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Is It Narcissism or Alcoholism? How to determine the cause of your loved one's behavior.

Are you in a relationship with someone who puts themself and their drinking before others? It can be hard to hold a connection with someone who appears to only think about themselves. A loved one’s drinking and selfish behavior can be devastating and cause a great deal of pain and disappointment. If you’ve ever wondered if your loved one’s issues involve only their drinking problem or may in fact involve narcissism as well, consider the following symptoms.

Narcissistic Personality Disorder (NPD) is a disorder in which someone acts selfishly and thinks highly of themselves. In reality, these behaviors are often a mask for an individual's fragile self-esteem and self-image.

Symptoms of NPD may include:

  • an exaggerated sense of self-importance

  • a sense of entitlement requiring constant, excessive admiration

  • an expectation to be recognized as superior even without achievements that warrant it

  • exaggeration of achievements and talents

  • preoccupation with fantasies about success, power, brilliance, beauty, or the perfect mate

  • belief that they are superior and can only associate with equally special people

  • monopolization of conversations and belittling or looking down on people they perceive as inferior

  • expectations of special favors and unquestioning compliance with their expectations

  • taking advantage of others to get what they want

  • an inability or unwillingness to recognize the needs and feelings of others

  • envy of others and the belief that others envy them

  • behaving in an arrogant manner, and coming across as conceited, boastful, and pretentious

  • insistence on having the best of everything — for instance, the best car or phone

Symptoms of alcoholism, or Alchohol Use Disorder, according to the DSM:

  • drinking more or longer than they intended

  • having made several failed attempts to cut down

  • spending a lot of time drinking or being sick from drinking

  • wanting a drink so badly they couldn’t think of anything else

  • drinking that interferes with relationships, school, or work

  • stopping activities that were once pleasurable to drink instead

  • drinking in dangerous situations

  • continuing to drink despite it exacerbating anxiety, depression, or another health issue

  • having to drink more to get the same effects

  • experiencing withdrawal (trouble sleeping, shakiness, nausea, sweating, racing heart, or seizure)

Someone with a drinking problem will put their drinking before anyone and anything else. Has your loved one failed to show up to something important to you? Have they let you down by agreeing to quit and getting drunk anyway? Do they often blame others or deflect when confronted about their drinking? ("You treat me so bad I have to drink” or “They had more drinks than me!”)

Alcoholics often deny that they have a drinking problem. Narcissists will also deny that there is anything wrong with them. In a conflict, a narcissist will turn everything around on you, gaslight, and refuse to apologize or agree to change.

Narcissists are full of entitlement and lack empathy for others, so they may do whatever they want to others with no regard to their feelings. Alcoholics do the same when they put their drinking first without concern for how it affects others.

Alcoholics and narcissists can also rapidly change moods and behavior. If you’ve dealt with a narcissist you know that one minute they can be charming and pleasant but then turn around and become threatening and attacking. Alcoholics can undergo similar shifts when under the influence and can seem like a different person in a matter of a few drinks.

Manipulation can be present with both issues as well. Alcoholics often use this tactic to get the drink they need. They will con a way to buy alcohol, drink in secret, and find a way to cover their drinking. For narcissists, manipulation is a way to use someone to get the reactions or attention they desire.

One thing neither personality likes is people setting firm boundaries and following through with them. This can make them feel out of control of both you and their needs. Telling a loved one “no," therefore, can be difficult because of their disproportionate reaction. Often the end of a relationship with a narcissist or alcoholic occurs when the final boundary has been set: “If you don’t change I can no longer be in your life.”

It can be hard to discern even from a clinical perspective if alcoholism is separate from narcissism. The behaviors can be similar while sober and intoxicated. The takeaway is that the individual needs treatment to make significant changes in their life. Depending on the severity of the problem, residential or inpatient treatment may be necessary. Once detox is completed and sobriety has begun, outpatient therapy can be beneficial. It is also recommended to utilize family or couples counseling to heal relationships as well.

If the person does not want to enter treatment or change, there may not be hope for healing. The best thing to do at that point is to seek out individual therapy for yourself and work on setting firmer boundaries.

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