Could you really confuse someone suffering from post-traumatic stress disorder, also known as PTSD, with the individual suffering from unhealthy levels of narcissism? Yes, I think it is possible. It would also be a tragedy if that happened. Let me explain more.

We know that many of the Vietnam War veterans developed problems with alcoholism or drug addiction. This probably happened because they were trying to deal with the symptoms of PTSD. Because we didn’t know about PTSD at the time, and we didn’t have treatments for it, veterans had to deal with PTSD symptoms on their own. And indeed, to deal with painful memories and flashbacks, for example, many turned to alcohol and drugs to self-medicate. Then, over time, they became alcoholics and drug addicts.

Some of these same veterans who developed PTSD committed emotional abuse and verbal abuse, using it against their wives and children. While this certainly wasn’t a good thing, again, it wasn’t surprising given her PTSD. Many with PTSD experience irritation or anger, often also at the slightest provocation.

If you’ve been reading about the harmful levels of narcissism, never mind the even more extreme version of unhealthy narcissism exhibited in Narcissistic Personality Disorder, or NPD, you may think these problematic behaviors sound familiar. That’s because many times, in the narcissist, we see addictions like alcoholism, drug addiction, and sexual addiction. Narcissists also have a propensity to commit emotional abuse, verbal abuse, and perhaps other forms of abuse, such as sexual abuse. So if you didn’t know someone was a war veteran, but you observed addictions and abusive ways in the individual, you might suspect that the person was a narcissist.

You may also suspect it for other reasons. The war veteran might be inclined to ignore the family; he or she may withdraw and not want to participate in important events that are significant to others. And, because the war veteran may seem reluctant to take on certain responsibilities, he may seem like he doesn’t care about others or that he is self-centered. Again though, these responses are likely not coming from narcissism, but could just as easily be symptoms of PTSD. Remember, those who suffer from unhealthy narcissism, and certainly those who are diagnosable with Narcissistic Personality Disorder, all display a certain number of common characteristics or traits. But what truly distinguishes Narcissistic Personality Disorder from other personality disorders is the characteristic of grandiosity.

I suspect you won’t find most war veterans to be great. In fact, most probably don’t want to talk about what they did and the horrible things they found. And again, they may like to isolate themselves. If they choose to be with others, they will probably want to be around those who are veterans like themselves. After all, they want to be with people who can understand what they went through, plus the resulting emotionally painful aftermath.

But now, let’s go back and discuss why it’s so important that we not confuse veterans who suffer from PTSD with those who suffer from narcissism. It is important because today, PTSD can be treated in many cases, but it must be detected early and not later. Also, because it tends to affect younger warriors more than older ones, and people in their teens and early twenties may be more likely to deny they have problems, it can be vital for others to recognize what might be happening. As a spouse, another family member, friend, or concerned member of the community, you may need to quietly step in and encourage this person to seek help.

We don’t need to repeat what happened to so many veterans and their families after the Vietnam War. There is hope this time, but there may also only be a small window of opportunity to make a real difference. Make sure the veteran with PTSD doesn’t miss out.