An individual wearing a grey hoodie is experiencing narcissistic abuse. He sits alone on the floor with his back to the wall, looking stressed out and distraught.

The Long-Term Effects of Narcissistic Abuse

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Here are some ways to recognize the signs and symptoms of narcissistic abuse.

Clinically Reviewed By:
Don Gasparini Ph.D., M.A., CASAC
February 18, 2023
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Narcissistic abuse can alter the way a person feels, thinks, or behaves. This type of emotional abuse is often called narcissistic abuse syndrome or narcissistic victim syndrome. 

While everyone can have occasional narcissistic behavior, it is important to know that narcissism is part of a larger narcissistic personality disorder and not a trait. People with narcissistic personality disorder have an unreasonably high sense of their importance. They seek attention and want others to admire them. 

Yet, behind a mask of confidence, people with true narcissistic personality disorder are unsure of their self-worth and are easily upset by criticism. In the early stages of a relationship, your partner may have perfect manners, but in time you experience manipulative, dominating, and exploitative behavior.

What are some examples of narcissistic abuse?

Abuse can take on many forms and examples of this mental illness can include psychological emotional, financial, and sexual abuse in a range of severity. Keep in mind that the abuse may not be easily detected since people with narcissistic personality disorder are experts at manipulation and control. These are some examples of narcissist abuse:

1. Gaslighting

The term originated from the movie 'Gaslight,' during which a husband intentionally convinced his wife she imagined things. This psychological abuse is intended to make you question your memory, sanity, or reality. 

2. Manipulating feelings

A narcissist may try to distort your reality if they feel threatened. For example, they may try to convince you that your best friend is not who you think they are, or that you deserve a better friend.

3. Emotional blackmail

A narcissist uses power and control to boost their ego. If their ego is threatened, they use extreme methods to restore balance. Emotional blackmail is a type of manipulation used to control your behavior using threats or punishments. The threat can be against something you hold dear, your reputation, or themselves (as in, "If you leave me, I am going to hurt myself.") This makes you feel you must comply to avoid a tragedy.

4. Overwhelming affection

This is also called love bombing and is a process of overwhelming you with affection, gifts, or praise. It can be used to bring you back to the relationship after a particularly difficult fight. But the actions are more about meeting the narcissist's needs than the partner's.

5. Deny or trivialize

These are common narcissism tools. They may deny a specific event happened or trivialize or belittle your emotions associated with the event. For example, you may hear that you're overreacting or being too sensitive. 

6. Never-ending contact

Ending a relationship with a narcissist can be challenging. They may re-enter your life for weeks or months trying to pull you back into an emotionally abusive relationship. For example, you may get the "Oops! I didn't mean to call/text/friend you!" The idea is to get you talking with them again. 

What are the symptoms of narcissistic abuse? 

It may be easier to recognize the symptoms of narcissist abuse syndrome in someone other than yourself. Narcissistic partners are experts at manipulating your thoughts, emotions, and behavior. Even children’s mental health suffers at the hands of a narcissistic parent. 

Insight and help from loved ones can reveal some of the following symptoms that indicate you may be a narcissistic abuse victim.

  • You feel lonely and isolated from friends and family.
  • You have a sense of mistrust for everyone.
  • You have trouble making decisions at home, at work, and for the family.
  • You are unable to confront your narcissistic partner or leave them.
  • You always feel like you’ve done something wrong.
  • You lose your self-identity or sense of self and identify with your narcissistic abusive partner.
  • You have symptoms of anxiety or depression or unexplained physical symptoms.

Physical symptoms can include appetite changes, trouble sleeping, fatigue, and stomach problems. The manipulation and abuse are often so subtle, that observers fail to recognize the behavior as abuse.


You may feel confused or even guilty, but do not fully understand what is happening. Unfortunately, friends and family don't always believe a victim of narcissistic abuse, and you may doubt yourself. They may even question your perception of events and assure you that you misunderstood, which feeds the efforts of the narcissist.

How to recognize the signs of narcissistic abuse

Long-term abuse and demeaning behavior can lead a person to believe they deserve the emotional abuse. In a relationship with a narcissist, it's common to feel drained - mentally, physically, and emotionally. 

They may not notice the pain they're causing, they just want their immediate goal met. When that happens, the abusive behaviors may disappear, only to reappear when they want something new. These are some of the signs of narcissistic abuse. 

Controlling behavior

This behavior continues to escalate over time as the narcissist demands more time and attention. Control is equivalent to power for a narcissist.

Social isolation

Narcissistic abusers isolate their partners, removing the person's support system, and making it easier to perpetuate the abuse. The narcissist becomes the sole source of validation, support, and affection. 


With increasing social isolation, the victim may mistrust others. This is compounded by the narcissist's lies and manipulation so the victim relies solely on their abuser for the "truth."

Verbal abuse

Insults, put-downs, and verbal snipes meant to demean the victim.

Disregarding boundaries

Victims of abuse aren’t allowed to make their own decisions or be physically separated from their abuser. This includes the invasion of digital privacy.


Victims feel like they are walking on eggshells, suffering from hypervigilance, and racing thoughts. To satisfy an abusive partner, victims constantly anticipate how the abuser will act.

Excuses for bad behavior

Victims make excuses or cover up the abusers' bad behavior. They may believe the excuse or it’s a self-preservation mechanism. 

5 ways narcissistic abuse affects your body and mind 

When you're in a toxic relationship with a narcissist, it can trigger mind and body trauma, including low self-esteem, panic attacks, and mental illnesses like anxiety and depression. The behaviors of a narcissistic parent are considered child abuse. Here are five more identifiable ways that narcissistic abuse affects your mind and body.

1. Chronic fatigue

This is one of the most common ways narcissistic abuse affects your health. Think of the abuser as an energy vampire who sucks the life out of you. Victims of narcissistic abuse syndrome have trouble sleeping and lack the motivation and energy to do anything.

2. Chronic stress

This is another common way victims experience physical symptoms of abuse. The demands and pressure of the abuser increase stress levels, which triggers stress-related physical problems such as high blood pressure, fatigue, digestive problems, and headaches. 

3. Loss of self-worth

Narcissistic abuse is a form of brainwashing. The victim no longer feels like the person they were before the abuse began, and they do not recognize themselves. Victims may experience trust issues, self-doubt, shame, and embarrassment.

4. Brain damage

Repeated emotional trauma can shrink areas of the brain responsible for memory and learning and grow areas responsible for fear, guilt, and shame. These changes can lead to cognitive problems, such as concentrating on tasks and memory loss. It is also common for victims to experience emotional lability, or mood swings, that are accompanied by irritability.

5. Self-destructive behavior

Victims may feel as if they need to punish themselves or use self-destructive behaviors to create a short-term escape from the situation. These behaviors can include substance use, overeating, overspending, or consuming large amounts of alcohol.

What happens when you respond to narcissistic abuse?

Narcissistic personality disorder is a clinical diagnosis that's characterized by the need for admiration and a lack of empathy for others. When individuals who have narcissistic personality disorder are confronted or held accountable for their actions, they often get angry, which is related to a narcissistic injury that occurred to the individual at an earlier time in their life. 

Two individuals sit on a bed together. One of them looks relaxed and is reading a book. The other looks distraught and stress.

Because narcissists outwardly appear entitled, it's sometimes difficult to see that they carry shame and poor self-esteem. When confronted with their behavior, the natural inclination is to blame someone else, deny they did something wrong, or get angry. This can lead to domestic violence and physical abuse.

When you confront a narcissist, they can't reflect on the actions or mistakes they made because it brings them to an understanding of their trauma or narcissistic injury. The natural reflex is to blame the person and refuse to acknowledge that there is anything wrong with them. 

For nearly the same reason, narcissists are judgmental. What they see in themselves, they also see in other people. While they cannot acknowledge their own mistakes, they can point out what is wrong with another, which gives them a sense of superiority.

What signs does a person show when they are emotionally abused by a narcissist?

Victims of narcissist abuse syndrome may display signs of emotional abuse, physical abuse, psychological abuse, verbal abuse, and domestic abuse. Victims in abusive relationships experience emotional and sometimes physical damage.

Psychological violence can include sabotage, smear campaigns, stonewalling, and various forms of coercion and control. Chronic abuse can lead to symptoms of post-traumatic stress disorder (PTSD), especially in victims who experienced other traumas. The result of narcissistic abuse can also include a pervasive sense of shame, overwhelming feelings of helplessness, and emotional flashbacks.


When a victim is in the middle of a narcissistic abuse cycle it's difficult to identify or name the experience since narcissists are expert manipulators and can twist reality to suit their needs. Victims may experience dissociation, during which they feel emotionally or physically detached from the environment. This disrupts their perception of reality and memory.

Victims may put aside their own needs to please a narcissistic abuser. Chronic stress triggered by emotional and psychological abuse can create physical health issues such as premature aging, weight gain or loss, and a suppressed immune system. In addition to depression and anxiety that are associated with victims of narcissistic abuse syndrome, victims may also experience self-harming tendencies or suicidal ideation.

Signs and symptoms of narcissistic abuse syndrome

Narcissistic abuse syndrome can be fatal since the long-term effects of narcissistic victims syndrome can lead to potentially life-threatening abusive behavior. Depression and anxiety can increase the risk of suicide or increase the risk of substance use disorder.

Long-term abuse can change a victim's brain, resulting in cognitive decline and memory loss. In turn, the changes in the brain can increase the risk for chronic stress, PTSD, and symptoms of self-sabotage. Individuals who are in recovery after a relationship with a narcissistic partner describe feelings of confusion, procrastination, low self-esteem, fear of failure, and worthlessness.

A narcissistic abuser may use financial abuse to keep the victim trapped in the relationship. They can restrict access to money, take control of the victim's income, or resort to narcissistic manipulation and harassment.

How Charlie Health can help

If you think you're in a relationship with a narcissist and are experiencing symptoms of narcissistic abuse syndrome, Charlie Health may be able to help. We recognize that everyone's mental health journey is unique, depending on what they've experienced. We use a personalized outpatient program with a therapist who is matched to meet your needs.

Coping with narcissistic abuse is challenging and can trigger long-term emotional, mental, or physical health damage. However, recovery is possible so you can live a healthier life with better mental health. Charlie Health is here to help - let's get started today

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