, 2022.

Medical Disclaimer

The Recovery Village aims to improve the quality of life for people struggling with substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare providers.