Narcissistic Personality Disorder and Addiction

Narcissistic Personality Disorder or NPD is a diagnosed mental disorder in which a person suffers from an exaggerated sense of self-importance coupled with an excessive need for positive attention or admiration and the inability to understand or empathize with the feelings of others. While the term ‘narcissist’ is often used to describe anyone expressing an exaggerated sense of self-importance or paying too much attention to their appearance (e.g. taking too many selfies), 1-6% of the population likely suffers from it. This disorder frequently overlaps with the symptoms of bipolar disorder, depression, anxiety, and substance use disorder. It is also very often found alongside substance-use disorders, as persons with narcissistic personality disorder are sometimes very prone to substance abuse and therefore, dependence and addiction.

If your loved one has either been diagnosed or is showing the signs of narcissistic personality disorder and are or may be addicted to a substance, there is help. Both narcissistic personality disorder and substance dependence can be treated with behavioral therapy (although substance dependence is easier to treat) and your loved one can get better.

Symptoms of Narcissistic Personality Disorder

Narcissistic personality disorder typically manifests in a variety of ways, with multiple DSM recognized types. However, most NPDs will show the following traits and symptoms.

Histrionics – NPDs will engage in histrionics for attention, showing an exaggerated need for praise and admiration.

Arrogance – A person with narcissistic personality disorder may act superior and arrogant and may feel that all praise is genuine and well-deserved, even when it’s not. This also manifests as entitlement, so that people believe they are owed something.

Denial – Like addicts, persons with narcissistic personality disorder are exceptional at denial and can easily brush off criticism or anything that does not flatter them.

Manipulation and Lying – Narcissists easily manipulate others through lying, blackmail, emotional pleas, and coercion.

Jealousy – Jealousy of others’ achievements, feeling that something was ‘their right’, jealousy of what they believe is their due, etc.

No Empathy – Persons with narcissistic personality disorder may have difficulty understanding how others feel. However, this doesn’t mean that they don’t feel, which is more indicative of psychopathy than narcissism.

Narcissist? Addict? Or Both?

It’s important to note that narcissists and addicts share many overlapping traits. Manipulation, lying, emotional blackmail, bullying, inability to understand the emotions of others, seeming insensitivity, and even an excessive need for admiration are all commonly found in both cases of addiction and narcissism. If your loved one has displayed these traits since before using, they are likely a narcissist. If the symptoms are new since the addiction, your loved one is likely just addicted – even if they’ve been suffering for years.

Why? The effect of addiction on the ego and self-esteem are well documented. Substance abusers can aggrandize the ego in an effort to lie to themselves about their substance abuse – causing narcissistic traits and personality.

Substance abuse typically causes euphoric rushes through overproduction or synthetization of neurotransmitters like dopamine and serotonin. Over time, this reduces natural production in the brain, reduces the ability of the brain’s reward system (you get a rush of dopamine when you do something good for someone else) to work, and even damages the brain’s neural pathways. So after using for an extended period an addict may develop emotional blunting so that they feel very little when not using – all they want or care about is the drug and they will do anything to get it. Because most people perceive others as themselves, a person who is emotionally blunted will believe that you feel to the same extent they do, not much at all. So, they will, often with little remorse, manipulate, lie, and steal in the same way that a very narcissistic person would.

Narcissistic Personality Disorder and Substance Abuse

Persons with narcissistic personality addiction are often drawn to substance abuse and alcoholism for a number of reasons. Dissatisfaction with others’, feeling as though no one understands them, and feeling like they are special and therefore either will not get addicted or using to be ‘cool’ are all common traits. Narcissists then go on to deny addiction, even when heavily addicted – and may be adept at lying, convincing others they can quit at any time, and otherwise refusing to face the reality of their own addiction.

For this reason, it can be particularly challenging to convince a narcissist that he or she needs help. You may need a professional intervention, a strong relationship, or some other drastic measure to get a narcissist into therapy. You will have to deal with denial, possibly anger, and strong emotions when forcing a narcissist to come to terms with their own addiction. Being empathetic, gathering a group of people your loved one trusts and loves, and being kind but firm is one way to slowly but surely convince them that they need help. If you make pleas about them and their health rather than their substance use, you may also have more success. For example, “I’m worried about you, please let me help”, instead of “you’re using again aren’t you”.

Personality disorders, including narcissism, also make it extremely more likely that a person will use and become addicted to a substance. In one study, 40% of alcoholics and 79% of drug users showed strong symptoms of personality disorders. While not the most common personality disorder, narcissism is the fifth most common, and therefore extremely prevalent in cases of addiction.

Treating NPD as a Comorbid Disorder

While narcissistic personality disorder is part learned-behavior and part genetic trait, it can be treated. However, it is crucial that the treatment facility understand the person’s mental and physical health history so that they can create a custom treatment plan capable of treating NPD as a comorbid disorder. Like with depression and bipolar disorder, the mental disorder is at least partially responsible for substance abuse. If you treat substance abuse without treating the disorder, the patient will likely simply return to substance use once out of treatment.

A clinical psychologist can create a behavioral therapy program designed to treat co-occurring disorders of NPD and addiction – so that the addict unlearns narcissistic behaviors while learning to cope with cravings, learning to cope with stress, and gaining the skills to move on with their life.

If your loved one has not been diagnosed with narcissistic personality disorder before addiction, treatment can become more complex. However, a good initial assessment with a follow-up assessment after detox can help many therapists to better understand the unique problems and mental condition of their patient, so that they can offer a personalized treatment program to meet their needs.

Narcissistic personality disorder is particularly difficult to diagnose and treat in addicts because many of the symptoms overlap, long-term users often develop strong narcissistic traits, and many will show the same behavior patterns whether they are addicted or addicted and narcissistic. Either way, you can get help, treat narcissism like the disorder it is, and get your loved one back.

Addiction and narcissism have a lot in common and often appear together. For this and other reasons, it makes sense to treat them both together. Your treatment facility should be able to offer a comprehensive addiction treatment program with behavioral therapy for both the addiction and the NPD – so that your loved one can make a full recovery. Good luck getting your loved one into recovery.

If you or someone you love is struggling with Narcissism and Addiction, contact us today and speak with one of our experienced and professional intake advisors, we’re here to help. Beginnings Treatment Centers is located in beautiful and sunny Southern California in Orange County, which has one of the best and most active recovery communities in the United States.