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Dual Diagnosis: Narcissistic Personality Disorder And Addiction

John Schaffer, LPCC

Medically reviewed by

John Schaffer, LPCC

March 7, 2019

Individuals who suffer from addiction, as well as a personality disorder, may have a harder time overcoming their addiction. Many of these individuals go undiagnosed and as a result, do not get the treatment that they need. A dual-diagnosis treatment program may be just what they need to put addiction behind them for good.

Approximately 31 million Americans have serious personality disorders. Many of those suffering also have an untreated or undiagnosed dual diagnosis—they have co-occurring substance use disorders. Nearly one half of all people affected by severe mental illnesses are also impacted by substance abuse and addiction. Addiction is a chronic disease of the brain that, without treatment, can result in drastic, adverse changes to a person’s health, family, finances, and more. In extreme cases, addiction left untreated may lead to overdose which can be fatal.

What Is Narcissistic Personality Disorder?

Narcissistic personality disorder is a mental disorder. People with this disorder feel a great sense of importance, and deeply need the admiration and compliments of others, yet lack empathy and understanding of others’ needs and feelings. However, these characteristics hide the person’s true feelings: fragile self-esteem and intense vulnerability to the criticism of others.

According to Mayo Clinic, “a narcissistic personality disorder causes problems in many areas of life, such as relationships, work, school or financial affairs.” This disorder can cause a person unhappiness when things don’t go as the person believes they should. In general, a person with this disorder measures happiness by the amount of favorable admiration he or she gets, the praise he or she receives. This can make it hard for others to be around or want to be around the person.

What Are The Symptoms Of Narcissistic Personality Disorder?

Because it is a personality disorder, narcissistic personality disorder causes a person to act in ways that may be unacceptable or adverse in many social settings. Some of the common personality characteristics include:

  • Seeming conceited
  • Seeming to brag often
  • Seeming to have an air of importance (being pretentious)
  • Tendency to dominate conversations
  • Tendency to intimidate or judge others, especially those the person believes are inferior to him or her
  • Strong sense of entitlement
  • Easily angered or frustrated when situations don’t turn out the way the person expected
  • Tendency to acquire things the person believes are top-rate: material “best” of things like cars, homes, etc.

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The other side of narcissistic personality disorder are feelings that many people close to the person may not see. These can include secret feelings of disappointment, humiliation, insecurity, shame, and vulnerability. In response to these feelings, people may act out in a rage—try to belittle the person who they believe made them feel this way. In contrast, this disorder can make a person depressed. Feeling superior to others can make the person feel he or she falls short of perfection at times, and this presents great disappointment and shame.

How Does Addiction Affect Narcissistic Personality Disorder?

Feelings of depression or shame may cause a person to seek ways to cope. This can lead to addiction when a person chooses to cope by seeking substances, such as alcohol or drugs, to quell the pain. But developing a dual diagnosis, or two disorders at once, can be detrimental to a person’s health. Research shows that the symptoms of mental illness may be worsened by drugs and alcohol, according to the National Alliance on Mental Illness (NAMI). Conversely, abusing drugs or alcohol can lead to development of mental illness due to the effects of substances on a person’s behavior, brain chemistry, mood, and thoughts. In other words, mental illness and addiction can each greatly affect the other. Before this happens, seeking treatment at an established rehab center may be the best course of action, and we at can help with that.

What Characterizes Addiction?

The American Society of Addiction Medicine (ASAM) defines addiction as, “a primary, chronic disease of brain reward, motivation, memory and related circuitry.” When use of substances turns into abuse, a person may develop addiction due to the changes in the brain’s messaging system. Once these changes occur, a person may be ruled by the addiction. Common addiction characteristics may become apparent, including:

  • A “need” to use the drug regularly, whether daily or several times per day
  • Experiencing extreme urges to use the drug
  • Maintaining a steady supply of the substance
  • Seeing a drop in performance at work or school related to substance use
  • Pulling back from social activities or personal interests and hobbies due to drug use
  • Obtaining the drug through risky means, especially if the person would not normally behave that way
  • Devoting increasing amounts of time and effort to obtaining and abusing the drug
  • Inability to stop using the drug, even if the person really wants to
  • Developing a tolerance to the effects of the substance, and needing more frequent or higher doses to achieve desired effects
  • Having withdrawal symptoms when not taking the drug, or when effects begin to wear off

Who Is Affected By Addiction?

Nearly half of all people with a severe mental illness also struggle with addiction to one substance or another. The National Institute on Drug Abuse (NIDA) reports that the 2013 National Survey on Drug Use and Health found that approximately 24.6 million Americans age 12 and above reported drug use for the past month. The connection between mental illness and addiction means that more people run the risk every day of developing a mental disorder due to the effects of substance abuse or addiction due to the hardships experienced with mental illness. Before this happens, getting a person with one or both of these issues into treatment could help save his or her life.

How Do You Treat A Dual Diagnosis?

NAMI states that “the most common method of treatment for dual diagnosis today is integrated intervention, where a person receives care for both a specific mental illness and substance abuse.” Integrated treatment services, such as those offered through rehab centers, help target the symptoms of a dual diagnosis and treat a person for both disorders. In fact, many rehab centers now focus on these treatment services. Rehab facilities may utilize a combination of methods to help a person recover: medication, counseling, behavioral therapy, alternative therapy, holistic therapy, gender-specific therapy and more. Comprehensive care is key to recovery success.

Where To Find Treatment Help

Inpatient treatment services make a world of difference for a recovering individual. A person struggling with addiction may feel isolated, ashamed, or unable to admit to his or her addiction. People with mental illness may experience similar feelings. Both disorders can cause a person to withdraw, and this can make self-treatment difficult. In a treatment center, recovering individuals are surrounded by supportive staff and peers who are going through similar feelings and circumstances. The community strength provided by a rehab center, free from the triggers of substance abuse and stress on mental illness, can aid in helping individuals make strides toward recovery.

How To Find Treatment Resources

Many struggle alone daily with addiction, mental illness, or both. If someone close to you is suffering, don’t wait until they succumb to their disorder. Speak to one of our experts today, and get help for your loved one. Contact us today at to learn more about our rehab centers, dual diagnosis, and the inpatient treatment difference.

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