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Narcissistic Personality Disorder And Addiction: Co-Occurring Disorders

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Narcissistic personality disorder (NPD) is a mental health condition that causes people to lack empathy and have an unrealistic view of the self. Narcissistic personality disorder symptoms are largely social and emotional, and may include severe arrogance and an excessive need for admiration.

Many with NPD also struggle with substance use disorders, such as alcohol addiction. When a mental health condition co-occurs with a substance use disorder, it’s called a dual diagnosis. Co-occurring disorders may also interact and influence one another. For example, narcissistic behaviors may feed off a person’s substance use, and vice versa.

Some of the behaviors associated with NPD are similar to the symptoms of active addiction, including a disregard of social consequences and strong feelings of superiority.

Despite this elevated sense of self, people who struggle with NPD may actually feel like outcasts, due to their antisocial behaviors. Those who struggle with co-occurring NPD and addiction may require the help of a formal treatment center to overcome these conditions.

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What Is Narcissistic Personality Disorder (NPD)?

Narcissism is classified as a Cluster B personality disorder. Narcissism affects more males than females, and often begins in the teens or early adulthood. Those who suffer from narcissistic personality disorder may have trouble maintaining relationships and careers, due to their inability to relate in a healthy manner.

People with narcissistic personality disorder may also show characteristics such as:

  • manipulation tactics
  • “better than” attitude
  • constant comparison to others
  • a focus on obtaining special treatment
  • an extreme need for admiration
  • an inability to get along well with others
  • a deep need to be right
  • impulsive decision making
  • attention-seeking behaviors, especially in medical environments
  • a demanding attitude
  • poor self-esteem
  • resistance to treatment

Narcissists may cut others down to make themselves look better. They may behave in a way that elevates themselves, without regard for how their actions affect others. People who suffer from NPD may also be extremely sensitive, and become hyper-focused on situations where they felt wronged.

People with NPD often indulge in elaborate fantasies about their potential greatness, past achievements, and dreams for the future. As intoxicating as these thoughts can be in the moment, fantasy is often an avoidance tool to cover up feelings of unworthiness and self-doubt.

The Link Between Narcissistic Personality Disorder And Addiction

Because the behaviors of narcissistic personality disorder can be so destructive, it’s difficult for people with NPD to form meaningful and lasting bonds. This can leave those who struggle with NPD feeling alone and worthless (even if they pretend otherwise).

Perhaps because of these isolating feelings, there is a strong link between narcissism and addiction. Rates of substance use are very high among people with NPD. More than 40 percent of people with NPD have a substance use disorder. Thirty percent also have a co-occurring mood disorder, and a third struggle with anxiety.

It seems like those with narcissistic personality disorder would feel good about themselves — after all, they spend a lot of time and energy puffing themselves up. Sadly, people with NPD actually report high levels of shame, helplessness, and anger (even when they are acting in a way that is self-admiring).

These oppositional feelings can create a lot of inner turmoil. Many people with NPD turn to alcohol and drugs to feel a sense of relaxation, comfort, and belonging. Research tells us that people who suffer from Cluster B personality disorders such as NPD are at an increased risk for substance use.

The most common drugs that people with narcissistic personality disorder use include:

  • alcohol
  • marijuana
  • stimulants (cocaine, ecstasy)
  • benzodiazepines (Xanax, Valium, Klonopin)

Dangers Of Narcissistic Personality Disorder And Substance Use

While narcissism is not usually considered a life-threatening condition, there are certain risks associated with NPD. This is especially true when the disorder co-occurs with addiction.

When people with NPD use stimulants, the risk of aggression and mood disturbances goes up. Benzodiazepines are also dangerous for this population, as these drugs have been shown to increase violent behavior among those with NPD.

People who suffer from co-occurring narcissism and addiction are also more at risk for dangers that include:

  • multiple suicide attempts
  • domestic violence
  • criminal convictions
  • financial issues
  • cardiovascular problems
  • gastrointestinal conditions
  • time spent in prison
  • history of interpersonal violence
  • resistant to proper medical treatment

Without formal treatment, people who suffer from NPD and addiction may be at risk for additional long-term consequences. If you or someone you love is struggling with narcissistic personality disorder and addiction, there is help available.

Risk Factors For NPD And Addiction

The exact cause of narcissistic personality disorder is unknown. However, genetics and neurobiology (the way the brain and the body interact) likely play a part. There are also certain personal factors that may affect a person’s chance of developing co-occurring NPD and addiction.

Risk factors for narcissism and addiction include:

  • unpredictable home environment
  • childhood use or neglect
  • traumatic events
  • early exposure to alcohol or drugs
  • other physical or mental health conditions
  • excessive praise or criticism as a child
  • extremely high expectations in the home
  • too little or too much attention from a parent or authority figure

Treatment, Intervention, and Information For Co-Occurring Disorders

It can be difficult to realize that you or someone close to you is suffering from a co-occurring disorder. Fortunately, substance use disorders and narcissistic personality disorder are treatable conditions that can be addressed with the help of a formal addiction treatment program.

Without dual diagnosis treatment, people with co-occurring disorders may struggle to recover from these conditions. If substance use is treated without regard to the personality disorder, it may be difficult for the person to find lasting recovery. Likewise, only treating the NPD leaves the person at risk for continued substance use.

Dual diagnosis treatment exists especially for those who suffer from co-occurring disorders like NPD and addiction. In a dual diagnosis treatment program, patients are provided with a customized form of treatment that treats the whole person. This holistic approach allows patients the opportunity to address each issue individually.

In a dual diagnosis rehab program, patients may be provided with a combination of behavioral therapy and certain medications. Research shows that this combination is the most effective in treating co-occurring disorders like NPD and substance use.

To learn more about narcissistic personality and addiction, or to find dual diagnosis treatment options near you, reach out to one of our specialists today.