What Is Post-narcissist Stress Disorder (PNSD)? Causes, Symptoms, And Treatments

Medically reviewed by Julie Dodson
Updated February 19, 2024by BetterHelp Editorial Team

Post-narcissist stress disorder (PNSD) is a specific form of post-traumatic stress disorder (PTSD) that may occur after a person has been in a relationship with someone who has narcissistic personality disorder. PTSD refers to an anxiety disorder that can develop after a person has experienced or witnessed a traumatic event. The disorder may involve intrusive thoughts about the trauma, nightmares, and increased anxiety surrounding anything that's reminiscent of the trauma. 

We will explore what narcissism is, how interacting with someone who has narcissistic personality disorder may lead to PNSD, and tips for healing from PNSD.

Understanding narcissism

People who have narcissistic personality disorder (NPD) have an inflated sense of their own importance, an excessive need for admiration or attention, and a lack of empathy for others. Some even experience narcissistic rage

People who have close relationships with someone with narcissists may develop post-narcissist stress disorder (PNSD).

Common traits of narcissism include:

  • Exhibiting an exaggerated sense of self-importance

  • Feeling superior to most others

  • Wanting to only associate with other people considered superior

  • Requiring excessive or constant admiration

  • Fantasizing about power, beauty, success, or brilliance

  • Acting in an arrogant or haughty manner

  • Wanting to always be the center of attention 

  • Taking advantage of or manipulating others for self-gain

  • Being unable or unwilling to recognize the needs and feelings of others

  • Being envious of others or believing that others envy them

Toxic relationships can take a toll

Effects of being in a relationship with someone who has narcissistic personality disorder

Whether it's a romantic or platonic relationship, being connected with someone who has narcissistic personality disorder can take an emotional toll. Their constant need for attention often leaves the people around them drained due to the expectation that if they must focus on the person with the disorder rather than take care of themselves. This lack of self-care coupled with the emotional strain of the relationship may cause one to feel overwhelmed or bewildered.

What causes post-narcissist stress disorder?

People with narcissistic personality disorder have a tendency to manipulate people in their lives for personal gain. This manipulation may include lying or gaslighting, which involves causing a person to question their sanity. For that reason, being in a romantic relationship or otherwise connected to a person with the disorder may prompt emotional trauma, leading to effects sometimes called post-narcissist stress disorder (PNSD)

A relationship with a narcissist can cause feelings of fear, distrust, heightened emotional responses, or self-doubt, as a person questions their perceptions of reality. After a relationship ends, symptoms of post-narcissist stress disorder may even be triggered by simple things such as a song on the radio, the smell of familiar cologne, or a nightmare about past events.

Are you in a relationship with someone with narcissistic personality disorder?

Being able to identify if you are in a relationship with someone who has narcissistic personality disorder could be the first step in addressing the issue and seeking help to prevent potential harm.

Signs that someone with whom you interact may have narcissistic personality disorder:

  1. They have an “all-about-me” attitude. They may seem to have an uncanny way of taking a conversation and turning it around to focus on them. When they don't receive the attention they crave, they may become resentful or act irrationally.

  2. They ooze with charm in the beginning. At the start of a relationship with someone who has narcissistic personality disorder, a person may believe they've met their new best friend or the love of their life. A person with NPD may shower those they meet with flattery and affection. This is a manipulation tactic that many such persons later use for their own personal gain.

  3. They lack boundaries. People with narcissistic personality disorder may show little concern for or even deliberately disregard boundaries those in their life try to establish. This tendency may mean they break promises or fall short of meeting obligations. They may borrow money and never repay it, for example, and show little or no remorse for their actions.

  4. They believe they are superior to others. People with narcissistic personality disorder may experience delusions of grandeur, which means they may overestimate their own importance or ability. They may believe themselves to be immensely powerful or popular, for example, even if this isn't objectively true.

  5. You feel alone or isolated in the relationship. Sometimes, people with narcissistic personality disorder become manipulative or abusive. This can involve trying to separate people with whom they're close from others, in order to make it easier to influence or control them. For example, they may try to put a wedge between you and your friends or family. Or, they may even try to influence or dictate places you go or how you spend your time.

  6. They react negatively to even constructive criticism or minor pieces of advice. People with this disorder generally cannot handle being criticized, and perceiving criticism may prompt an extreme emotional reaction.


People with narcissistic personality disorder generally do not see their behavior as inappropriate and may find it hard to believe that they have any kind of problem. For this reason, they may go undiagnosed or refuse to receive treatment. They may also view people's attempts to help them or suggestions to undergo therapy as personal attacks.

Tips for helping someone who has post-narcissist stress disorder

After a relationship with someone who has narcissistic personality disorder has ended, a person with PNSD may experience helplessness, rage, anxiety, or depression. There are ways you can help a person with PNSD.

  • Listen without judgment: Keep in mind they may have been criticized or treated as inferior in the relationship, so the last thing they need is further judgment. Instead, give them the chance to speak and listen to them without saying your opinion, even if you struggle to understand why they didn't stick up for themselves better or leave the relationship earlier.

  • Validate their feelings: They may feel sad, angry, or bitter. The relationship was likely emotionally taxing, and they may have to relearn healthy ways to express their emotions. Validate that their emotions make sense given the situation, rather than suggesting they are overreacting or need to quickly move on.

  • Provide unconditional love and support: If they are isolated from their loved ones, they may need to build a brand new support system. Make clear that you're available to provide support as they heal.

Living with post-narcissist stress disorder

Post-narcissist stress disorder can cause overwhelming feelings of stress and fear. There are ways to cope during this period, however. If you think you have PNSD, try these strategies for healing:

  • Get enough sleep: Lack of sleep may increase anxiety and worsen PNSD symptoms. Plan for at least eight hours of sleep each night. This will give your body and your mind time to recuperate and begin anew the next day.

  • Practice healthy habits: Regular movement, whether that's taking a walk or sweating in the gym, can improve overall physical and mental health. Similarly, relaxation techniques, like meditation, deep breathing, and journaling, can help activate your body’s natural relaxation response. Try to avoid alcohol and drugs and, instead, focus on eating a healthy diet.

  • Seek professional help: If you believe you might have post-narcissist stress disorder, you may want to make an appointment to see your doctor or a mental health professional. Therapy, medication, or both may help you move through this difficult time more easily. 

Toxic relationships can take a toll

Seeking help for post-narcissist stress disorder

If you're seeking help for post-narcissist stress disorder (PNSD), you may want to consider online therapy. Online mental health service providers, such as BetterHelp, give individuals an opportunity to connect with licensed, professional counselors from wherever is most convenient for you. Online therapy also allows people to avoid potential anxiety about having to travel to or be seen entering a therapist's office.

Post-narcissist stress disorder is likely to be treated similarly to PTSD, a disorder often treated using cognitive behavioral therapy (CBT). CBT is a form of therapy that helps people change their thought patterns and behaviors in ways that may improve their anxiety and depressive symptoms. An overview of 38 different research studies found that online CBT is just as effective as face-to-face CBT when treating anxiety disorders including PTSD.

Many are already using BetterHelp for similar issues. Here are some of their recent reviews about their BetterHelp counselors:

“He is very clear in what he says; he openly calls things by their name and gives real help. He listens, gives advice, and provides reassurance where needed. It often is difficult to deal with a narcissistic person, and to have a therapist that openly acknowledges narcissistic patterns is a great help. I appreciate his openness very much.” 

“In my very first session with DeWanda I was very relieved and impressed with how she made me feel safe. Her spiritual insight was very important to me, as well as her knowledge of dealing with a narcissist. This has been a very stressful and unexpected revelation and her professional compassion came through loud and clear. I am looking forward to her guidance on my healing journey!!” 


Although traumatic, the experience you had with a person with narcissistic personality disorder does not have to control your life. Even on days when stress levels are increased or you feel overwhelmed, it is possible to achieve a sense of control and learn to cope with post-narcissist stress disorder. If you need help managing the symptoms of this disorder, reach out to a qualified BetterHelp therapist today.

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