Alcohol was a major influence in F. Scott Fitzgerald's life. During his wife's emotional turmoil, he consumed alcohol excessively. Although a heart attack was listed as his official cause of death, his lifestyle and alcohol dependency were significant factors in his untimely end. Similarly, alcohol dominates and ruins Dick Diver's existence. At first, Diver appears as a lighthearted socialite who often reaches for a drink but never overindulges. By the novel's conclusion, however, alcohol has played a part in the downfall of his marriage and career.

Dick Diver is not the sole character affected by alcohol. Nearly every character in the story partakes in varying levels of excess, and Abe North ultimately loses his life because of his drinking habits. In Tender Is the Night, Fitzgerald highlights the effects of alcohol on his characters and their professional lives.

Although only a handful of characters in Tender Is the Night can be considered artists, Fitzgerald portrays them with more admiration than the other characters. For instance, Albert McKisco first appears as an aspiring writer, but when Diver meets him again years later on a ship coming back from America, McKisco has become a successful author and a far more pleasant companion. At the clinic he runs with Dr. Gregorovius, Diver is profoundly moved by the passing of a woman painter—the only case he truly seemed to care about.

Following World War I, as Europe focused on reviving its economy, there was a significant effort to entice wealthy Americans to visit the continent. However, this affluence was accompanied by the stereotype of the "ugly American"—seen as loud, brazen, unsophisticated, and completely self-absorbed.

Fitzgerald, who spent a considerable portion of his adult life in Europe, observed the influence Americans had on European culture firsthand. His novel, Tender Is the Night, captures some of these influences. In their quest for American financial support to fuel emerging capitalist systems, Europeans were compelled to sacrifice much of their cultural legacy, losing a vital part of the identity that set them apart from America and the rest of the world.

Fitzgerald's story takes place in an upper-class environment, complete with servants, personal assistants, and the formalities that come with great wealth. Nicole Diver, born into privilege, receives a substantial allowance from her sister, who oversees their family's finances. As a result, she and Dick Diver are constantly surrounded by the luxury that wealth affords. Their high social status is never questioned, and their peers often engage in discussions about family heritage. For instance, Baby Diver questions Dick about his family background and financial situation before he marries Nicole, and when she helps Dick out of jail, she continuously reminds the police of their high social standing. Abe North, consumed by alcohol, falls into the lower classes where he meets his demise, and even Dick Diver, once overtaken by drinking, finds himself lost in the obscurity of small-town America, far from the elite circles of his European life.

Although Dick and Nicole Diver have two children, they are rarely mentioned unless there are marital or relationship problems. At the fair, after Dick is accused of bothering a patient, the children are left with a gypsy woman, and after a car crash, they are quickly taken to the inn. In one of the few instances where a character talks directly to a child, Rosemary asks Topsy if she wants to become an actress, which causes Nicole to leave angrily. It is only after deciding to separate from Nicole that Dick spends time with the children, but shortly after moving to upstate New York, he stops all communication...

Incest plays a crucial role in Tender Is the Night. Nicole's emotional and psychological breakdown originates from the incestuous relationship her father forced upon her. This traumatic event impacts every aspect of her and Dick's lives; nothing in Tender Is the Night remains untouched by Devereux Warren’s sexual abuse of his daughter.

The title of the film starring Rosemary Hoyt, Daddy’s Girl, is no accident. Likewise, it is intentional that both Rosemary and Nicole are attracted to the much older Dick Diver. In many ways, Dick acts as a father figure to these women, especially to Nicole, as much as he is a partner or lover. Fitzgerald intentionally weaves the theme of incest into his novel to create a profound effect.

When Dick Diver first meets Nicole, he is an ambitious and promising psychiatrist, deeply dedicated to his work and aiming to write a comprehensive book on psychiatry. However, as he becomes more entrenched in the profession, he starts to see psychiatry as a luxury only the wealthy can afford. In Book Two, Dick talks with Dr. Gregorovius about Gregorovius's youthful dream of creating “an up-to-date clinic for billionaires.” Fitzgerald portrays the field more as a business enterprise than a healing practice. One of the rare cases Dick truly cares about involves a female artist who doesn't fit the mold of a rich, pampered client. Her death profoundly affects him, making him contemplate leaving psychiatry altogether. After years in the field, he becomes so conflicted about his perspective on psychiatry that he struggles to even decide on a suitable title for his book.

Fitzgerald, drawing from his experiences with his wife Zelda and her severe mental health challenges, gained a profound insight into the field and its workings. Tender Is the Night provides a critical examination of the profession.

Beneath the façade of luxury and the seemingly ideal lives of affluent American expatriates, a significant undercurrent of violence is present. When Dick and Nicole escort Abe North to the train station, a woman unexpectedly shoots a man. Earlier in the narrative, Tommy Barban and Albert McKisco engage in a duel. In a drunken state, Dick attacks a bandleader, a taxi driver, and a detective, only to be violently restrained by the police. Abe North, associated with the death of Jules Peterson, is last mentioned in connection with his own violent death at a New York speakeasy. The novel is also deeply overshadowed by the violence Nicole endures at the hands of her father.

Although Tender Is the Night is set in the years between the two world wars, the enduring effects of World War I are evident throughout the story. At the clinic, Dr. Gregorovius notes that even though Diver did not participate directly in the war, he has not escaped its influence. Gregorovius points out to Dick, "some shell-shocks who merely hear an air raid from a distance. We have a few who merely read newspapers." Later, Dick has a dream filled with wartime imagery and wakes up thinking, "Non-combatant’s shellshock." While visiting the Somme battlefields with Abe North and Rosemary, Dick delivers a lengthy reflection on the war's destruction. He comments, "All my beautiful lovely safe world blew itself up here with a great gust of high explosive love." World War I had destroyed much of what Europe was celebrated for, along with countless lives. Fitzgerald explores this theme repeatedly in Tender Is the Night, perhaps connecting it to the underlying violence in his characters' lives.

In almost all of his major works, Fitzgerald often delves into the theme of wealth and its effects on people and society. In Fitzgerald’s fictional universe, nearly every character is wealthy or has access to the luxuries that come with immense riches. Set during the "Jazz Age," Tender Is the Night explores the lives and eventual downfalls of a select group of affluent Americans. Under Fitzgerald's examination, none of these wealthy characters are shown in a positive light. Baby Diver, who manages her family's fortune, is portrayed as manipulative and domineering; her father, a rich Chicago industrialist, devastates Nicole's life through sexual abuse. Although Dick Diver is not wealthy himself, once he fully immerses himself in Nicole's opulent world, he loses his own aspirations and slowly falls into alcoholism. According to Fitzgerald, wealth offers little more than the means for exciting but ultimately destructive adventures.