Narcissist-Induced Anxiety: Seven Signs You May Have PNSD

Updated March 26, 2024by Regain Editorial Team

At some time or another, all of us present with narcissistic tendencies. Maybe we’re feeling untouchable after a coveted job promotion or we need a little extra attention from loved ones. The thing is, these healthy amounts of narcissism are reasonable.

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Is living with PNSD making you develop unhealthy habits?

It’s when narcissism becomes narcissistic personality disorder (NPD) that problems arise. A narcissistic person has high self-esteem and an inflated sense of their own importance. As a result, they have a deep need to be superior to those around them. Understanding narcissism, especially narcissistic rage, is essential for developing and maintaining relationships.

Most narcissists have an excessive need to prioritize themselves. Signs you’re dealing with someone who has narcissistic personality disorder include:

  • They have an over-the-top sense of self-importance
  • They’re often preoccupied with fantasies about power, beauty, love, or wealth
  • Their belief in their own specialness goes beyond what is considered normal
  • They showcase a need for constant admiration
  • They feel entitled to special treatment
  • They’re often willing to exploit others
  • They present with a lack of empathy and general disregard for others
  • They resort to name calling
  • They voice extreme envy of others or a belief that others are envious of them
  • They frequently engage in arrogant behavior or speech patterns

Only around 6% of the US population has a narcissistic personality disorder. Still, even one narcissist can permanently change the way you or your loved one moves throughout life. For example, living with a narcissistic partner or parent may lead one to develop post-narcissist stress disorder.

Are you or your loved one recovering from living with someone who has a narcissistic personality disorder? It can be helpful to learn about post-narcissist stress disorder (PNSD), how it could affect your lifestyle, how to develop healthy habits, and how therapy can help you recover.

What is post-narcissist stress disorder?

Post-narcissist stress disorder is another name for narcissist abuse syndrome. Individuals develop this condition after undergoing long periods of narcissistic abuse at the hands of a parent, sibling, guardian, or spouse with a narcissistic personality disorder.

  • Narcissistic abuse is a non-physical, typically emotional form of verbal manipulation
  • Many narcissists want to control their victims and use specific language to achieve their goals. For example, they may:
    • Question their victim’s sanity
    • Promote mistrust of the victim’s family (particularly, their parents in a romantic relationship)
    • Make the victim feel alienated and that only the narcissist cares for them
    • Exacerbate overwhelming feelings of abandonment, worthlessness, laziness, etc.
    • Cause the victim to doubt what they want or their ability to make decisions

All of this is to gradually convince their victim to obsess on their own faults or mistakes. The abuser encourages you to look away from the abuse, give in to the narcissist’s will, and, ultimately, idealize the narcissist.

The end goal of narcissistic abuse is to cause the victim of a narcissist to believe, think, and feel the way the narcissist wants them to. Because narcissistic abuse doesn’t feature insults, threats, or shaming, it can creep up insidiously.

A person with NPD victimizes a person over a long time, especially since they’re typically a spouse or a victim's parent. A narcissist victim may experience a condition called narcissistic abuse syndrome or post-narcissist stress disorder (PNSD).

Seven signs you may have post-narcissist stress disorder

As their monikers suggest, PTSD and PNSD have much in common. In fact, some suggest that PNSD is a type of complex PTSD (CPTSD). Since PNSD and PTSD are often mistaken for one another, it should be no wonder the two conditions many of the same symptoms.

Here are seven symptoms of post-narcissist stress disorder one may experience when dealing with narcissistic abuse syndrome:

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1. Intrusive thoughts, memories, flashbacks, or nightmares

A person with PNSD may experience sudden thoughts or memories of their abuse. Flashbacks and nightmares are also frequent in people who endured more severe forms of narcissistic abuse like gaslighting.

The content of PNSD intrusive memories and thoughts, flashbacks, and nightmares are different from those of PTSD. With PTSD, people have dreams and memories of the traumatic event. Meanwhile, PNSD intrusive thoughts and flashbacks usually consist of images or memories of the narcissistic abuse or abuser.

2. Physical-emotional reactions to reminders of the abuser

While PTSD more commonly brings about physical reactions to the trauma triggers, PNSD typically features emotional reactions. Narcissistic abuse syndrome triggers also differ from PTSD triggers. People living with PTSD more commonly react to reminders of their abusers in general rather than a specific traumatic event.

3. Avoiding thoughts, people, or situations associated with the abuser

Experiencing negative emotional or physical reactions to reminders of their narcissistic abuser may lead to avoidant behaviors. Victims of narcissistic abuse may avoid places or situations that remind them of the abuser. If the narcissistic abuse took place in the home, they might have trouble being around family, even if the narcissist is no longer present.

These avoidant behaviors can take a toll on relationships and the everyday tasks in life. Like PTSD, dealing with your emotional and/or physical reaction to these triggers is essential for the healing process. That’s where therapy can come in.

4. Negative thoughts about self and others

Narcissistic abusers know that if you feel confident, assertive, and love yourself, their manipulations may not work as well. That’s why they work hard to plant doubts about your worth and the worth of others into your mind.

As with PTSD, these negative self- and other-related thoughts may persist after you’ve escaped the abuser. For this reason, many individuals with both PTSD and PNSD report self-isolating to avoid negativity.

5. Distorted sense of blame

When victims are constantly forced to make excuses for their abuser’s behavior, they begin to develop a distorted sense of blame. The abuser may convince their victim that they are not to blame for their actions. Instead, their outbursts are somehow your fault.

This is called blame-shifting, and it’s a way for narcissistic abusers to avoid taking responsibility for their behavior. Victims who have self-doubt are chronically exposed to blame-shifting develop a distorted sense of who’s at fault, often to the point that the victim doesn’t recognize when others are failing to take responsibility, too.

6. Sense of detachment and isolation

Constant gaslighting can force a person to doubt their reality. The continuous tendency to self-blame for the narcissist’s behavior can take a toll on close relationships. Even after the narcissistic emotional abuse is over, negative emotions may make victims feel uncomfortable going out into the world. Panic attacks and anxiety disorders can hold them back from living their best life. Victims may question their every move and decision, making staying at home and away from potentially manipulative people seem much more appealing.

7. Difficulty sleeping and hyper-vigilance

As we’ve mentioned, people with PTSD and PNSD often experience disturbing and intrusive dreams. This challenge can lead to trouble sleeping. With insomnia comes other physical and mental health issues, such as weight gain, irritability, and difficulty concentrating.

Living with PNSD may also influence your perception of the people around you. Many people who’ve been victimized by narcissistic abuse report feeling hyper-vigilant for manipulative qualities in others.

Because of the distorted reality they also experience, people with PNSD may blow situations out of proportion, as they perceive people around them to be a threat. This is also common to people with PTSD, if not more severe. Like people with PTSD, those diagnosed with PNSD may have suicidal thoughts.

If you are thinking about suicide or if you are thinking about harming yourself, you can call the 988 Suicide and Crisis Lifeline 24/7 or visit

How is PNSD diagnosed and treated?

Since the DSM doesn’t recognize PNSD as a mental illness, there are no formal tools to diagnose it. For that reason, people in a relationship with a narcissist who has suffered narcissistic abuse are often misdiagnosed with post-traumatic stress disorder.

However, some evidence shows that the same post-traumatic stress disorder treatments can be beneficial for individuals with PNSD. Primarily, that means getting back to the root cause of your symptoms—narcissistic abuse.

Individuals in recovery from narcissistic abuse may benefit from therapy—specifically cognitive therapy and eye movement desensitization and reprocessing (EMDR) therapy.

Cognitive therapy is a type of talk therapy that focuses on your thoughts. Cognitive therapists help you identify negative beliefs about yourself and other harmful thoughts. Then, you learn how to restructure those thoughts more helpfully.

EMDR is a therapy technique that shows great promise for treating people with post-traumatic stress disorder and PNSD. Using guided eye movements and verbal conversation about the traumatic event(s), your brain can learn how to reprocess the memories and change how you react to them.

If you suffer from flashbacks or nightmares about the abuse, you may also benefit from exposure therapy. This technique teaches narcissistic abuse victims to face memories that scare them. That way, you can learn healthy ways to cope with those frightening memories.

In some cases, therapy may not be enough alone. Antidepressants and anti-anxiety medications may help alleviate some of the more severe symptoms of post-narcissist stress disorder. If you have insomnia due to night terrors, sleeping medications or nightmare suppressants like Prazosin are promising.

The bottom line on treating PNSD is that you don’t have to suffer in silence. Find a traditional therapist near you or an online therapist like the professionals at Regain to start enjoying your life again finally.


If you or your loved one is suffering from post-narcissist stress disorder, find comfort in knowing that you aren’t alone. Narcissistic abuse can occur to anyone, especially since a narcissist—even one with an exaggerated sense of self-worth—can be extremely hard to spot.

Getty/Vadym Pastukh
Is living with PNSD making you develop unhealthy habits?

Also, take comfort in the fact that you don’t have to live with PNSD forever. If you are in a toxic relationship with a narcissist or are considering leaving a narcissist, consider speaking with a therapist. Working with an online mental health professional can help you or your loved one find support through narcissistic abuse syndrome. Get started with Regain today to find an accredited therapist who can help you overcome prolonged living symptoms with a narcissist abuser.

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