I think Anthony was born with the ability to be honest with himself and others (unlike Opie or Jim, who are both bullshitters, born and bred). That's the impression I get from him from the stories he told about his childhood. When he was a little boy, he was self-loathing, riddled with anxiety, and narcissistic. That's not healthy, but at least he seemed to be honest about his own limitations. I mean, you can't be self-loathing and clueless about yourself at the same time.
Now obviously, post-2014 Anthony is a bullshitter, perhaps even worse than Opie (although he can never reach the level of Jim "Fake Alcoholic" Norton). So what happened?
Well, people change. And he's a life-long binge drinker. That alters your brain chemistry.
If Anthony has an inner child, it must be telling him, "you're a fraud. Just retire already. And for God's sake, man, cut that useless retard Joe out of your life."
But the beer-pickled higher brain is telling him that the subreddit is "libtards" and "haters" and that displaying mindless loyalty to his brother and sister will somehow be his salvation.
So tl;dr: if he were sober, he would have done the right thing and retired in 2014, or at least would not have declared war on his own fans. But because his neurons have been partially dissolved by ethanol, he lost his self-awareness. He's literally delusional. But there must be a small part of his psyche that is screaming at him that he's behaving like an asshole, and I'm sure that's a never-wracking experience.