How Staying With a Narcissist Can Affect Your Physical Health?
When I first started digging into narcissistic relationships, I expected the usual emotional fallout—anxiety, self-doubt, the whole spiral. But what really got me was how often survivors report actual, measurable physical symptoms.
Chronic fatigue, autoimmune flare-ups, digestive issues—stuff that’s not just “in their head,” but written all over their bodies.
Here’s the kicker: even seasoned professionals often focus on the psychological damage, while the somatic impact flies under the radar. But when someone’s living in a state of constant hypervigilance—second-guessing every word, walking on eggshells—that’s a stress response on loop. And we know where that leads: HPA-axis dysregulation, cortisol spikes, immune suppression.
One woman I spoke to had been misdiagnosed with lupus for years—turned out, the trigger wasn’t medical.
It was her marriage.
So let’s talk about that silent toll.
Because it’s real.
And it’s messing with more bodies than we think.
Chronic Stress and Dysregulation of the Nervous System
If you’ve worked with trauma survivors, you already know the body keeps score (thanks, Dr. van der Kolk). But when we zoom in on narcissistic abuse specifically, the pattern of chronic stress looks a little different—and it’s sneakier.
It’s not a single traumatic event, it’s death by a thousand manipulations. And that constant state of emotional instability? It wrecks the nervous system in slow motion.
Here’s what I’ve found: survivors of narcissistic relationships often live in a near-permanent state of fight-or-flight. This isn’t just garden-variety stress. It’s the kind that chronically activates the HPA axis—the body’s core stress response system.
Every sarcastic jab, every subtle gaslight, every emotional withdrawal keeps the system on high alert.
Over time, this leads to cortisol dysregulation: either the body starts pumping out way too much of it, or the adrenal glands tap out completely. And once cortisol goes haywire, the dominoes start falling.
You see this show up in all sorts of ways:
- Disrupted sleep cycles (can’t fall asleep or waking up wired at 3am)
- Constant fatigue, even after rest
- Weakened immunity—think frequent colds or long recovery times
- Unexplained weight gain, especially around the midsection
- Heightened anxiety or panic attacks, even in “safe” environments
What’s wild is how often this stuff gets misattributed to overwork, aging, or “just life.” But when I started connecting the dots, it was clear: these bodies weren’t just tired—they were exhausted from surviving.
Now, here’s where it gets more interesting. A lot of trauma experts are digging into polyvagal theory, and it offers a super compelling lens for understanding this.
The theory, developed by Dr. Stephen Porges, explains how the vagus nerve plays a key role in regulating our stress response.
Survivors of narcissistic abuse often experience sympathetic dominance—that chronic fight-or-flight state I mentioned—but many also dip into dorsal vagal shutdown, where they go numb, dissociated, or just emotionally flat. The body’s trying to protect itself, but the cost is massive.
Think about it: someone might look calm on the outside, but inside they’re frozen, disconnected, and their system is functioning like they’re under siege.
And this nervous system dysregulation doesn’t stay in the head—it radiates through the whole body.
Here’s a real-world example that stuck with me. A man I interviewed had been in a narcissistic relationship for over a decade.
Toward the end, he started experiencing heart palpitations and unexplained chest pain. Multiple ER visits, full cardiac workup—nothing wrong. Doctors said it was anxiety.
He wasn’t convinced.
After leaving the relationship, those symptoms disappeared in under three months. What changed? His nervous system finally got the message it was safe.
What I find most striking is that these aren’t rare cases. This kind of systemic dysregulation is showing up everywhere—in therapy rooms, primary care clinics, even in chronic illness management. But unless we ask the right questions, especially about relational dynamics, we miss it.
So here’s the point: when someone is chronically exposed to narcissistic behavior—whether it’s overt control or subtle emotional sabotage—their body gets stuck in survival mode. And until that threat is removed or processed, no amount of yoga, vitamins, or sleep hygiene will fully reset the system. The body isn’t just tired—it’s been under siege.
And in my opinion?
That changes how we need to talk about health—and healing.
Common Physical Health Manifestations in Survivors
Alright, let’s dig into the real, lived side of this—how narcissistic abuse shows up in the body.
This part of the conversation doesn’t get enough air time, and when it does, it’s usually buried under “stress” as a catch-all. But stress from narcissistic abuse is not generic. It’s chronic, insidious, and relationally rooted, and it often leaves a trail of mysterious or misdiagnosed physical symptoms.
I’ve broken this down into four key systems where symptoms tend to show up. Obviously, these aren’t exhaustive, and no two survivors are the same—but you’ll probably recognize some repeating patterns.
A. Cardiovascular and Respiratory Issues
This was one of the first categories that really jumped out at me during my research. Survivors often report symptoms that mimic serious cardiovascular disease—but with no clinical explanation.
1. Hypertension:
Living in constant fear—never knowing when the next blow-up or silent treatment will land—keeps blood pressure elevated. Even when they’re “relaxed,” the nervous system is still on alert. Over time, that sustained tension can lead to chronic hypertension, a serious risk factor for stroke or heart disease.
2. Heart palpitations and arrhythmias:
This one’s wild. I’ve read accounts where people ended up in emergency rooms with chest pain and irregular heartbeats, only to be told everything looked normal. Spoiler alert: it wasn’t. It was their body reacting to the trauma of being constantly invalidated or walking on eggshells.
3. Shortness of breath:
This usually shows up during arguments or post-conflict. It’s not a panic attack per se—it’s more like the body momentarily forgets how to breathe. Survivors describe this as “like drowning in air.” I’ve even seen this paired with hyperventilation or coughing fits, especially in those with underlying asthma.
B. Gastrointestinal Disorders
This is a huge one. The gut-brain connection is well-documented, but it hits hard in narcissistic dynamics where the person has no sense of safety—not even in their own body.
1. IBS (Irritable Bowel Syndrome):
This shows up all the time. The constant cortisol flooding, paired with adrenaline, can throw gut motility totally off. The result? Chronic diarrhea, constipation, or both. What’s especially telling is that symptoms often flare before or after contact with the narcissist.
2. Acid reflux and ulcers:
Ever had that “pit in your stomach” feeling? Now imagine living with that feeling 24/7. That kind of acidic internal state can trigger GERD, ulcers, and stomach lining inflammation over time.
3. Disordered eating and appetite dysregulation:
Some survivors report binge-eating during or after interactions, while others lose their appetite completely. It’s not about food—it’s about nervous system overwhelm, where eating becomes either a coping mechanism or a forgotten task.
I spoke to a therapist who told me one of her clients lived on crackers and ginger ale for two years.
Why?
Her narcissistic partner had so thoroughly shamed her around eating and body image that her digestive system practically shut down. That’s not just emotional damage—it’s a gut health crisis.
C. Musculoskeletal and Neurological Symptoms
Let’s talk about pain—because narcissistic abuse hurts, literally.
1. Chronic pain syndromes:
Neck tension. Back pain. Jaw clenching. TMJ. It’s like the body is physically holding all the unsaid words, all the suppressed rage. Many survivors develop what looks like fibromyalgia, though the root is often tied to unresolved trauma.
2. Migraines and tension headaches:
Some survivors get migraines so severe they lose vision temporarily. Others have daily tension headaches that no medication touches. A lot of it ties back to nervous system overload, but also to overstimulation—think constantly scanning a room, anticipating mood shifts, bracing for conflict.
3. Numbness, tingling, or “electric” sensations:
This one’s lesser-known but fascinating. Survivors often describe weird neurological symptoms—numb hands, tingling limbs, burning skin sensations. These aren’t always measurable, but they’re very real to the person experiencing them. It’s the nervous system saying, “I can’t take anymore.”
One person described it like “my body was buzzing all the time, like I was plugged into an outlet.” That kind of somatic overload doesn’t happen overnight. It builds through years of subtle, cumulative trauma.
D. Immune and Inflammatory Conditions
Here’s where things get especially dicey. When the body is stuck in a trauma loop for years, it doesn’t just get tired—it turns on itself.
1. Autoimmune disease flare-ups:
This one gets tricky because correlation isn’t causation—but I’ve seen so many survivor accounts where autoimmune issues either began or worsened during narcissistic relationships. Think: Hashimoto’s, lupus, rheumatoid arthritis. The theory? Chronic inflammation from long-term stress dysregulates the immune system until it starts attacking the body.
2. Chronic inflammation:
Even without a formal autoimmune diagnosis, inflammation is a common thread. Survivors might experience persistent joint pain, brain fog, or skin conditions like eczema or psoriasis. Again, stress-induced. And often misdiagnosed or minimized.
3. Constant illness:
This one’s more anecdotal but compelling. Multiple survivors told me they were “always sick” during the relationship. Colds that wouldn’t go away. Stomach bugs every few weeks.
Constant sore throats. Once they left or distanced themselves from the narcissist, their immune systems seemed to rebound. One woman told me, “I haven’t been sick in three years since I left him. Not once. Isn’t that crazy?”
So, What Does This All Mean?
When survivors walk into a clinic or a therapist’s office with a laundry list of seemingly unrelated symptoms, we can’t just treat the list. We have to ask: What’s the context here?
Because sometimes, what looks like a thyroid issue or fibromyalgia or IBS is actually the body responding to emotional terrorism.
And I don’t say that lightly. Narcissistic abuse isn’t just emotional neglect—it’s psychological warfare. And the body keeps the score, even when there’s no physical blow.
So next time someone says, “I’ve seen every doctor and no one can find anything,” maybe the question shouldn’t be, “What’s wrong with you?” Maybe it should be: “Who’s still in your life that’s making you sick?”
