Dual Diagnosis: The Link Between Narcissism and Addiction

A narcissist is a person who struggles with an inflated or heightened sense of self. Someone who is considered to have narcissistic tendencies will often possess an exaggerated or unrealistic self-image that fuels feelings of superiority over others. In Greek mythology, the idea of narcissism is represented by the character Narcissus, who becomes obsessed with and falls in love with his own reflection. As the story goes, Narcissus’ complete self-absorption results in the neglect of those around him, as well as his own tragic downfall.

In today’s social media driven culture, we are no strangers to the concept of narcissism. However, while the majority of people demonstrate “typical” or non-serious narcissistic tendencies throughout life, roughly 0.5 to 1 percent of the population are diagnosed with a condition known as Narcissistic Personality Disorder. In spite of an elevated sense of self, NPD is a co-occurring disorder shown to cause feelings of isolation which can lead to long-term problems with substance abuse and addiction. Those suffering from a dual diagnosis of narcissism and addiction can overcome their battles with drug or alcohol abuse through proper treatment and effectively addressing the underlying causes and consequences of NPD.

What is Narcissistic Personality Disorder?

Narcissistic Personality Disorder, or NPD, is a Cluster B personality disorder in which a person’s idea of his or herself is unnaturally heightened and often leads to both social and interpersonal consequences. According to the Mayo Clinic, “Cluster B personality disorders are characterized by dramatic, overly emotional or unpredictable thinking or behavior” and include antisocial personality disorder and borderline personality disorder in addition to NPD.

While exact causes of Narcissistic Personality Disorder are unknown, the condition has been closely tied to genetic and neurobiological factors such as childhood abuse/neglect, traumatic events, or growing up with excessive amounts of praise or criticism. NPD affects both males and females but is generally more common among men (about 50-75 percent of all diagnosis).

Common symptoms of NPD include:

  • An exaggerated and unrealistic view of oneself
  • An inability to feel empathy for others
  • Strong need for admiration
  • Severe arrogance
  • Superiority complex

However, despite a person’s elevated feelings of self-importance, those suffering from NPD often struggle with feelings of isolation or being an outcast in society. Due to a lack of regard for social consequences, someone with NPD may also manipulate or cut others down to make themself look/feel better. This results in trouble building and maintaining meaningful relationships both in one’s personal (friends, family, spouses) and professional (coworkers, bosses, career path) life. Because of the self-destructive effects of behaviors associated with NPD, substance abuse of alcohol, stimulants, and/or benzodiazepines is unfortunately very common.

What is a Dual Diagnosis?

NPD is a co-occurring disorder with substance abuse and addiction – more than 40 percent of people diagnosed with NPD end up developing an addiction to drugs or alcohol. A dual diagnosis of NPD and addiction must be effectively treated by fully understanding the relationship between substance abuse and its co-occuring disorder. In order to fully overcome an addiction to drugs or alcohol, it’s important to address the specific challenges a person faces with NPD and how this relates to their substance use. If only the addiction itself is treated, the chances of relapse are extremely high. Professional and personalized dual diagnosis treatment is necessary when considering substance abuse and a co-occurring disorder like NPD.

Understanding the Link Between NPD and Substance Abuse

Victims of NPD are more likely to develop a problem with substance abuse as a means to cope with the effects of their disorder. Someone with NPD may suffer from intense feelings of shame or helplessness, contrasted by an outward appearance of arrogance and superiority. Because of this inner-turmoil, people with NPD often use drugs or alcohol as a coping mechanism to relax or seek comfort and belonging. Research shows that victims of Cluster B personality disorders like NPD are at a higher risk of developing a substance abuse disorder or addiction.

There are certain risks associated with a dual diagnosis of NPD and addiction. Depending on the substance being used, a person with NPD may become increasingly aggressive or violent while under the influence of their drug or alcohol of choice.

Common risks of NPD and substance abuse include:

  • Attempted suicide or self-harm
  • Domestic violence
  • Criminal behavior
  • Cardiovascular or Gastrointestinal problems
  • Resistance to treatment

However, it is very possible to overcome a dual diagnosis of narcissism and addiction. When treating NPD and substance abuse, it’s important to understand the link between a person’s addiction and the co-occuring mental disorder that often fuels it. With proper, focused therapy, a person can get the treatment they need to healthily control the effects of NPD and break free of the bonds of their substance abuse.